The maternal mortality ratio is unacceptably high in Africa. Forty per cent of all pregnancy-related deaths worldwide occur in Africa. On average, over 7 women die per 1,000 live births. About 22,000 African women die each year from unsafe abortion, reflecting a high unmet need for contraception. Contraceptive use among women in union varies from 50 per cent in the southern sub-region to less than 10 per cent in middle and western Africa" UNFPA

Early and unwanted childbearing, HIV and other sexually transmitted infections (STIs), and pregnancy-related illnesses and deaths account for a significant proportion of the burden of illness experienced by women in Africa. Gender-based violence is an influential factor negatively impacting on the sexual and reproductive health of one in every three women. Many are unable to control decisions to have sex or to negotiate safer sexual practices, placing them at great risk of disease and health complications.

According to UNAIDS, there is an estimated of 22.2 million people living with HIV in Sub-Saharan African in 2009, which represents 68% of the global HIV burden. Women are at higher risk than men to be infected by HIV, their vulnerability remains particulary high in the Sub-Saharan Africa and 76% of all HIV women in the world live in this region.

In almost all countries in the Sub-Saharan Africa region, the majority of people living with HIV are women, especially girls and women aged between 15-24. Not only are women more likely to become infected, they are more severely affected. Their income is likely to fall if an adult man loses his job and dies. Since formal support to women are very limited, they may have to give up some income-genrating activities or sacrifice school to take care of the sick relatives.

For more information on HIV/AIDS and Reproductive health, please visit the following websites:

Source: TheEastAfrican

More needs to be done for Tanzania and the rest of the world to end the Aids public health threat by 2030, a newly launched global HIV/Aids report shows.

Although Tanzania has had a positive impact in fighting HIV/Aids, the new report reveals that the key populations in the country still lag behind when it comes to testing and treatment. Launched in Dar es Salaam on Tuesday, the new report titled ‘Dangerous inequalities’ shows early testing, prevention and treatment measures have slowed down, hence Aids-related deaths and new HIV/Aids cases are rising.   

Available data shows there are over 4.9 million people living with HIV/Aids in Tanzania while only 1.3 million are on treatment. According to UNAIDS data, Tanzania has over the past ten 10 years consistently reduced new HIV infections and reduced Aids-related deaths by 46.6 percent and 50 percent respectively. Prof Tumaini Nagu, Tanzania’s Chief Medical Officer, noted that although the country has made progress, more needs to be done since with the new report findings, it is evident that some key populations — including adolescence girls — have been left behind.

"50 percent is a good progress but we haven't really made progress when it comes to adolescent girls, which is actually what our strategic health plan requires us to do. That is why we are currently targeting them together with other groups such as migrants, fisheries, people living in rural areas for we cannot fight the epidemic disease with one-size-fits-all kind of solution," she said.

On her part, Winnie Byanyima, Executive Director for the Joint United Nations Programme on HIV and Aids, (UNAIDS), commended Dodoma’s efforts in the fight against HIV/Aids. “Tanzania is the leader, a strong performer in the fight against this disease. The country has succeeded in reducing new infections by almost 50 percent and successful treatment scale up has led to over 50 percent reduction in the number of Aids-related deaths,” said Ms Byanyima.

New infections rising

“The world is not on track to end the Aids pandemic.  New infections are rising and Aids deaths are continuing in too many communities. Inequalities are holding us back,” added Ms Byabyima. The report shows that gender inequalities, inequalities faced by key populations and inequalities between children and adults have had negative impacts on Aids response by countries. In sub-Saharan Africa, adolescent girls and young women are three times more likely to get HIV than their male counterparts, according to the report.

“The world will not be able to defeat Aids while reinforcing patriarchy. We need to address theintersecting inequalities women face. The only effective route map to ending Aids, achieving the sustainable development goals and ensuring health, rights and shared prosperity, is a feminist route map. Women’s rights organisations and movements are already on the frontline doing this bold work. Leaders need to support them and learn from them,” added Ms Byabyima

Source:NewsMedical

Women in sub-Saharan Africa continue to have an elevated risk of death following childbirth long after the 42-day postpartum limit the WHO uses to define pregnancy-related deaths, a new analysis shows.

