Executive Summary

This report examines recent changes in the demographic situation of Senegal, particularly those related to fertility and mortality rates. Although the data reviewed for this study vary quite substantially in quality and level of coverage, on careful analysis they produce a rather consistent story of demographic change over the last 30 years.

The population of Senegal, estimated at 6.9 million in 1988, increased by 2.7 percent per year between 1976 and 1988. This rapid growth can be attributed to both sustained high fertility—on average each woman bears approximately six children—and declining mortality. The United Nations estimates that the population will more than double between 1988 and 2015, to 14.3 million and that it will reach close to 17 million by 2025 (United Nations, 1991).

FERTILITY

According to the latest large-scale national demographic survey in Senegal—the Demographic and Health Survey of 1992-1993 (DHS-II)—if fertility rates were to remain constant, women entering their reproductive lives today could expect to bear, on average, 6.1 children over the course of their lives. However, it is doubtful that young women starting their reproductive lives today will actually achieve this level of fertility, which would require no change in fertility behavior over 35 years. National demographic surveys



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Population Dynamics of Senegal Executive Summary This report examines recent changes in the demographic situation of Senegal, particularly those related to fertility and mortality rates. Although the data reviewed for this study vary quite substantially in quality and level of coverage, on careful analysis they produce a rather consistent story of demographic change over the last 30 years. The population of Senegal, estimated at 6.9 million in 1988, increased by 2.7 percent per year between 1976 and 1988. This rapid growth can be attributed to both sustained high fertility—on average each woman bears approximately six children—and declining mortality. The United Nations estimates that the population will more than double between 1988 and 2015, to 14.3 million and that it will reach close to 17 million by 2025 (United Nations, 1991). FERTILITY According to the latest large-scale national demographic survey in Senegal—the Demographic and Health Survey of 1992-1993 (DHS-II)—if fertility rates were to remain constant, women entering their reproductive lives today could expect to bear, on average, 6.1 children over the course of their lives. However, it is doubtful that young women starting their reproductive lives today will actually achieve this level of fertility, which would require no change in fertility behavior over 35 years. National demographic surveys

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Population Dynamics of Senegal indicate that fertility declined by over one child per woman between 1975-1978 and 1989-1992. The decline in fertility in Senegal has occurred almost entirely among women under age 30. A comparison of age-specific fertility rates between 1975-1978 and 1989-1992 reveals that the decline in fertility among women aged 15-19 is approximately twice as large as that among women aged 20-29 (32 versus 17 percent). Furthermore, the decline among women aged 20-29 is twice as large as that among women over age 30 (17 versus 8 percent). Fertility decline in Senegal is also strongly associated with differing levels of urbanization and education. Even in the late 1970s, the World Fertility Survey (WFS) reported that fertility was lower among urban and literate women. However, both of these groups were relatively small and overlapped considerably, so that the net effect on the national total fertility rate estimates was small. These subgroups have now become larger and their effect on the general level of fertility more noticeable. A decline in fertility first appeared in Dakar in the early 1980s, and, to date, still appears to be limited to urban areas. The total fertility rate in Dakar, the most densely populated region, has fallen from 6.8 children per woman in 1975-1978 to 4.9 children per woman in 1989-1992. All surveys indicate that women with some education report lower fertility than women with no education, and an ever-increasing fraction of the school-aged female population is going to school (World Bank, 1988). The driving force behind the changes in the level and pattern of fertility has been a trend towards later marriage. Of course, in some areas of Senegal, such as Casamance, women have always married relatively late. However, the more general trend towards later marriage probably began in Dakar in the 1980s and has been spreading to the interior of the country ever since. The pattern of later marriage is also strongly linked to formal education, although signs of change are emerging even among women who have never attended school. Little of the fertility decline in Senegal appears to be attributable to either a decrease in ideal family size or an increase in the use of modern contraception. There has been a trend towards wanting fewer children, which stretches across all parities and all age groups of women. However, current preferences still lie very close to the physiological maximum level, assuming a continued regime of delayed marriage and long birth intervals. The proportion of women using modern contraception has increased over the recent past. Nationally, use of modern contraception among currently married women has increased from less than 1 percent in 1978 to a little under 5 percent in 1992-1993. However, use is almost entirely restricted to certain subgroups of the population, particularly women in urban areas and

