Baseline Survey: Dassalami Soce Health Needs Assessment

Venchele Saint Dic

Health Preventative Educator

B.P. 77 Karang Senegal, West Africa

Vencheles23@gmail.com

W e d n e s d a y , M a r c h 2 0 , 2 0 1 3

INTRODUCTION

Dassalami Soce is a village located in the Fatick region, in the rural community of Toubacouta of the Foundiougne department. It accounts for a population of 826 Muslim habitants of the following ethnicities: Mandinkas, Sereers, Peuls, Toucouleurs, Bambaras and Diolas. The Mandinkas are the predominant ethnic group in the community.

The major illnesses at Dassalami are diarrhea, respiratory infections, conjunctivitis, childbirth complications, chickenpox, minor wounds and cephalous infections. The health hut serves more than 1240 individuals including two surrounding villages, Saroudia and Boutilimite.

Based on the current necessities of Dassalami Soce, I administered a baseline survey to men and women aged10-59 years old and mothers of children aged 0-5 years old from November 28th 2012 to January 21st 2013. The purpose of the survey was to examine the needs and trends of living in Dassalami, and analyze the discrepancies between the current needs and resources of the population. This report will provide a health overview of the results of the survey on mosquito net usage, safe water and latrine access, handwashing knowledge, equipped handwashing stations, maternal and child health, diarrhea, mother and child nutrition, family planning and youth development on sexual education. I anticipate the results will provide insights to my community on potential programs that can be implemented to alleviate the village’s health challenges.

METHODOLOGY

A community meeting was organized to explain the purpose of the baseline survey two months before its implementation. The first step was the translation of the survey from French to Mandinka from November 3rd to November 8th 2012, by using wording that minimized miscommunication between the interviewer and the participants. Then, a Mandinka speaker who was knowledgeable about the community, Fatou Sarr, was selected to explain the questions appropriate to the literacy and educational level of the participants. Thus, we anticipated for this strategy to increase the validity and reliability of the answers provided on the survey. This baseline survey was the first to be overseen in Dassalami Soce.

On November 28th 2012, a simple random strategy was devised to calculate the sampling size of households that would be interviewed for the survey. Dassalami Soce accounts for 826 habitants in 403 family households. The household number was then divided by 12 giving us a total of 34 households to visit. But, in order to reduce selection bias and convenience sampling bias, we visited every third household which reduced the number to 26 households to be statistically significant at the community level.

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The administration of the survey lasted for two months. The survey was characterized by a series of structured interviews including open/closed and multiple questions coupled with indirect observations. We surveyed 133 men and women aged 10-59 years old and mothers of 65 children aged 0-5 years old. The average length of the interview ranged from 2 hours 75 minutes for large families to 15 minutes in small families. In order to receive quality data, we were careful that our meeting dates never coincided with any previously or routinely scheduled activities in the community, including festivities and work in the fields. We visited two to three households daily and the interviews were scheduled at 5pm when the women and men would return from work in the fields. When exiting the interview, we counted the houses to be visited the next day and informed the participants of our arrival.

The participants were read informed consent including the following information: the purpose of the survey, risks to the study participant, including physical, social, and emotional, benefits to the study participant and community, including, if necessary, a statement that there are none, information on confidentiality of the data collected as well as the questions and questionnaires, including the use of identifiers and access to personal data, information regarding withdrawal from the study without any penalty and information on study procedures and duration. This was done to inform and empower family households to make a voluntary decision about whether or not to participate in the study.

The survey questions measured specific knowledge on mosquito net usage, safe water and latrine access, handwashing knowledge, equipped handwashing stations, maternal and child health, diarrhea, mother and child nutrition, family planning and youth development on sexual education. The objective was to obtain an overview of the health challenges of the community and to identify with indirect observation the causes of these challenges. Excel spreadsheets were used to enter data for all the surveys, to identify errors or inconsistencies that might have been overlooked. It also ensured that the correct number of data surveys was entered in the system matching the appropriate question codes. This facilitated the data cleaning and analysis of the survey results. Data entry was completed on January 31st 2013.

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RESULTS

MALARIA PREVENTION:

MOSQUITO NET USAGE

HE170: Number of individuals who slept under an ITN the previous night.

The family households were asked on mosquito net usage for each individual. Out of 85 people who reported they slept under mosquito nets, the majority of responses camefrom individuals 18+yrs old and mothers of infants aged 0-5yrs old. 71 percent of the individuals aged 18+ yrs reported they did not sleep under a mosquito net versus 55 percent who reported they slept under a bed net. 39 percent of the mothers with infants aged 0-5yrs reported their children slept under mosquito nets compared to 22 percent who reported their children did not sleep under bednets (see table 1).

