Opposing Trends in Child Mortality in Sub-Saharan Africa . Are Health Care Services Adapted to Needs?: The Case of the Construction of a New Hospital in a Rural Area of Senegal

Malick Kante, Institut National d'Études Démographiques (INED)
Emmanuelle Guyavarch, Institut National d'Études Démographiques (INED)

In Africa, more than elsewhere, health care services remain insufficient. Construction of new medical infrastructures and improvement of health programs are a priority especially in rural areas. Are they sufficient to improve health when modern sanitary equipments are opened in non-equipped areas? We study here the case of the construction of an ultra-modern hospital in a rural area of Senegal, Bandafassi, whose population has been followed for more than 30 years. The analysis of demographic surveillance data, which provide an accurate record of mortality trends in the population from the early 1970s until 2006, shows that this hospital has not reduced maternal and infant mortality. The analysis of complementary studies, based on the perception of this new hospital by the population and their way of using the health care services, gives some explanation to these failure.