Researchers analyzed data from 12 sub-Saharan African countries to examine whether the 42-day definition accurately captures deaths following childbirth.

The analysis found that while the risk of death fell substantially throughout the 42-day postpartum period (relative to a comparison period of 12-17 months postpartum) the risk of death was still estimated to be 20% higher from 42 days to four months following childbirth. This has major policy implications for the improvement of maternal health in sub-Saharan Africa and other low- and middle-income countries.

The team included researchers from the London School of Hygiene & Tropical Medicine (LSHTM), the Medical Research Council Unit The Gambia at LSHTM and the Kenya Medical Research Institute-Center for Global Health Research. The research is published in The Lancet Global Health.

It's vital that we have up-to-date evidence and action to make childbirth safer for every woman. To measure pregnancy-related deaths, there must be a time limit on the definition but it is concerning that the risk of death remains 20% higher from 42 days until around four months after childbirth. In light of this, we are calling for the WHO to extend the 42-day postpartum limit currently used in the definition of pregnancy-related deaths. Our results also suggest that national and international guidelines for postpartum care should include visits beyond 42 days for women who experience chronic morbidity."

Ursula Gazeley, Lead Author, LSHTM

Dr Momodou Jasseh, author from MRC Unit The Gambia at LSHTM, said: "This demonstration of an increased risk of death for mothers beyond 42 days postpartum in Sub-Saharan Africa suggests that the true burden of pregnancy-related mortality may be substantially underestimated in the region. Unless concerned governments commit to enhancing health management information systems that generate the requisite data on maternal outcomes after 42-days postpartum, the real burden will remain elusive."

Dr Sammy Khagayi, author from the Kenya Medical Research Institute, said: "Despite the reduction in mortality around childbirth for both mothers and babies in areas with limited resources like Western Kenya, it is vital to go a step further to provide quality care for the mothers beyond the recommended postpartum period. Ante- and post-partum pregnancy monitoring would go a long way in reducing late maternal deaths. This will be achieved if we invest in data collection platforms to monitor and track women from pregnancy to 6 months postpartum."

This large, multi-country study analyzed almost 30 years' worth of data from 1991-2020, from 30 Health and Demographic Surveillance Systems (HDSS), across 12 African countries. In total 647,104 births and 1,967 deaths within one year of giving birth were recorded in the HDSS.

This analysis was based on deaths after childbirth from any cause. To plan interventions and prevent deaths, the authors call for urgent further investigation on the causes of death after 42 days postpartum in low- and middle-income settings.

Limitations of the research include that HDSS data do not always include pregnancy reports and so the analysis did not include pregnancy-related deaths before childbirth, which is likely to underestimate maternal risk.

The research was funded by the UK Economic and Social Research Council.

Source:africanews

Moroccan women demonstrated outside parliament in the capital, Rabat, yesterday calling for abortion to be legalised.

The protest on International Safe Abortion Day came weeks after a teenage girl, Meriem, died in a village in the centre of the country following a clandestine termination.

Abortion is illegal in Morocco and is punishable by up to five years in prison, except in cases when the woman's health is in danger.

As the activists honoured the teenager with posters saying ‘We are all Meriem’, they urged lawmakers to make the termination of pregnancy a legal option for women.

‘There are many who die every month, every year for the same reason, because of clandestine abortions, and they are not listened to, not even considered. They’re not honoured, as today we honour Meriem and those who died like her,’ said activist Sarah Benmoussa.

She added that they were also trying to create a stable and healthy environment for all other women who might find themselves in the same situation, with an unwanted pregnancy.

Having a child, the women said, must be a choice. ‘We're here today because our voices matter,’ said Khaoula, a 23-year-old journalism student, ‘Every human being should be able to control their own body.’

