Gender and Health

1
Gender and Health

• H.E. ADV Bience Gawanas
• Commissioner for Social Affairs, AUC

2
Overview

• Introduction
• Gender and the health related MDGs
• Gender and health and the context of Africa
• Successes
• Challenges/Gaps
• Issues for discussion

3
Introduction

• The Constitutive Act of AU has objectives
  specific to gender, health and development in
  Africa
• Gender is important to the causes and
  consequences of inequity in health
• Not just biological, such as hormones, but also
  social and cultural.
• Lower social autonomy of women exacerbates their
  biological vulnerabilities to infections such as
  HIV and malaria

4
Introduction

• It is therefore important to distinguish between
  possible biological and social and cultural
  factors to the causation of ill health
• A gendered approach to health therefore leads to
  appropriate responses from the health care system
  and from public policy.
• Womens health is not just about their
  reproductive functions

5
Gender and the Health Related MDGs

• MDGs identified as health related include
• Goal 1 Eradicate extreme poverty and hunger
• Women and girls are over represented among the
  poor, 70 of the poor in the world are women.
• Allocation of food and nutrition often biased
  against women and girls young girls suffer brunt
  of malnutrition

6
Gender and the Health Related MDGs

• Goal 4 Reducing child mortality
• Child health and well-being, including
  nutritional health tied to the health, and mental
  health of their mothers.
• Goal 5 Improving maternal health
• Young girls are still being married off before
  they are physically and emotionally mature
• Link between education of girls and initiation of
  child bearing, number of children, attendance at
  antenatal clinics, and where deliveries are had

7
Gender and the Health Related MDGs

• Goal 6 Combating HIV and AIDS, Malaria and TB
• There is a breakout session on HIV and AIDS and
  gender
• Women more vulnerable to malaria infections, but
  interventions focus on intermittent treatment in
  pregnancy
• Financial security
• Women are the carers, whether sick of not

8
Gender and the Health Related MDGs

• Goal 7 Ensuring environmental sustainability
• Access to safe drinking water and improvement in
  the lives of slum dwellers are the targets
• Goal 8 Global partnership for development
• Access to affordable medicines, often not
  engendered
• Access to social protection and employment

9
Gender and the Health Related MDGs

• Although Goal 2 on education is not considered to
  be health related, health of a household is
  directly related to the educational attainment of
  the mother
• Goal 3 on gender equity is also integral to
  womens health the social position of women,
  violence against women issues, trafficking, early
  marriage, and other harmful traditional practices
  

10
Africa, Gender and Health

• Poverty, conflicts, HIV and AIDS
• Very young populations, 50 made up of children
  and youth
• High rates of orphans and vulnerable children,
  from conflicts and HIV and AIDS
• Resulting in low social and human capital
• Human resources for health crisis internal
  migration from rural to urban areas, from public
  sector to HIV AIDS programs and projects, and
  external migration from Africa to the diaspora

11
Africa, Gender and Health

• Poverty leads to poor health systems poor
  access, poor quality of care. Highest rates of
  maternal mortality ratios globally are found in
  this region
• Alcohol and drug abuse rates are high in the
  region, women in the region use and abuse alcohol
  at high rates. Abuse of alcohol and drugs is
  linked to increased vulnerability to HIV
  infection

12
Africa, Gender and Health

• Alcohol and drug abuse programs often do not
  admit women, women often do not seek care, women
  who abuse alcohol and drugs are often stigmatised
  by health care workers,

13
Successes

• Endorsement by African Heads of State and
  Government of the Africa Health Strategy and
  Maputo Plan of Action on Reproductive Health
• Regional economic and health communities are at
  different levels of developing and implementing
  specific strategies All countries are scaling up
  towards universal access to primary health care
• All countries are scaling up towards universal
  access to primary health care

14
Successes

• The Pharmaceutical Manufacturing Plan for Africa
  was adopted in 2007 to promote access to
  affordable medicines
• Many countries offer free or subsidized sexual
  and reproductive health care services and
  commodities, affordable health services for rural
  communities, training of grassroots health
  workers
• Many countries are implementing the Roadmap on
  Reducing Maternal, Infant and Child Mortality
• Increase in contraceptive prevalence from 12 in
  1990 to 21 in 2005.

15
Challenges

• Rates of maternal mortality are still high, 13
  countries still have MMR over 1000 per 100,000
  live births
• Inequitable distribution of health care services,
  especially in the rural areas
• Womens health taken to refer to only
  reproductive functions, so other aspects, like
  mental health or access to ART when not in
  context of PMTCT is inequitable

16
Challenges

• Health care providers, although majority are
  women, are often gender blind, not inquiring
  about violence, or about HIV, or about alcohol
  and drug abuse, nor do they screen for common
  mental disorders, such as depression and anxiety
• Financing of health care is gender blind, not
  possible to track if women have access to same
  resources as men in relation to health care when
  it is not reproductive health care

17
Issues for Discussion

• Tracking of the MDGs indicators for the most part
  is not gender disaggregated, is it feasible to
  have all MDG data disaggregated for gender?
• Should institutionalisation of engendered
  tracking of all health financing be introduced?
• What models do we have for reducing maternal and
  child mortality in the region, how can they be
  scaled up and replicated in other countries?
• Determinants of health are multi-sectoral, how
  can key sectors work together to deliver a
  holistic health care package to all African
  women?
• How can men be mobilised to promote health for
  all and a society free of gender based violence?