In the Ranérou department, in the sylvo-pastoral zone of Ferlo, access to healthcare for adolescents remains a major challenge despite Senegal's efforts to decentralize health services. Covering an area of over 15,000 km², Ranérou is the second largest district in the country, but paradoxically one of the least equipped in terms of socio-economic infrastructure, particularly health infrastructure. Limited health provision in the face of pressing demand Mansour Diop, the first head nurse of Ranérou and former mayor of the commune in 2002, testifies to the progress made thanks to policies and programs supported by NGOs, with the construction of around ten health posts, each staffed by a nurse and a midwife. However, he highlights an alarming reality: "Several localities in the department, which has a population of approximately 103,203, remain without health facilities. » In 2023, Ranérou had only 2 general practitioners, 15 state midwives, and 29 nurses and assistants, an insufficient number to meet the needs of a dispersed population. Adolescents, the system's great forgotten care. The care of adolescents is particularly problematic. Services adapted to their needs are rare and concentrated in large health centers. Mansour Diop says: "Recently, I received a young, unmarried pregnant girl. I educated her mother against abortion and referred the teenager to a health center for prenatal monitoring." Adolescents, often accompanied by their mothers, must travel long distances to access these consultations. Achétou Babou, former midwife and president of the departmental women's consultative committee (Bajeen Gokh), draws a worrying observation: "Access to care for adolescents is limited, both medically and behaviorally. There is no center dedicated to adolescents in the department. » In the south of Ranérou, the lack of suitable infrastructure is glaring. Teenage pregnancies, common in middle and high schools, are aggravated by sociocultural obstacles and stigma, which discourage young girls from seeking care. Initiatives to counter the shortcomings To address these shortcomings, the committee led by Achétou Babou has set up an alert system. "We organize talks to raise awareness among adolescent girls about their sexual health, contraception, and to deconstruct myths," she explains. These actions aim to combat early marriage, a cultural practice that is still widespread, and to meet the specific needs of adolescent girls, who are more vulnerable than their male counterparts, although the latter also require support. A call to action Faced with this "obstacle course," local stakeholders are calling for the strengthening of health infrastructure and the creation of centers dedicated to adolescents. Improving access to healthcare, particularly for young girls, remains crucial to breaking down sociocultural barriers and reducing teenage pregnancies in this region where structural challenges are hampering health development.