Call for law to change

Faced with hundreds of clandestine abortions performed daily, in 2015 the Moroccan government debated the need to review the legislation.

An official commission recommended that the termination of pregnancies be legalised in special circumstances, but no reforms followed, despite lobbying by women's rights activists.

‘We renew this call today,’ said Fouzia Yassine from Spring of Dignity, a coalition of Moroccan feminist associations, ‘Lawmakers bear responsibility for this situation and for the violence and hardships the women endure.’

Concerns following US ruling

The recent United States Supreme Court decision to strip women of the right to have an abortion has raised concerns globally, with many asking if the same could one day happen in their country.

It is estimated that tens of thousand of women die each year from complications resulting from unsafe practices to terminate a pregnancy.

Across the world yesterday, women and men took to the streets to highlight the need for abortion to be an inalienable women’s right.

Source: Human Rights Watch

L’Union Africaine devrait fournir des lignes directrices et encourager des réformes politiques afin de garantir que les filles puissent poursuivre leur scolarité.

Source: TV5 Monde

En Sierra Leone, l’avortement est interdit sauf si la vie de la femme est en danger. C’est aussi l’un des pays où le taux de mortalité maternelle est l’un des plus élevé au monde. Face à ce constat, le président lui-même s’est engagé à faire bouger les choses. Le gouvernement a approuvé une nouvelle loi pour une “maternité sans risque”, qui sera soumise prochainement au vote du Parlement: légaliser l’avortement, et ainsi révoquer une loi qui remonte à 1861.

SOURCE: DW

The abortion debate in Africa is going in the opposite direction to the one in the US. Experts say that legislation in countries such as Benin and South Africa is becoming more progressive. But there are exceptions.

SOURCE: The Conversation Africa

Adolescent girls and young women in sub-Saharan Africa have a very high risk of acquiring HIV. The latest global AIDS update report suggests that a staggering six out of seven new infections among 15-19-year-olds in sub-Saharan Africa are among girls.

Entrenched gender inequalities make young women and girls more vulnerable to coercive behaviour that leaves them unable to negotiate safe sex.

But there is a method for adolescent girls and young women to protect themselves from HIV without having to convince a partner to use a condom at the time of sex. Pre-exposure prophylaxis, or PrEP, is a pill containing antiretroviral drugs that can help prevent HIV. If taken consistently, PrEP can reduce the risk of sexually transmitted HIV infection by about 99%.

HIV prevention medication has been part of HIV prevention efforts since around 2014. Globally, PrEP has contributed to declines in new HIV infections among high-risk populations. But this does not seem to be the case for adolescent girls and young women in sub-Saharan Africa.

In a recent study, my colleagues and I at the Manicaland Centre for Public Health Research interviewed healthcare providers in eastern Zimbabwe to understand the low uptake of PrEP and what they would recommend to improve it.

Insights from healthcare providers

We asked 12 healthcare providers about their experiences of making HIV prevention services available to young people. We asked them specifically about PrEP. We also invited the healthcare providers to share their top three recommendations for improving access to PrEP for young women.

This is the first study of its kind to focus on the perspectives of healthcare providers in southern Africa. Considering their perspectives is particularly important. Healthcare providers are not only at the front-line in the delivery of PrEP. They often live in the same community and understand the socio-cultural contexts of their clients. This combination of experiences is valuable and must inform future programming.

Their recommendations point to six actions.

  • Run PrEP awareness campaigns, specifically at schools, giving adolescent girls and young women information about PrEP and how to access it. The campaigns would also have to debunk myths about PrEP only being for women engaged in sex work – a common myth in the study area – as well as fears about potential side effects. Campaigns targeting adolescent girls and young women must be accompanied by community campaigns. These should encourage parents to talk to their children about HIV prevention methods, including PrEP, and to shift community perceptions about PrEP as a pill that encourages promiscuity.

