Health system in Senegal

Senegal has 14 medical regions and 78 health districts as of 31 December 2019.[1] Senegal’s health system operations are implemented at the district level. Each health district has at least one health centre – a secondary health facility with a medical team that provides direct care and oversees the district’s prevention efforts. Health centres are attached to the district’s health posts, staffed by a nurse or midwife, which generally serve as the first level of contact with the population.[2]

Health posts are responsible for a number of health huts, which have trained community health workers and the necessary structure and equipment for providing basic services that include the diagnosis and treatment of uncomplicated malaria. Since 2008, community case management of malaria can be provided by home care providers, who are lower-level community health workers who work from their own homes rather than in a specific health facility.[3]

Tertiary facilities include hospital centres that provide specialised care. These hospitals, which are found at the regional, departmental or communal level, typically provide care coverage for approximately 150,000 residents. There are also seven national hospital centres in Dakar.[3]  The health system has a network of regional pharmacies that supply the facilities and care providers of the corresponding regions. These regional pharmacies receive supplies from the national pharmacy. In addition to public sector facilities, there are also a number of private clinics and health posts throughout the country.[3]

The administration of the health sector is also structured along three levels: central (Ministry of Health and Social Affairs – MoHSA), intermediate (14 regions) and peripheral (78 health districts). The public health care system is complemented (particularly in Dakar, the capital city) by a growing private sector which is estimated to represent nearly 70% of the total provision of health services and which is increasingly involved in the CMU policy. [1,3]

The health sector has experienced a number of reforms in the past decade, notably so as to facilitate the decentralisation policy for which implementation is still lagging behind. [3]