297. The major constraints bedeviling the decline in maternal mortality as well as
infant and child mortality which the government of Senegal is striving to control
through its new policies are:
Difficulties in accessing care and drugs ;
Time spent in reaching a healthcare facility and the average fee paid
for consultation could also be a limiting factor for access to health care;
Interruptions in vaccine supplies in health centres and health posts ;
Very limited capacity for resource mobilization for the health sector ; and
Lack of awareness raising and communication among the various
stakeholders in the sector leading to unwarranted reduction and
inconsistency in the implementation of activities.
298. Moreover, significant gains have been made in access to drinking water
but poor results observed in access to sanitation:
If current trends are maintained, the objective of access to water for
100% of the urban population and 82% of the rural population could be
attained: this rate increased from 93% in 2006, to 98.79% in 2011 for the
urban population, and from 69.5% in 2006 to 80.1% in 2011 for the rural
population. Beyond the infrastructural gains, the major challenge at this
stage is the provision of regular supply of quality drinking water.
In the area of sanitation, a lot of efforts still need to be made to improve
access by the rural population to an improved system of sanitation. The
rate of access to sanitation in the urban centres rose from 62% in 2005 to
63.3% in 2011 while the rate moved from 26.2% in 2005 to 34.3% in 2011.
299. The high costs and low investments are visibly the root cause of inadequate
basic infrastructure especially in the rural communities. In addition to these, one
can mention the high cost of individual sanitation infrastructure, poor
households and inadequate resources for local governments. The upsurge of
floods in 2012 clearly showed lack of consistency in the management of housing
occupancy areas and drainage systems in the urban centres in general, and
waterways, in particular.
300. On housing and living conditions, it must be noted that as a result of the
rapid urbanization related to rural-urban drift, the dirty and insanitary parts of
most urban centres of Senegal account for 30 to 40% of occupied lands, and
these locations are home to a very huge percentage of the population.
301. The reckless occupation of land, building of « slums and shacks », the
problems of hygiene and public health caused by repeated floods, insecurity
relating to poor urbanization are a host of factors which have worsened the
vulnerability of the population and deepened the worsening living conditions in
the popular communities, such a situation substantially reduces the right of
Senegalese citizens to health.
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