  • Involve adolescent girls and young women in the rollout of PrEP. Young women must design, feature in and deliver the awareness campaigns. Young women need role models of peers on PrEP.

    • Eliminate costs associated with PrEP uptake. PrEP is freely accessible in many sub-Saharan African countries. But getting to the clinic, taking time off work to go to the clinic for refills and monitoring, and getting registered at the clinic may come at a cost. In resource poor settings, these small associated costs can be prohibitive and need to be eliminated, either through reimbursements or through an incentive-based payment system.

    • Strengthen the human resource capacity of health services to deliver PrEP. PrEP is still relatively new in many sub-Saharan African settings, including Zimbabwe. Although PrEP has been available in Zimbabwe since 2018, it has been limited to certain population groups through demonstration projects. PrEP services to adolescent girls and young women are still limited and in their infancy. A young woman looking for PrEP is therefore unlikely to find specialised and dedicated staff who is ready and available to assist. Investments are needed to make available a cadre of trained prescribers who can deliver PrEP to young women in a professional and timely manner.

    • Make PrEP services youth and female friendly. Strong gender norms subject many adolescent girls and young women in sub-Saharan Africa to different forms of social control around their sexuality. The healthcare providers recognised their role in this. Young women fear going to the clinic, worried they might be seen by community members. They also fear the attitudes and indiscretions of healthcare providers, who may disapprove of a young girl’s use of PrEP, and may tell parents that their girl is sexually active. Healthcare workers fully recognise these challenges and call for the delivery of PrEP through sexual and reproductive health hubs that are discreet, youth friendly, and staffed by young and sex-positive healthcare workers. They also recognise that such services must be open outside school hours if they are to reach adolescent girls.

    • Improve the PrEP pill and its packaging. The pill is big and some people find it uncomfortable to swallow. Some may also experience significant side effects. Its packaging challenges secret PrEP use.

    Looking ahead

  • A recent report by the Zimbabwe Ministry of Health and Child Care found young women to have an HIV incidence more than nine times higher than that of their male peers. HIV prevention service planners looking to increase access and uptake of PrEP among adolescent girls and young women in Zimbabwe and elsewhere in the region must take heed of these findings.

    Many more actions will of course be needed for the effective rollout of PrEP for adolescent girls and young women in sub-Saharan Africa.

    However, the six actions emerging from our interviews with healthcare workers in Zimbabwe highlight solutions to some key challenges.

Source: Agence Mauritanienne d'Information

L’Association Mauritanienne pour la Promotion de la Famille, en partenariat avec l’Union Internationale pour l’Organisation de la Famille (région du monde arabe), a organisé, lundi à Nouakchott, un atelier sur les mutilations génitales féminines et l’attitude de la religion par rapport à cette pratique.

ATTENTION: Mentions de viols et violences sexuelles

Source: rfi

La décision de la Cour Suprême américaine de révoquer le droit à l’avortement fait réagir jusqu’en Afrique. Sur le continent, l’interruption volontaire de grossesse (IVG) reste interdite dans une grande majorité de pays. C’est le cas en Côte d’Ivoire par exemple, où l’avortement n’est autorisé qu’en cas de danger pour la vie de la mère ou en cas de viol et d’inceste. Une proposition de loi est toutefois en préparation pour libéraliser les IVG, mais ce n’est pas encore gagné.

SOURCE: UNFPA 

SELOKOLELA, Botswana/UNITED NATIONS, New York – “Menstruation is still considered a secret that is hardly discussed,” Ogaufi Moisakamo, in Botswana, told UNFPA. “When I got my first period, I was also ashamed of informing my mother. And when I finally told her, she only warned me against playing with boys as it would ‘get me pregnant’.”

SOURCE: Concord

The United Nations children’s Fund (UNICEF) has warned that menstrual health and hygiene management is still out of reach, particularly among the poorest, ethnic groups, refugees, and people with disabilities in sub-Saharan Africa.

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