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Population Dynamics of Senegal women with at least a primary-level education, so that the absolute number of users is still very low. In summary, the above features suggest that Senegal's small fertility decline is unlike those that have occurred recently in other sub-Saharan African countries. In Botswana, Kenya, and Zimbabwe—usually considered to be the three countries in the vanguard of African fertility transition—fertility declines are associated with increases in the use of modern contraception. Botswana, Kenya, and, to a lesser extent, Zimbabwe, have also experienced a decline in teenage marriages, but they have also experienced a greater separation of teenage marriage and teenage fertility, consequently leading to an increase in nonmarital fertility. This separation of marriage and fertility has had the effect of reducing the influence of marriage on fertility rates (Working Group on the Social Dynamics of Adolescent Fertility, 1993). In Senegal, fertility has fallen because marriage has been delayed, and marriage and fertility have remained linked. On the other hand, the Senegalese pattern matches more closely, but not exactly, the pattern found in certain northern African countries during the first phase of their fertility declines. For example, most of the initial decline in fertility observed in countries such as Algeria, Egypt, and Tunisia can be attributed to later age at first marriage (Fargues, 1989; National Research Council, 1982). In these countries, the initial phase of fertility decline was immediately followed by a second phase linked to a substantial decline in the demand for children and a corresponding increase in modern contraceptive use among married women. Whether Senegal follows this pattern and experiences a second phase of fertility decline immediately following the first will depend on what happens to the demand for children. As noted, this report documents a small decline in women's ''ideal" family size, but that decline is achievable with later age at first marriage and is too small to increase the demand for modern contraception. Assuming Senegal achieves further increases in primary and secondary school enrollment for women, as well as greater urbanization, further fertility declines can be expected to occur in the near future. In rural areas, further declines in actual fertility can be achieved through the mechanism of later marriage. However, in urban areas, particularly Dakar, most of the decline in actual fertility that is achievable solely by an increase in age at marriage has already occurred, so that future fertility reductions must await greater coverage of modern contraception. If the government of Senegal wishes to foster fertility decline, strong policies targeting both girls and women of reproductive age are needed. For girls, policy should aim at increasing formal education. For women, action should be taken to promote the availability of contraception while increasing women's functional literacy and reducing their domestic burden. These policies, combined with interventions aimed at improving maternal

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Population Dynamics of Senegal and child health, should have a good chance of making women more receptive to the use of modern contraceptives. MORTALITY Both child and adult mortality have undergone substantial declines over the past several decades in Senegal. Child Mortality Senegal has undergone a continuous decrease in child mortality since World War II. In 45 years, from 1945-1990, child mortality—measured by the probability of dying before age 5—fell substantially, declining from approximately 400 to 130 per 1,000. This decrease accelerated toward the end of the 1970s and the beginning of the 1980s. The difference between child mortality rates in urban and rural settings is sharp. Between the mid-1960s and 1986, child mortality declined at a relatively slow pace in Dakar, from about 150-200 to about 100 per 1,000. By contrast, until the early 1970s, child mortality ranged between 350 and 400 per 1,000 in the rural areas; as noted above, the mortality decline in the rural areas, which was by no means homogenous, began only in the late 1970s in most areas. The probability of dying decreased from 370 per 1,000 in the early to mid-1970s to 230 per 1,000 a decade later. Because of the relatively rapid decline in child mortality in the rural as compared with the urban areas, the differential between the two narrowed from three to one during 1960-1975 to two to one at the beginning of the 1980s. Regional differences in child mortality are marked and have been consistent over time. Since the late 1960s, the probability of dying before age 5 has been far lower in the western grand region1—where it fell from 183 per 1,000 in 1968 to 111 per 1,000 in 1988-1992—than in any of the other three grand regions. In general, the second-lowest child mortality has been in the northeastern region, where it fell from 253 to 183 between 1968-1972 and 1988-1992, followed by the central region, where it fell from 304 to 170 in the same time period. Child mortality has remained the highest in the southern region, where it has consistently been almost twice that found in the west. Ironically, the study area of Mlomp, a rural area in the south, experienced the earliest and one of the most rapid declines of all the small-scale study areas reviewed in this report. The pattern of mortality decline in Mlomp—where the decline in infant mortality occurred before that in child mortality—was also slightly different from that recorded elsewhere. Mlomp's early and rapid mortality decline and the unusual pattern of that decline are likely the result of the establishment of a private dispensary and a maternity