The number of children aged 0-5yrs old sleeping under mosquito nets is 14 times lower than the number of individuals 18+yrs old who sleep under bednets. This suggests that more advocacies

should be taken in the health structures on mosquito net usage for children of pregnant and lactating women year-round. The number of children aged 6-14yrs old sleeping under mosquito nets is 42 times lower than the number of individuals aged 18+ yrs sleeping under bednets (see table 1). The percentage of individuals aged 18+yrs who slept under mosquito nets is 16 times lower than the ones who did not

sleep under mosquito nets. This may suggests that school officials and teachers need to emphasize more on the usage of mosquito nets in schools in villages.

The results were further analyzed by gender to identify the vulnerable groups who are not using mosquito nets. The number of women

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who slept under bed nets is greater than men. Paradoxically, the percentage of women who did not sleep under mosquito nets is 38 times lower than men. 88 percent of women including pregnant women slept under bed nets compared to 12 percent of men (See table 2). The percentage of men who slept under mosquito nets is 76 times lower than women who slept under bed nets. This suggests that more funding at the health structures should be allocated to organize campaigns promoting the use of mosquito nets to women and men. Overall, of 126 individuals interviewed for the survey, 67 percent of households sleep under mosquito nets compared to 33 percent who do not sleep under bed nets (see table 3).

Next, the mothers of infants aged 0-5yrs old were asked if their children who had diarrhea slept under mosquito nets. Of 104 mothers who were interviewed about their children having diarrhea, 22 percent reported that the children who had diarrhea slept under bed nets as opposed to 78 percent who reported their children did not have diarrhea and did not sleep under bednets (See table 4). Out of 104 mothers interviewed, 11 children who had diarrhea slept under bed nets versus 2 children who had diarrhea and did not sleep under bed nets. Then, there were 8 children who did not have diarrhea and did not sleep under bednets. Overall, more children who had diarrhea slept under mosquito nets than those who did not. The graph showing the total cases of diarrhea for the fiscal year of 2012 shows the upward and downward trend of the rate of diarrheal diseases across seasons. The highest peaks of diarrhea cases are seen mostly in the months of February, July and October. Those results suggest more sensitization on diarrhea and the importance of handwashing and the use of mosquito nets to mothers during these months. This also indicates the financial means of certain families who are able to purchase mosquito nets further creating a gap between people who can or cannot afford mosquito nets for their households.

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SAFE WATER ACCESS AND LATRINE ACCESS

HE62: Safe Water Access: Number of people in household having access to clean, safe drinking water

HE67: Latrine Access: Number of people who have access to an improved latrine

The families were asked about the availability of clean water and functional latrines in their households. Of the 52 people interviewed in 26 households, there were more people who did not have safe water and latrine access. Respectively, 40 percent of the population did not have safe water access which explains the reason 100 percent of the households do not have safe water to cook with, explaining the dysentery issues and skin infections children face in the village (See Table 5 & 6). The percentage of households who do not have latrine access is 46 times higher than the ones who do have access to latrines (See table 5). Those figures imply the construction of new latrines for families and finding ways to clean the water source of the village whether it is through the installation of faucets in the community. As a result, this would decrease the rate of diarrhea and skin infections children have in Dassalami Soce.

HANDWASHING

HE70: Handwashing-Improved Knowledge: Number of people who can identify 3 or more critical times when they must wash their hands, and 3 examples of appropriate hand etiquette

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Family members were asked to identify key times to wash their hands with soap. Seven out of fifty people aged 50+ reported two or more handwashing times. The number of handwashing times reported by people ranging from ages 50+ and 18-24yrs is 40 times lower to the number of handwashing times reported by individuals aged 25-49yrs old (see table 7). 70 percent of people aged 25-49yrs old reported two or more handwashing times. 100 percent of individuals aged 50+ reported one or no handwashing times compared to the rest of the age groups. These statistics imply there should be causeries on handwashing at the village level. We should also aim to target the age groups 50+ and 18-24 yrs because younger children have the tendency to look up to older adults. If the adults do not wash their hands, the children will follow their behaviors and this further increases diarrheal and dysentery diseases.

