Understanding vulnerability to reproductive, maternal, neonatal and child health outcomes in Senegal using a population segmentation

Abstract Background Senegal has made improvements in maternal and child health over the last decades, but disparities in outcomes persist. There is a limited understanding of how vulnerability to poor maternal, reproductive, neonatal and child health outcomes in the country is distributed. As such, this study aims to understand what distinct population segments can be identified among women in Senegal based on multidimensional social, cultural, behavioural, economic, environmental and health-related characteristics and how maternal, reproductive and child health outcomes differ across these segments. Methods This study uses a cross-sectional descriptive segmentation study design based on the pooled data from the 2018 and 2019 Senegal Demographic and Health Surveys (DHS) that included 7816 women who had been in a union and given birth to a child in the prior 5 years which was the study population. The segmentation was done iteratively, with the initial list of variables developed and matched with the DHS together with the Ministry of Health and maternal and child health experts. After assessing the associations between outcomes and variables of interest, principal component analysis was used to reduce the number of variables and latent class analysis to create segments based on the fit of the model. Results We found 9 segments that were differentiated by urban or rural location and varying vulnerability to poor reproductive, maternal, neonatal and child health outcomes. The segmentation findings show deep health disparities among women in Senegal, with substantial heterogeneity in health behaviours, service utilisation, and structural determinants across population groups. Conclusions The segment-level analysis of Senegalese women reveals entrenched inequalities in health service access and maternal and child health outcomes. Achieving meaningful progress will require a shift from national-average targets to equity-oriented, data-driven, segment-specific strategies combining health system strengthening, sociocultural interventions, and broader socioeconomic development.