Women’s health: Recognising the invisible crisis on the continent

Microbiologist and former Zambian Cabinet minister Nkandu Luo addressing delegates at the third International Conference on Public Health in Africa held in Lusaka, Zambia, recently.

MIRRIAM Maungwa (34) looks older than her age.

For the past decade, the mother of three has been the chief labourer in their small-scale tobacco production business in rural Nyazura.

She suffered a respiratory-related ailment a few years ago and has since recovered.

“I have been into tobacco production since I got married about 10 years ago. From the seedbed to the tobacco floors, I am involved. I had a serious cough two years ago due to tobacco; it was a bad experience, but I have since recovered,” said Maungwa.

This is not Maungwa’s predicament only, but several women and girls in Africa face multiple health challenges because of the roles they play in society with little to no attention being given to ensure they get access to quality healthcare.

Microbiologist and former Zambian Cabinet minister Nkandu Luo told delegates at the third International Conference on Public Health in Africa held in Lusaka, Zambia, recently, that most women are susceptible to diseases because of the roles they play.

 “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. They are exposed to house dust and environmental pollutants. We don't even do research on that," she said.

“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 everyday at home and at work.”

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

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

"Women suffer from common infections because of sitting at the bed of the sick. They are the caregivers in the homes and in hospitals. 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 the mother, aunty, 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,” she added.

According to the World Health Organisation, women constitute 70% of the health workforce globally, deliver healthcare to about five billion people and contribute an estimated US$3 trillion annually to global health. They also hold over 80% of nursing jobs, over 90% midwifery positions and only 25% of leadership roles in health. 

Dr Matshidiso Moeti - World Health Organization (WHO) Regional Director for Africa

United Nations Special Rapporteur on the Right to Health Tlaleng Mofokeng highlighted how law and health can impede each other especially with regards to young women's access to adequate health.

United Nations Special Rapporteur on the Right to Health Tlaleng Mofokeng

Mofokeng said South African athlete Caster Semenya encountered racism and discrimination when she was forced to take hormonal treatment to decrease her naturally occurring testosterone levels for her to take part in international competitions.

"That regulation exacerbated 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 competitions. This affected her for more than a decade," Mofokeng said.

Zimbabwe is currently battling a cholera outbreak with women being the primary caregivers putting them at risk of contracting the epidemic disease that has ravaged over 18 African countries according to the report by Centres for Disease Control and Prevention (Africa CDC).

Public health specialist and Mashonaland West provincial medical director Celestino Dhege in an interview said women and young girls were generally disadvantaged in 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 Health ministry 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 healthcare.

"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 are made by men and sometimes that could be a disadvantage to a woman.

"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 ignore their health to a greater 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.”

Health systems specialist and deputy director of policy, planning and health economics Tonderai Kadzere added: "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 healthcare issues. The new public health order that Africa CDC is moving towards is now mainstreaming gender in healthcare.”

He also emphasised the importance of research on issues to do with health saying it is a key principle which has made the government able to come up with effective healthcare policies.

But in Chitenderano area, in Nyazura, Maungwa feels her contribution to their tobacco farming business is all that is needed. Getting a cough is a primary thing to her as she thinks it is part of her everyday life.


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