Exploring the Layers: Unpacking African Women's Health Challenges
By Sokona Sy, Lydia Nobert, Serge Bataliack and Humphrey Karamagi
Every year, on March 8th, International Women's Day is celebrated worldwide. For many women in the Region, this day signifies much more than just an opportunity to don their finest garments and be exempted from household chores. It is a powerful reminder of the ongoing battles for gender equality and the complex, often distressing realities that women face. Specifically, the health of African women is a significant concern. They contend with disproportionately high mortality rates, far exceeding those of other global regions.
Additionally, violent and destructive practices such as female genital mutilation persist in specific communities, while gender-based violence continues rampant. These issues resonate with the urgency to raise awareness and advocate for women's rights in the African Region. This blog post emphasizes that celebrating women's rights is not limited to one day a year but should be an ongoing commitment. It underscores the need to defend and safeguard these rights, combat inequalities, and improve the health and well-being of African women.
Diverse Health Challenges Across Age Cohorts for African Women
The young girls and women in the African Region face distinct challenges depending on the age cohort. In 2021, approximately 168.2 million girls aged between 0 and 9 were counted in the African Region, making up 29% of the total female population. When examining causes of death and mortality rates, these numbers are like those of boys. However, there's a notable divergence between genders during adolescence, particularly concerning HIV/AIDS. In 2022, every week saw, 4,000 adolescent girls and young women aged 15 to 24 contract HIV worldwide, 3,100 of these infections occurring in sub-Saharan Africa. Adolescents also experience significant complications from pregnancy and childbirth, especially in the Region's low- or middle-income countries. The disparity becomes evident in women of reproductive age compared to women from other regions. Women in the African Region are more likely to die from communicable diseases (such as HIV, tuberculosis, and malaria), maternal and perinatal conditions, and nutritional deficiencies. Despite a substantial
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reduction of approximately 38% in maternal mortality rates since 2000, rates remain high in sub-Saharan Africa, the highest globally.
Regarding non-communicable diseases, one out of four deaths among adult women can be attributed to conditions like heart disease, cancer, and diabetes. Despite the availability and recognition of this data, services remain inadequately accessible in numerous African countries. Lastly, it's important to note that the risk for a sub-Saharan African woman to develop cancer before age 75 is 14.1%, with breast cancer (4.1%) and cervical cancer (3.5%) being the most prevalent. In 2018, 19 out of the top 20 countries with the highest cervical cancer rates were in sub-Saharan Africa. Furthermore, Africa is the Region where women face the highest risk of being killed by an intimate partner or family member (3.1 female homicides per 100,000 women).
Sociocultural factors hindering women and girls from accessing quality healthcare services
Health, influenced by gender, can significantly impact health outcomes. The health of women and girls is mainly affected by the disadvantages they face due to discrimination, power imbalances between men and women, exclusive focus on women's reproductive roles, and emotional and sexual violence against them. Indeed, various social, economic, and cultural factors influence women's health in Africa. The complexity of this issue is illustrated by female genital mutilation (FGM). Between 2012 and 2020, around 35% of girls and women aged 15 to 49 underwent female genital mutilation in the African Region, including approximately 16.7% of girls aged 0 to 14.
The top ten countries (for girls and women aged 15 to 49) in the Region with highest FGM are Guinea (94.5%), Mali (88.6%), Sierra Leone (83%), Eritrea (83%), Burkina Faso (75.8%), Gambia (72.6%), Mauritania (66.6%), Ethiopia (65.2%), Guinea-Bissau (52.1%), and Côte d'Ivoire (36.7%). Conversely, around 72% of girls and women aged 15 to 49 opposed female genital mutilation in the African Region (2013-2021). In this case, differences between various stratifications in certain countries are minimal (namely education, ethnicity, residence, and wealth quintile), highlighting the significant roles society, culture, peer pressure, and the environment we live in play in health issues.
This reinforces that when it comes to women's health, a multisectoral approach is essential. It should encompass a wide array of data (socio-determinants for health, universal health coverage, etc.) while enhancing the responsiveness of healthcare systems to meet the specific health needs of women.
For more information:
Atlas of African Health Statistics 2022
iAHO’s fact sheet on FGM in the African Region
iAHO’s fact sheet on maternal mortality in the African Region
WHO’s Women's Health fact sheets
United Nations International Women’s Day