The results were further used to evaluate whether the people who had used cleaning agents such as soap were able to identify the key times to wash their hands. 65 percent of people aged 25-49yrs who had used soap for washing their hands had the highest handwashing reporting times compared to the other groups (See table 8). The number of individuals aged 18-24yrs and 50+yrs who had used soap is eight times lower than the individuals aged 25-49yrs old.

Moreover, the percentage of individuals aged 50+ yrs who reported two or more handwashing times is 86 times lower than those who reported one or no handwashing time. The percentage of individuals aged 18-24yrs and 50+yrs who reported two or more handwashing times is 35 times lower to the reporting times of the individuals aged 25-49yrs (See table 8). The people aged less than 18 yrs old had the lowest reporting rate of using soap and handwashing times compared to the other age groups. This further recommends that schools should be included in promoting the importance of handwashing to children.

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EQUIPPED HANDWASHING STATIONS

HE 72: Number of households having soap or ash or another disinfecting material) and safe water for proper handwashing at a hand washing station commonly used by family members

During the interview, it was observed that 73 percent of individuals in family households do not have soap and safe water for proper handwashing at a handwashing station compared to 27 percent who do have access to soap for proper handwashing at a handwashing station (See table 9).

MATERNAL AND CHILD HEALTH

Healthy Pregnancy and Safe Delivery

HE94 (Four Antenatal Visits): Number of mothers with infants <12 months reporting that they had four or more antenatal visits during pregnancy.

Lactating and pregnant mothers were asked about the number of antenatal visits they had attended at the nearest health hut or health post. The total number was 54 antenatal visits combined for the 11 mothers. Out of 11 households with pregnant/lactating mothers, the average number is 5 antenatal visits.

Birth Plan

HE96: Numbers of mothers with infants <12 months reporting they had a birth plan that included arrangement for HIV testing, giving birth in a facility, exclusive and immediate breastfeeding, and emergency transportation

Skilled Birth Attendant

HE97: Number of mothers with infants <12months reporting that their births were attended by a skilled attendant

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These mothers were asked about the birth plan they used before the arrival of their newborns. Out of the 11 mothers with infants less than 12 months old, 82 percent planned for arrangement for HIV Testing, giving birth in a facility, exclusive and immediate breastfeeding and emergency transportation compared to 18 percent of women who planned some of these or none before the birth of their newborns (See table 10).

When the data was examined by age group to assess the groups of mothers who did or did not have a birth plan, 67 percent of women aged 25-49yrs had a birth plan versus 100 percent of the rest of the women who did not have a birth plan (See table 11). This further suggests that health structures should ensure the complete coverage of pregnant women during and after the pregnancy due to lack of information and financial means.

The age group 18-24yrs old had the lowest percentage among the other groups to have a birth plan. The percentage of women aged 25-49 yrs old who answered that they planned for arrangement for HIV Testing, giving birth in a facility, exclusive and immediate breastfeeding and emergency transportation is 33 times lower than the ones who reported planning some or none of these tasks before the birth of their infants. Those results recommend more causeries and campaigns, especially with women in their early twenties, to help them have a birth plan during their pregnancy. Dassalami Soce has a health hut and 100 percent of the births are attended by a skilled birth attendant, the matrone and the health agent (ASC) of the community (See table 12). Overall, more women in their mid-twenties and early fifties did not have a birth plan prior to giving birth than the rest of the women who had a birth plan.

IMPROVED CHILD HEALTH

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Newborn Care- Knowledge of symptoms requiring urgent care: Number of women who are able to identify 2 or more signs or symptoms indicating the need to seek immediate care for the newborn

The mothers were then asked if they could identify symptoms that would require them to bring their infants to the health post or health hut. About 76 percent of women aged 25-49yrs identified three or more symptoms which would lead them to seek immediate care for their newborns versus 80 percent who only reported one symptom or no symptom that would lead them to seek immediate care for their newborns. The age group 15-17yrs had the lowest reporting rate of three or more danger signs to seek care for their newborns compared to the other age groups (See table 13). The percentage of women aged 25-49yrs old who reported three or more symptoms which would lead them to seek immediate care for their newborns is 4 times less than those who either reported one or no symptoms. In conclusion, more mothers reported less than two symptoms that would signal them to take their children to the health post or health hut.

Post-natal Visits: Number of mothers of infants <12 months reporting that their infant received a post-natal visit from a trained health worker within two days of their birth

Mothers were asked if they had received post-natal visits within two days of the birth of their infants. 75 percent of mothers aged 18-24yrs old with infants less than 12 months old reported that they did not receive a post natal visit from a trained health worker within two days of their birth compared to 25 percent of mothers aged 25-49yrs.

