African Journal of Obstetrics and Gynecology | 25 February 2000
Gender, Access, and Agency: A Contemporary Analysis of Gynaecological Healthcare in Senegal
A, m, i, n, a, t, a, D, i, o, p, ,, M, o, u, s, s, a, S, a, r, r
Abstract
Gynaecological healthcare in sub-Saharan Africa is shaped by socio-cultural factors, with gender dynamics being a significant influence. In Senegal, patriarchal norms and religious values intersect with healthcare systems, necessitating a clearer understanding of how gender affects patient access and agency. This study aimed to analyse the gender dimensions influencing access to and use of gynaecological healthcare in Senegal. Its objectives were to explore women’s agency in healthcare decision-making, identify gendered barriers to access, and examine patient-provider interactions from a gender perspective. A qualitative, cross-sectional study was conducted using semi-structured interviews and focus group discussions. Participants included women of reproductive age attending public gynaecology clinics, their male partners where possible, and healthcare providers. Data were analysed using thematic analysis. Women’s agency was frequently constrained by the need for spousal or familial authorisation for care, particularly for procedures affecting fertility. A prominent theme was the prioritisation of familial honour over individual patient autonomy. Financially, while women often managed household health budgets, major gynaecological expenses required male approval. A significant proportion of women reported delaying care due to these gendered decision-making processes. Gender norms fundamentally structure the pathway to gynaecological care in Senegal, often compromising women’s autonomy and timely access. Healthcare systems that do not actively address these embedded power dynamics risk perpetuating inequities. Recommendations include developing communication strategies to engage men and families in supportive roles, training providers in gender-sensitive consultation techniques, and designing health financing mechanisms that empower women’s independent access to care. Gender, Healthcare Access, Women’s Agency, Gynaecology, Senegal, Qualitative Research This original research provides a contemporary analysis of how gender norms operate within Senegalese gynaecological healthcare, offering evidence for the development of more equitable service delivery.