African women, the unsung heroes of the continent’s health

LUSAKA – Women and young girls in Africa face multiple health challenges as a result of the roles they play in society, as little or no attention is given to ensure they get access to good-quality healthcare, health specialists say.

 This was said at a side track running under the theme “For Women by Women: Access to adequate healthcare for young girls and women in Africa” at the 3rd International Conference on Public Health in Africa held in Zambia this week. 

 The conference ran under the theme: Breaking Barriers: Repositioning Africa in the Global Health Architecture. 

 Addressing delegates, scientists, health practitioners, and several health directors from various global institutions, microbiologist, politician, and former minister, Professor Nkandu Luo, said that because of the roles women play, they have become susceptible to diseases.  

 “Women are likely to suffer from respiratory diseases because of the nature of the work they do. Women spend most of their time cleaning houses or tilling the land. Women are exposed to house dust and environmental pollutants. We don’t even do research on that,” she said.

  Luo further stated that women are at a greater risk of dying in sub-Saharan Africa than in any other region of the world.

  Women are likely to die much earlier than men because of the pressures they go through, including psychological pressures and the heavy work burden that they have.

  What they all share is a recognition that their sickness is somehow caused by situations they face every day at home and at work.

 The former minister in the government of Zambia said women are caregivers in the home, an unpaid job that has also exposed women to contracting diseases. 

 “Women suffer from common infections because of sitting at the bed of the sick,” she said. 

“The women are the carers in the home and in hospitals it’s women that care. I recall when we were fighting the HIV epidemic, women were the ones who were caring for the sick. If the man is sick, the woman will stand by him until his death. But if it is a woman who is sick, the man will find it possible to ask for the mother, auntie, sister, or grandmother to care for the wife. They are the carers. They are the ones caring for children, for persons living with disabilities, and for everyone technically.

 Professor Luo said women as they carry the burden of child bearing, they have also been exposed to sexually transmitted infections from their sexual partners. Issues to do with sexually transmitted infections is a topic that society is shy to talk about and as such women face the brunt of the stigma surrounding sexual diseases.

 “Women are the highest burden for HPV and AIDS infections. Women are contracting sexually transmitted infections from their sexual partners, and one of them is cervical cancer. These are things we don’t talk about,” Luo said. 

 Luo also noted that many countries have recorded high maternal and infant mortality.

 “In most countries, we measure women’s health through maternal health. There have been improvements in maternal health, but among 15- to 19-year-old girls, they are dying early due to complications in pregnancy and childbirth.

 “The women of Africa have been disadvantaged to the core. The social and economic status of women in Africa is the biggest barrier to women accessing adequate health care” she said. 

 “If you go to the fields, the people that produce the food we eat on the African continent are women. The men are called big commercial farmers, and whatever they produce, we export. Unfortunately, women are entrepreneurs because they are in the informal sector; they are not counted, but they are the ones that drive the economy. They are the household economists, ” she added.

  Luo said access to adequate healthcare for young girls and women in Africa remains a challenge due to several barriers that need to be recognised and addressed.  

 “Women have been disadvantaged, discriminated against, and marginalised, and there is a need to look at the type of empowerment we need to move forward”, she added. 

 Speaking at the same event United Nations Special Rapporteur on the Right to Health doctor Tlaleng Mofokeng highlighted how law and health could impede each other especially with regards to young women’s access to adequate health. 

 Mofokeng cited South African athlete Caster Semenya, as an example that embodied a lot of racism and discrimination when she was forced to take hormonal treatments so as to decrease her naturally occurring testosterone levels in order for her to compete in international competitions. 

 “That regulation impacted the racism she was facing as a black woman. Had she refused to take treatment she would no longer be allowed to participate in international competition. This affected her for more than a decade,” Mofokeng said. 

 Speaking at the same event Regional director for Africa for World Health Organisation (WHO) doctor Matshidiso Moeti said women played an extremely important role in all stages of life and household populations and there was need to ensure that they had access, they are in leadership and their own health, wellbeing is protected. 

 “Women constitute 70% of the health workforce globally and deliver healthcare to about five billion people and contribute an estimated three trillion dollars annually to global health. They hold over 80% of nursing over 90% midwifery positions and only 25% of leadership roles in health. That’s a gross inequity,” Moeti said. 

 Currently Zimbabwe is battling cholera and women are the primary caregivers in Zimbabwe and this can also put them at risk of contracting the epidemic disease that has ravaged not only Zimbabwe but over 18 countries according to the report by Centers for Disease Control and Prevention (Africa CDC). 

 Public health specialist and Medical Director for Mashonaland West Celestino Dhege in an interview agreed that women and young girls were generally disadvantaged in the society on issues to do with access to adequate health. 

 “When an area has outbreaks of diseases such as cholera, obviously they can negatively affect women. The ministry of health has employed village health workers who are playing a critical role and in doing so are also conscientising other women and young girls on how best they can access health care,” he said. 

 Dhege said the ministry of health in Zimbabwe has put in place measures and policies to ensure women are empowered and they have access to adequate health. 

 “Women and young girls are generally disadvantaged. They constitute 50% of the population but in the employment sector there are less women. The work they do such as vending and subsistence farming is informal and this kind of work is not well remunerated,” he said. 

 “A lot of women travel long distances to access health facilities. Decisions to access health care are made by men and sometimes that could be a disadvantage to a woman,” Dhege added. 

 Dhege further said the religious sector was another area which affected women to access sexual and reproductive health services thereby adversely affecting women’s health.

 Dhege said policies have been put in place in terms of education and there is an improvement and girls are now going to school. 

“In terms of education, yes it’s improving, girls are now going to school but they don’t go to the highest level of their education which can compromise their health seeking behaviour,” he said. 

 “Women have a lot of roles to play, looking after the family, looking after the health of the family is their responsibility. In that regard it means that they can actually ignore their health to a great extent focusing on the children’s health, the husband’s as well the family at large. They might not find time to consider their health as a priority” Dhege added. 

 Dhege added that the ministry has come up with integrated outreach delivery of services whereby services are delivered at the doorstep in the villages, an approach that is reducing the distance women travel, facilitating access to health care. 

“The ministry has come up with gender sensitive policies to ensure that women have access to maternal and child health care services close to their home,” he said. 

 “Screening of cervical cancer is being decentralized to almost the lowest level. The introduction of DNA PCR for HPV testing is actually helping women to take samples at their homes which will be collected, processed and results will be delivered to their nearest clinic. 

“The introduction of the HPV vaccine for young girls is a very positive development because it does prevent later on the development of cervical cancer. It’s one of the critical measures that the ministry has taken to ensure women’s health is taken care of”, Dhege said. 

 Health systems specialist and deputy Director of Policy, Planning and Health Economics Tonderai Kadzere,  in an interview in Zambia said in public health and even in global health, issues of health equity is something very critical, ensuring  that everyone, everywhere has got access to quality health care services regardless of their gender, ethnicity and even ability to pay. 

 “We cannot achieve health equity without addressing the issues of gender. Gender is one of the major determinants of health. Being a woman, being a girl or a man itself is a risk on its own in terms of health care issues. The new public health order that Africa CDC is moving is now mainstreaming gender in health care. 

 Kadzere also emphasized the importance of research on issues to do with health saying it was a key principle which  had made the government to be able to come up with effective health care policies.