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More mothers aged 25-49yrs reported they received a post-natal visit from a trained health worker within two days of the birth of their children compared to 14 percent of mothers aged 18-24yrs old. More mothers from the age group 25-49yrs reported that they received a post-natal visit from a trained health worker within two days of the birth of their children compared to 25 percent of mothers who reported they did not receive a visit (See table 14). This problem could be alleviated if they increase the number of matrones in the health facilities to help mothers prepare for the birth of their infants.

About 75 percent of mothers aged 18-24yrs reported that they did not receive a post natal visit from a trained health worker within two days of the birth of their children compared to 14 percent of mothers who reported that they received a visit. Of 11 mothers interviewed, 7 stated that their infant received a post-natal visit within two days of birth compared to 4 mothers reporting their infant did not receive a post-natal visit from a trained health worker (See table 14). In general, more mothers reported post-natal visits within two days of the birth of their children than those who did not receive any visit from a trained health worker.

DIARRHEA

HE140: Number of children aged 0-59 months who had diarrhea since the last reporting period, whose mothers reported that they received either oral rehydration therapy, or increased fluids and those they continued to give them food

ORS Solution Intake

The mothers who answered that their children had diarrhea were asked if the children received Oral Rehydration Drink (ORS). Out of the infants aged 0-59 months, the age groups most affected with diarrhea were the infants aged 0-5 months and 24-59 months. The

number of mothers who reported most that their infants did not have diarrhea were infants aged 24-59 months. The infants aged 24-59 months were given more ORS solution compared to the other age groups. The infants most affected with bouts of diarrhea and who were not given ORS was aged 0-5 months. The infants aged 0-5 months and 24-59 months had the highest percentage of having diarrhea compared to the other age groups (See table 15). The mothers of the infants

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aged 24-59 months who had diarrhea had the highest percentage of ORS intake compared to the other age groups. The second highest group compared to the infants aged 24-59 months who had high percentage of diarrhea and to receive ORS were infants aged 12-23 months (See table 15). This would suggest health structures to allocate more resources to relais in villages to hold causeries with mothers on giving ORS to children with diarrhea. As a result, it would decrease infant mortality rate caused by dehydration.

Breastfeeding Frequency

Then, the mothers were asked how frequently they breastfed their children when they had diarrhea. This was not applicable to the children aged 24-59 months because they stopped breastfeeding. Coincidentally, the mothers with children aged 24-59 months had the highest number of children who did not have diarrhea. The mothers who continued to breastfeed their children during diarrhea were less across all age groups. In 31 percent of the infants aged 0-5 months who had diarrhea, 50 percent of the mothers responded they breastfed them at the same rate or they increased breastfeeding than usual (See table 16). In 15 percent of infants aged 6-11months who had diarrhea, 100 percent of the mothers reported they breastfed less than usual compared to 23 percent of children aged 12-23 months who had diarrhea, and 50 percent of their mothers reported they breastfed them more than usual.

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Water Intake

Subsequently, the mothers were asked about the water intake of their children during diarrhea. The children aged 24-59 months were given more water than usual compared to the other age groups. The number of mothers who reported that they gave water to their children was less for infants aged 0-5 months, 6-11 months and 12-23 months (See table 17). In 31 percent of infants aged 0-5 months who had diarrhea, 50 percent of mothers reported the infants received the same amount of water because most of them were breastfed. These children received water from the breastmilk. In 23 percent of children aged 12-23 months who had diarrhea, 50 percent of mothers reported they received less or the same amount of water than usual. In 31percent of children aged 24-59 months who had diarrhea, 57 percent of mothers reported the children received more water than usual.

Food Intake

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These questions were followed by inquiries on the amount of food children received during diarrhea. In 31 percent of infants aged 0-5 months who had diarrhea, 67 percent of mothers reported they gave them the same amount of food as usual. In 15 percent of infants aged 6-11 months who had diarrhea, 33 percent of mothers reported they gave them less food than usual (See table 18). In 23 percent of infants 12-23 months who had diarrhea, 33 percent of mothers reported they gave them less or the same amount of food as usual. In 31percent of children 24-59 months who had diarrhea, 57 percent of mothers reported they gave them more food than usual.

Vaccinations

HE142: Number of children aged 12-23months who completed their WHO required immunizations (BCG, DPT3, OPV3, and one measles vaccine) by 12 months of age

In total, there are 52 children aged 12-23 months who have had the WHO required immunizations (See table 19). Nevertheless, the percentage of children vaccinated is still in the low ten percent in Dassalami Soce. This may imply that the health structures should ensure full health coverage of children. If they are going to organize vaccination campaigns, the health staff should adapt information on the vaccinations based on the educational level of families.

