Senegal is a country with an approximate area of 197 thousand sq. km. (UNO, 2001). Its population is 10.339 million, and the sex ratio (men per hundred women) is 99 (UNO, 2004). The proportion of population under the age of 15 years is 43% (UNO, 2004), and the proportion of population above the age of 60 years is 4% (WHO, 2004). The literacy rate is 49% for men and 29.7% for women (UNESCO/MoH, 2004).
The country is a low income group country (based on World Bank 2004 criteria). The proportion of health budget to GDP is 4.8%. The per capita total expenditure on health is 63 international $, and the per capita government expenditure on health is 37 international $ (WHO, 2004). The main language(s) used in the country is (are) French, Wolof and Serer. The largest ethnic group(s) is (are) Wolof, and the other ethnic group(s) are (is) Fulani, Serer, Toucouleur, Diola and Manding. The largest religious group(s) is (are) Muslim (approximately 95%). The life expectancy at birth is 54.3 years for males and 57.3 years for females (WHO, 2004). The healthy life expectancy at birth is 47 years for males and 49 years for females (WHO, 2004).
In a study done in the primary care setting, Diop et al (1982) used a 10-item screening questionnaire to assess 545 children (5-15 years) and the 24-item Self-Reporting Questionnaire (SRQ) to assess 933 adults. Almost 17% of children had emotional/behavioural or neuro-psychiatric disorders and 16% of adults had psychiatric illnesses. Beiser et al (1976) developed an emic questionnaire to tap symptoms of psychiatric distress. In a sample of more than 400 subjects, they found that the idiom of expressing distress was not limited to the somatic, and they were able to discriminate between mentally ill and well people in the local frame of reference. Seck et al (1994) reported on findings from a UNESCO study on epidemiology of drug abuse in young people. Drug use was common among the youth and was associated with certain religious practices, curiosity, ignorance of harmful effects and lack of education. Gueye et al (1998) identified erectile dysfunction in 16% of diabetic outpatients (n=431). Complications of diabetes (especially neurological) and duration of diabetes were associated with the risk of erectile dysfunction. Thiam et al (1998) assessed 1025 psychiatric out-patients. Schizophrenia and hysteria were the commonest diagnoses made. The occurrence of hysteria was associated with disturbances in interpersonal relationships (49.6%) and difficulties of daily life. Big Charcot attacks were seen in 10% of the patients. Hysterical personality type was common in these patients (85.1%). Reitter et al (1996) reviewed the hospital records of 450 persons with suicide attempts. Such attempts were common among young (particularly in young women) and the commonest cause was family problems (all problems: 42%, marital problems: 15%).
MENTAL HEALTH RESOURCES
Mental Health Policy A mental health policy is present. The policy was initially formulated in 1980. The components of the policy are advocacy, promotion, prevention, treatment and rehabilitation.
Substance Abuse Policy A substance abuse policy is present. The policy was initially formulated in 1997. The Law number 97 – 18 of 1st December 1997 serves as the policy for substance abuse.
National Mental Health Programme A national mental health programme is absent. The draft of the National Mental Health Plan is ready and it will be put up for approval in January 2005.
National Therapeutic Drug Policy/Essential List of Drugs A national therapeutic drug policy/essential list of drugs is present. Details about the year of formulation are not available.
Mental Health Legislation The most recent laws in mental health are law 75-80 of 9th July 1975, Decree 75-1092 of 23 October 1975 and Decree 75-1023 of 23 October 1975. The Law number 97 – 18 of 1st December 1997 also has mental health implications. The latest legislation was enacted in 1975.
Mental Health Financing There are budget allocations for mental health. The country spends 9% of the total health budget on mental health. The primary sources of mental health financing in descending order are private insurances, social insurance, out of pocket expenditure by the patient or family and tax based. The country does not have disability benefits for persons with mental disorders.
Mental Health Facilities Mental health is a part of primary health care system. Actual treatment of severe mental disorders is available at the primary level. The programme for primary mental health care was developed in 1975 with the assistance of WHO. Regular training of primary care professionals is carried out in the field of mental health. In the last two years, about 350 personnel were provided training. Out of the 200 personnel trained over the last two years, 100 were nurses and the remaining physicians. There are community care facilities for patients with mental disorders. Community care is provided by private clinics and traditional healers.
Psychiatric Beds and Professionals
psychiatric beds per 10 000 population
beds in mental hospitals per 10 000 population
- Psychiatric beds
in general hospitals per 10 000 population
beds in other settings per 10 000 population
- Number of
psychiatrists per 100 000 population
- Number of
neurosurgeons per 100 000 population
- Number of
psychiatric nurses per 100 000 population
- Number of
neurologists per 100 000 population
- Number of
psychologists per 100 000 population
- Number of
social workers per 100 000 population
Non-Governmental Organizations NGOs are involved with mental health in the country. They are mainly involved in advocacy, promotion, prevention, treatment and rehabilitation.
Information Gathering System There is mental health reporting system in the country. The country has data collection system or epidemiological study on mental health.
Programmes for Special Population The country has specific programmes for mental health for children.
Therapeutic Drugs The following therapeutic drugs are generally available at the primary health care level of the country: carbamazepine, phenobarbital, sodium valproate, amitriptyline, chlorpromazine, diazepam, haloperidol, lithium.