LET US FOCUS ON WOMEN'S HEALTH

Dear All,

Lets us discuss the health of women, who are our mothers, sisters, and colleagues.

Women and men are inseparable partners in ensuring the continuity of humanity. Women as mothers have unique roles from conception, pregnancy, and childbirth. They are the pillars of families providing helpless newly-born children with critical nutrition and support. Women also provide men and children with homes where the characters and values of people are shaped and communities are built. It is evident that giving priority to the health of women must take center stage in all societies and health systems.
Reproductive health is defined by WHO as “a responsible, satisfying, and safe sex life with the capability to reproduce and the freedom to decide if, when, and how often to do so”. There are health risks at every stage of the cascade in this definition which call for support from the health system and society. These risks include infections, fistula, infertility, and unwanted pregnancies with related mental health implications that impact women’s wellbeing and power dynamics in society.

Women also have cancers and tumors affecting the uterus and cervix, ovaries, and breast, and aging in women comes with post-menopausal disorders and decalcified fragile bones.

Sub-Saharan Africa (SSA) made significant progress during the MDG period with women’s health indices when maternal mortality (MMR) and morbidity declined by 45%. However, this still leaves Africa far behind other regions of the world. The current MMR figures for SSA average 1000 deaths per 100,000 births compared with 25/100,000 in other regions; is a matter of concern and shame.

Annually, half a million women die as a result of complications of pregnancy and childbirth. 99% of these deaths occur in developing countries, where preventable pregnancy-related complications remain leading causes of death for women during reproductive years. These include hemorrhage, infections, pre-eclampsia, ectopic pregnancy, and obstructed labour resulting in obstetric fistula afflicting mostly teenage mothers with devastating health and social consequences.

The WHO definition of reproductive health makes no reference to the menstrual cycle; an important component of women’s health. This is a cyclical physiological phenomenon when the uterus prepares for pregnancy. If pregnancy does not occur, the uterus is very disappointed and sheds tears of blood; discarding the carpet that was prepared for the arrival of the new baby which is the bleeding during the monthly period. Proper management of periods is an important subject in women’s health. The period has a financial cost for accessing period products, there are opportunity costs when women and girls cannot attend a school or other activities due to period-related issues. Period management and access to period products should become a national issue so that facilities are made available for women and girls as needed. In 2021, Scotland became the first country in the world to make period products free for anyone who needs them, and some countries, including Africa, have eliminated the tax on period products. There should be a global campaign to de-stigmatize menstruation and increase easy and free access to period products.

What should SSA countries do to achieve SDGs related to women’s health?

The first step is to raise the place and value of women in African societies. African communities should know that maternal deaths are preventable and are not acts of God. They should cause their governments to prioritize women’s health and fully implement to scale well known Safe Motherhood practices. Each death in every health facility and every village should be fully investigated and lessons learnt and shared with communities. It is well known that the acid test of a well-functioning health system is one that can mount a safe maternal delivery including and an obstetric emergency in the middle of the might. It is also known that countries with the highest maternal mortality rates are also those with the lowest use of family planning methods. Therefore, access to these services through effective Community Health programs is a high priority. Family planning prevents adverse outcomes and maternal and newborn deaths by reducing women’s exposure to high-risk pregnancies and unintended and closely spaced pregnancies. Family planning will also support the achievement of the demographic dividend in countries by lowering the high population growth rates.

How can other sectors help?

There are important interventions in other sectors that contribute to improving women’s health; including ensuring that all girls are supported to go to school for as long as possible. The Whole of Society Approaches should also be employed to engage cultural and religious leaders. The media are an important player in getting messages out to the population and keeping the visibility of women’s health high at all times so that it becomes an issue over which political elections are won and lost in countries and the quality of leadership is judged. Healthy women make happy communities and societies.

What do say?

Francis.