1. Senegal Case Study: Scaling Up Community
Health Services to the National Level
through INGO Partnerships
Presentation:
David Shanklin, MS
Integrating Community-Based Strategies into Existing
Health Systems: The Unique Role of INGOs
May 5 – 9, 2014
Silver Spring, MD

2. Original Purpose of the Program
• Health huts in Senegal have been in existence since 1978,
inspired by the spirit of the Alma Ata Declaration and the
promise of universal primary health care.
• Health juts were intended to provide basic health
promotion and selected curative services in areas without
immediately available public health facilities.
• Public support for health huts was abandoned by the mid-
1980s, and almost all were closed by the end of the
decade.
• A new health hut initiative was begun in 1998 as a pilot
project by ChildFund (then known as Christian Children’s
Fund) in order to resuscitate health huts at a local level.

3. Scaling Up Senegal’s Community Health
Services
Project Characteristics
USAID Projects
CANAH CANAH II CAMAT PSSC PSSC II
Dates 1998-02 2002-06 2003-06 2006-11 2011-16
USAID Funding Source CSHGP CSHGP Mission Mission Mission
(Sector Focus) (MCH) (MCH) (TB/Malaria) (Integrated) (Integrated)
USAID Funding Levels $992,218 $1.25 Million $870,846 $26 Million $40 Million
Geographic Coverage 2 Districts 3 Districts 4 Districts 13 Regions 14 Regions
65 Districts 71 Districts
Target MCH Population 137,000 163,393 502,035 3,369,633 9,098,014
(>25% of Nat'l Pop) (>70% of Nat'l Pop)
Health Huts/ 60 HH 154 HH N/A 1,620 HH/ 2,245 HH/
Outreach Sites 703 Sites 1,969 Sites

5. Scaling Up: Project’s Learning
Transitions
CANAH:
• Formative
research
identifying
and working
with key
community
stakeholders
• Organizing &
training
health
committees
and HVs
• Organizing
HH and later,
Outreach
Sites
CANAH II:
• Extending community
health services
• Liaising with local
MOH
• Formulating unified
vision of health
PSSC:
• Standardizing basic CB MCH
• Coordinating CB MCH with multiple
implementing partners
• Nationwide scale-up
PSSC II:
• Urban extension
• Additional service components
• Transfer of HH/OS to community and MOH
CAMAT:
• Additional services,
such as TB, Malaria
and Nutrition
• Increased service
area coverage

6. Health Promotion/Communication
Health Systems Strengthening
FacilityServices
Community
Health
HIV/AIDS/TB
USAID/Senegal's Conceptual Pirogue:
Improved Health Status of the Senegalese Population

7. Community-Based Strategy
Community mobilization using multiple local groups
with consistent health messages and practices
(based on early formative research) –
• Project’s community
mobilizers
• Community health workers
and volunteers (TTBA, health
volunteers, community
educators, health committee
members)
• TB cells
• Youth

8. Community-Based Strategy (cont’d)
• Pregnant women’s solidarity groups
• Grandmothers and godmothers
• Community leaders

9. Rural and urban populations dependent primarily on
the health huts and outreach sites for health services.
 Estimated total population – 9,098,014
 Infants and children 0–5 years – 1,771,968
 Children of school age – 2,544,364
 Pregnant/lactating women – 354,394
 Women of reproductive age – 2,090,013
Target Population

10. Intervention Areas
14 Regions
71 Districts out of 75
4,214 Health
Huts/Outreach Sites

11. Strengths of INGO Participation
• Geographic expansion and population coverage
• Expansion in the number of services provided
• Standardization of services and systems
• Engagement of MOH at the local, regional and
national levels
Most Recent Results
• October 2013 national Community Health Policy
• April 2014 Five Year Strategic Plan for Community
Health

12. Thank You