FAMILY PLANNING

Contraceptive Knowledge

HE99: Number of women who are able to identify at least two methods of modern contraception

Women were asked about their knowledge on methods of modern contraception. Out of 17 women who were asked to identify at least two methods of modern contraception, 53

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percent of them were able to identify them versus 29 percent who did not identify any methods of modern contraception (See table 20). This further suggests the need to engage women more in causeries on family planning and facilitate their access to these methods of contraception such as birth control pills.

The responses were viewed by gender and it was found that 100 percent of women did not know any methods of modern contraception. 78 percent of men could identify at least two methods of modern contraception compared to 22 percent of women. Furthermore, 75 percent of women could not identify at least two methods of modern contraception compared to 25 percent of men (See table 21). Overall, the percentage of women who could not identify at least two methods of modern contraception was 50 times higher than men; and the percentage of men who could identify at least two methods of modern contraception was 56 times higher than women.

When the results are viewed by age, it was found that 55 percent of youths less than 15 yrs old did not report any methods of contraception followed by adults aged 25-49 yrs old. Out of all the age groups, 89 percent of adults aged 18-24yrs were the only ones to identify one or more methods of contraception compared to youths aged less than 15 yrs old (See table 22). Overall, the percentage of adults aged 18-24 and 25-49yrs who could identify at least two methods is 78 times higher than those who are less than 15 yrs old. Then, the percentage of youths less than 15 yrs old who did not report any methods of contraception was 10 times higher than those who are 25-49yrs old.

Warning Signs during Pregnancy

HE91: Number of mothers who are able to identify 2 or more warning signs during pregnancy indicating the need to seek immediate care with a provider

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Out of the 48 mothers who were asked to identify warning signs during their pregnancy that brought them to the hospital, 76 percent of mothers aged 25-49yrs reported 2 or more warning signs where they sought immediate care with a provider compared to 24 percent of mothers aged 18-24yrs (See table 23). 50 percent of mothers aged 25-49yrs reported one or no warning signs during their pregnancy indicating the need to seek care compared to 33 percent of mothers aged 18-24yrs. Of all the age groups, the mothers aged 15-17 yrs had the lowest percentage of reporting one or no warning signs during their pregnancy. Overall, the percentage of mothers aged 18-24 yrs who reported two or more warning signs during their pregnancy are 9 times lower than those who either reported one or none.

NUTRITION

Nutritional Diversity

HE7: Number of adults who reported eating at least 3 servings of fruits and vegetables and one protein/animal source of food (egg, dairy, meat, fish, poultry, lentils, beans) in the day preceding the assessment

When women and men were asked if they ate at least 3 servings of fruits and vegetables and one protein/animal source of food (egg, dairy, meat, fish, poultry, lentils, beans) in the day preceding

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the assessment, 87 percent of females reported not eating at least 3 servings of fruits and vegetables and one protein source compared to 13 percent of men (See table 24). In contrast, 75 percent of females reported eating at least 3 servings of fruits and vegetables and one protein source compared to 25 percent of men. Overall, more women than men reported not eating at least 3 servings of fruits and vegetables and one protein/animal source of food (egg, dairy, meat, fish, poultry, lentils, beans) in the day preceding the assessment and 100 percent of females did not know if they consumed at least 3 servings of fruits and vegetables and one protein/animal source of food. These statistics perhaps recommend that the health structures should be more involved in showing the importance of the nutritional values in food for women and men at the community level.

Out of 79 people interviewed in 26 households, 67 percent of them reported they ate at least three servings of fruits/vegetables and one portion of protein/animal source of food (egg, dairy, meat, fish, poultry, lentils, beans) in the day preceding the assessment versus 29 percent who reported not eating these servings of food.

IMPROVED INFANT AND YOUNG CHILD FEEDING PRACTICES

Exclusive Breastfeeding

HE112: Number of infants <12 months of age with a mother reporting their child was exclusively breastfed (may have received vitamins, minerals, medicines or ORS, but no other food or liquid including water) for the first six months

Out of 48 mothers interviewed on exclusive breastfeeding for children less than 12 months old, 32 answered that these infants needed breast milk only and 13 answered that infants less than 12 months of age needed breast milk and other

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food for the first six months. Respectively, 58 percent of mothers stated that infants aged 6-12 months needed breastmilk only and 42 percent of mothers stated that infants aged 0-5 months needed breastmilk only (See table 26). Out of 13 mothers who were interviewed, 100% of mothers stated that infants aged 0-5 months needed breastmilk only. Overall, the percentage of mothers who believe infants 0-5 months need breastmilk and other food is 58 times higher than the mothers who believe infants 0-5 months only need breastmilk. No mothers reported that infants 6-12 months needed breastmilk and other food.

