Senegal is showing bold leadership in its commitment to building a more equitable and effective health system—by directly confronting gender inequalities faced by frontline community health workers. In a groundbreaking initiative, the Ministry of Health and Social Action (MSAS), with technical support from the Financing Alliance for Health (FAH), conducted a national gender analysis of its Community Health Workers (CHWs), or Acteurs Communautaires de Santé (ACS).
This first-of-its-kind study was government-led and strongly supported with technical guidance from FAH to ensure that the study delivered actionable, field-grounded insights. This progressive move marks a new chapter in gender-responsive health system strengthening—one that offers a model for countries across Africa.
Why This Study Matters
CHWs form the foundation of Senegal’s health system. They serve as the vital link between communities and formal health services—delivering care, education, and trust where it’s needed most. Yet, for too long, little was known about the gendered dynamics that shape their work, their recognition, or their rights.
The Financing Alliance for Health proudly supported this initiative as a trusted technical partner to MSAS, providing analytical tools, strategy, and expertise. Together, we helped generate evidence that will inform
.
What the Gender Analysis Revealed
Spanning eight diverse regions – Dakar, Louga, Kaffrine, Kolda, Sédhiou, Ziguinchor, Kédougou, and Tambacounda, the study employed a robust mixed-methods approach to assess disparities in workload, recruitment, roles, pay, recognition, and mobility.
Key Findings:
Women Women comprise the majority of CHWs, yet only 18% receive regular compensation, compared to 38% of men
CHWs are highly valued by communities: 87.5% of beneficiaries expressed strong satisfaction with services-especially those provided by women.
Senegal: A Regional Leader in Gender-Responsive Health
This initiative aligns with Senegal’s broader commitments to equity and inclusion, including:
- The National Strategy for Equity and Gender Equality (SNEEG 2, 2016–2026);
- The National Health and Social Development Plan (PNDSS 2019–2028);
- And regional and global frameworks like the African Union Gender Equality Declaration, ECOWAS/UEMOA strategies, and the Sustainable Development Goals.
Rather than shying away from inequities, Senegal is confronting them through transparency, evidence, and reform. This marks a significant shift from symbolic recognition to system-wide accountability.
From Insight to Action: Policy Recommendations
The report provides a roadmap for reform to improve equity, motivation, and impact:
- Formalize CHW roles with contracts, compensation, and protections;
- Invest in gender-responsive financing with dedicated budgets for women’s capacity-building and leadership;
- Ensure women’s participation in governance and supervisory roles;
- Strengthen logistics and mobility to reduce access gaps;
- Address the care burden through work-life balance supports;
- Institutionalize gender analysis across health workforce planning and evaluation.
FAH’s Perspective
At the Financing Alliance for Health, we believe gender equity is not a side issue—it’s a systems issue. Fairly compensated, well-equipped, and empowered CHWs—especially women—are central to delivering sustainable universal health coverage.
Senegal has taken a courageous and practical step forward. By pairing political will with evidence and partnership, they are setting the pace for gender-responsive health financing in Africa.
Join the Movement
We call on governments, donors, and partners to:
- Finance gender-transformative CHW programs.
- Support the implementation of Senegal’s recommendations.
- Replicate this model of national gender analysis in other countries.
Let’s ensure that every CHW—especially every woman—can work with dignity, safety, and opportunity.
References
- This blog is based on the “Rapport de l’étude sur les inégalités vécues par les ACS,” finalized in April 2025 by Senegal’s Ministry of Health and Social Action, with technical support from the Financing Alliance for Health.
