AIDS3

The health sector :

Senegal has long emphasized prevention and primary health care as themost rational use of limited resources. Spending on health from public funds is aroundUS$ 1 per capita. This is supplemented by donor funds, but at least 40 percent of spending on health comes out of family budgets. Poor families in Senegal spend more on health than on anything else except for food.
Reproductive health and child health are well established priorities, and are reflected in health indicators. Infant mortality and under-5 mortality rates both dropped dramatically between 1970 and 1996. In that time, infant deaths fell from 135 to 60 per 1000 births, and the fall in under-5 mortality was greater still. Family planning services are
expanding: modern contraceptive use doubled in the five years to 1997. The country.s STD control programme will soon enter its fourth decade. Safe motherhood is actively promoted, with most pregnant women now going to clinics for care before child-bearing.
This provides an important opportunity for sexual health education. With the advent of AIDS, it also provides a solid infrastructure for monitoring the spread of infection.
NGOs are especially active in the field of health.at least a quarter of all NGOs nationwide invest in this field. This proved particularly important in the 1980s and early 1990s, when an economic downturn and a devaluation of the currency led to a collapse of much of the government-run infrastructure in health. The number of medical
consultations fell by eight percent between 1978 and 1986, even though the population grew by 28 percent over the same period. NGOs were obliged to step in to take up much of the slack, and became very active in rallying public support for health campaigns.
It was against this background of economic distress.a background shared with many other countries on the continent.that the fight against AIDS was launched in Senegal.

Marriage patterns :

As in many West African countries, polygamy is common in Senegal. Over all, nearly half of all married women share their husband with other wives. In polygynous societies it is a general rule that men marry much later than women (since a small number of older, wealthier men are able to partner a much larger number of younger women).
This is certainly the case in Senegal, where half of all women are married by 20 but where half of men remain unmarried by age 31. In the 1997 behavioural survey in Dakar, half of all the female respondents were married, compared with less than one third of the
male respondents.
Senegalese women tend to be relatively old at first marriage compared to women in other countries in Africa. And the age of marriage has been rising in recent years. Twenty years ago, of girls aged 15 to 19, just over four in 10 were still single. By 1997, over seven out of 10 were unmarried in their late teens. The age at marriage is rising because more girls are spending longer at school than they used to. In fact, those with no schooling are still getting married young: half of unschooled girls are married by 18. For women with secondary education or above, the median age at marriage is a full 10 years more than that.
For men, education makes a difference to marriage patterns, too. The more educated a man, the less likely he is to have several wives. However there seems to be a sort of social compensation for formal monogamy: more educated men are also likely to have more sexual partners overall in their lives than less educated men.
Married women in Senegal rarely have partners beside their husband. In the 1997 Dakar study, 99 percent of married women said they had not had sex with anyone except their husband in the preceding 12 months. Among men, the proportion is much higher: some 12 percent of married men said they had sexual partners other than their
wives in the preceding year. Unfortunately, these data do not exist for the pre-AIDS era.
However as discussed below, these rates of extramarital activity are low compared to those found in other countries.