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Population Dynamics of Senegal clinic in 1961, which soon after their establishment were providing high-quality health services to a large majority of the residents in the area. The acceleration of the mortality decline in rural areas beginning in the late 1970s can be linked to the improved infrastructure of health programs in Senegal, which until that time had been located almost exclusively in the urban area of Dakar. Two initiatives had a large impact on the rural areas: (1) the new primary health care policy, which, starting in 1978, led to the construction of a large number of maternity clinics in rural areas, and (2) the World Health Organization's Expanded Programme on Immunization (EPI), which, when implemented in 1981, had as one of its goals better services for children in rural areas. By the beginning of the 1990s, vaccination had increased substantially throughout Senegal. Fifty-five percent of children aged 12-23 months were completely vaccinated in 1990, up from 18 percent in 1984. The improvement in rural areas greatly exceeded that in urban areas, narrowing the gap that had earlier existed between the two. Since the early 1990s, however, greater emphasis has been placed on the EPI services in urban areas than in rural areas. Therefore, the rural-urban gap is likely widening again, and greater emphasis on EPI services in rural areas is needed. Surprisingly, the period of economic stagnation and the implementation of the structural adjustment policies did not produce the large adverse effects on child mortality that might have been expected. Differences in mother's level of education and urban/rural residence are the two socioeconomic variables most strongly related to differentials in child mortality in Senegal. A child whose mother has attended school is almost one-third less likely to die, regardless of other factors, underscoring the importance of female education not only for fertility, as suggested above, but also for child mortality. Likewise, living in an urban area is associated with a risk of death one-third to one-half lower than that in rural areas. Adult Mortality Adult mortality has also been falling in Senegal. The expectation of life at age 15 for males increased from 48.3 to 49.9 years of age between 1976 and 1988, and that of females from 47.1 to 51.5 years between 1972 and 1988. These national-level declines are supported by results from local surveys. As with child mortality, adult mortality levels are not uniform throughout the country. Survivorship data from the 1988 census indicate that in the early to mid-1970s, adult mortality ranged from very high levels in the southeastern part of the country to relatively low levels in the west. In the southeastern regions of Tambacounda and Kolda, the likelihood of someone aged 15 dying before reaching age 60 was 50 percent. In the five more

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Population Dynamics of Senegal centralized regions of Diourbel, Fatick, Kaolack, Louga, and Ziguinchor, however, the likelihood of dying between the ages of 15 and 60 was around 35 percent. In the western regions of Thiès and Dakar and in Saint-Louis, the probability of dying between the ages of 15 and 60 was around 20 percent. As with child mortality, adult mortality is negatively related to socioeconomic status—as indicators of wealth increase, adult mortality decreases. In all cases, the negative relationship is stronger for female adult mortality than for male adult mortality. NOTE 1.   The term "grand region" is used throughtout this report in reference to the four WFS and DHS regions, as opposed to the ten administrative region used in discussions of the 1998 census. (Figure A-1 shows the geographic area included in each of the "grand" region. Figure 2-2 shows the 10 administrative region and the 30 administrative departments.)