Weaning Practices Knowledge

HE114: Improved Knowledge: Number of women who are able to identify three optimal complementary feeding practices using locally available foods

When mothers were asked to identify complementary feeding practices for their children, 77 percent of mothers aged 25-49 yrs reported two or more complementary feeding practices using locally available foods compared to 23 percent of mothers aged 18-24yrs. The percentage of mothers aged 15-17 yrs who reported one or no complementary feeding practices was 60 times lower than the mothers aged 18-24yrs and 25-49yrs (See table 27). Of all the age groups, mothers aged 25-49 yrs had the highest percentage in identifying two or more complementary feeding practices for their children. Next, the percentage of mothers aged 18-24 yrs who identified two or more complementary feeding practices was 17 times lower than the ones who reported one food or none. It is suggested that more sensitization should be done at the community level to incite men and women to cultivate a variety of foods. This increases the choices of foods they provide to their children. Also, it would be recommended to reach out to NGOs who may work on nutrition projects in respective regions.

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Under 5 Nutrition Knowledge

HE118: Number of women who are able to identify at least two foods that provide essential nutrients needed during childhood (<5years old) for good child development

When the mothers were asked about the nutrient foods they could give their children, the women aged 25-49yrs had the highest percentage of identifying two or more foods that provide essential nutrients needed during childhood (<5 years old) for good child development. 33 percent of women aged 15-17yrs and 18-24 yrs reported one type of food or none that provide essential nutrients needed during childhood (See table 28). The women aged 25-49 yrs reporting on foods that provide nutrients were 58 times higher than those who are 18-24yrs old. Finally, the percentage of women aged 18-24yrs who have identified two or more foods that provide essential nutrients was 12 times lower than the ones who reported one food or none.

YOUTH DEVELOPMENT

Youth Improved Knowledge

HE42: Number of youth who can identify at least one behavior to prevent unwanted pregnancy or prevent STIs

Out of 25

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adolescents who were interviewed about behaviors to prevent unwanted pregnancy and STIs, 91 percent of youths aged 18-24yrs old identified one or more behaviors to prevent unwanted pregnancy or prevent STIs. The percentage of youths aged 18-24 yrs old who identified one or more behaviors was 81 times higher than the youths aged less than 15 yrs old and 15-17yrs old. 100 percent of youths less than 15 yrs old did not identify one or more behaviors to prevent unwanted pregnancy or prevent STIs. Overall, the percentage of youths less than 15 yrs old who identified one or more behaviors was 95 times lower than the ones who did not report any behaviors. This may suggest more causeries to encourage parents to openly talk about sex education to their children. It also would be helpful to value sexual education starting from elementary schools and to continue organizing campaigns on the subject toward young adults.

When the results were examined by gender, it was found that 70 percent of females identified one or more behaviors to prevent unwanted pregnancy/STIs compared to 30 percent of men. By contrast, 80 percent of females could not identify behaviors that prevented unwanted pregnancy/STIs compared to 20 percent of men. The percentage of men who reported one or more behaviors was 10 times higher than those who did not report behaviors; and the percentage of women who reported one or more behaviors to prevent unwanted pregnancy/STIs was 10 times lower than those who did not report any behaviors. These questions concluded the baseline survey administered in Dassalami Soce.

CONCLUSION

In many Senegalese communities, men, women and adolescents continue to be marginalized groups in the access to health services. I administered this survey with the successful collaboration of my community, Dassalami Soce, to gain an understanding on the discrepancies between the health needs and resources available to the population. The survey measured specific knowledge on mosquito net usage, safe water and latrine access, handwashing

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knowledge, equipped handwashing stations, maternal and child health, diarrhea, mother and child nutrition, family planning and youth development on sexual education. The results pointed out to potential programs and/or training that can be put in place to alleviate the community’s drawbacks. Some future suggestions could be to reinforce the health structures to provide essential information on the prevention of health diseases, primarily targeting the women and youths of rural communities. I hope permanent solutions are found to these endemic health problems with the continued collective work of health authorities, to attain the country’s health objectives in the international realm.

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