Sub-Saharan Africa has over 500 million women who make up about fourteen percent of the female population in the world and half of the continent’s population. Most of these women are faced with challenges in their daily lives due to disparities like them having a lower status than men in every sphere of life. Important gaps exist in reproductive and maternal healthcare services distribution among women living in sub-Saharan Africa. This paper aims to show some of the disparities faced by women living in this area, explain some determinants of health, mention some interventions that are being used and some that are being introduced, and offer some recommendations that will aim at improving some of the policies. According to Pons-Duran et al, (2018) maternal and reproductive healthcare for women living in Sub-Saharan Africa is inadequate and can barely meet the goals set globally by the post-2015 plan that is Sustainable Development Goals (SDG). The main cause of this issue is due to inefficient and unequal distribution of health care. Women in sub-Saharan account for about two-thirds of global maternal deaths. Despite some of the interventions made between 1990 and 2015, the cases of disparities have not reduced and this has resulted in women who are vulnerable not accessing healthcare services. These women have to undergo pregnancies and the child-bearing process outside of the system of health care.
Key policy issues
In South Africa, the Commission for Gender Equality (CGE) aims at protecting and promoting gender equality, investigating inequality, and investigating complaints on issues relating to gender inequality (CGE, Overview, 2022). They aim at tackling the issue of gender inequality that is affecting most African countries. By investigating inequality they will be able to properly address the issue and come up with initiatives that will help in reducing and eradicating these disparities that mostly are encountered by women. When women facing disparities take their complaints of not receiving proper healthcare to the CGE, the commission can take action against those responsible for discriminating against these women. They help these women get access to public services that they have been denied.
The Policy Brief by the UN Women organization, (2022) explains that over the past two decades the number of social protection programmes in Sub-Saharan Africa has grown. Some countries have achieved universal coverage of some specific social protection implements in like Mauritius and Cabo Verde which have the old-age pension. Due to the gender gaps, this social protection coverage remains low in Africa. Only a low number of women can enjoy the social protection coverage and this is because of the high disparity levels in African regions. Policymakers in this region aimed at reducing and eradicating these gaps by strengthening social protection services and making the coverage broad. According to the UN Women organization, (2022), one of the policies known as “The Africa We Want” by the Addis Ababa Declaration and the African Union was in support of extending coverage on social protection.
The Global Gender Gap Index (GGGI) aims at closing these gaps that cause inequality for women. The main focus of GGGI is participation and creating opportunities in economic, survival, and proper healthcare, women’s political empowerment, and ensuring that there is access to the attainment of education. UNICEF aims at achieving gender equality by preventing early childhood marriages (UNICEF) providing social and healthcare to adolescent mothers, ensuring that the girl child completes their secondary education, and most importantly ensuring that equal opportunities are given to both girls and boys.
According to World Health Organization (WHO) (Maternal mortality, 2022), in the year 2017 eight hundred and ten women died daily from cases related to childbirth and pregnancies due to cases of inequality in the healthcare departments. The other causes that prevent women from accessing quality medical care are due to poverty, lack of information, and limited and poor quality healthcare services. As a result of inequality in Sub-Saharan Africa the Covid-19 pandemic affected the vulnerable groups in these regions the most. According to the Frontier in Global Women’s Health (2021), women and young girls use more preventive health care services unlike men but in such a pandemic they were affected the most as they reported more mental and physical unhealthy problems.
Due to low social-economic backgrounds, the inequality for these women and girls has greatly increased. And the Covid-19 virus may have caused further inequalities in the health and income departments in Sub-Saharan Africa resulting in severe repercussions. Due to the pandemic, there has been limited access to healthcare services, especially in reproductive healthcare. The inequalities following the Covid-19 pandemic brought about an increase in cesarean rates among patients affected by the virus. This caused heightened neonatal and maternal complications that are risky to women. The barriers that limit women from accessing healthcare in the Sub-Saharan region have caused an increase in neonatal health conditions that have brought about an increase in mortality rate and child morbidity in the region. Women forming the workforce in healthcare services during the pandemic region was 65% this also resulted in a high number of deaths of women in the African region this is According to Frontier in Global Women’s Health (2021).
Determinants of health
The determinants of health include gender, socioeconomic, ethnicity, access to health services, and policymaking. According to the (ODPHP) Office of Disease Prevention and Health Promotion (2020) policies set by the local and state governments impact an individual or a population’s health. Policies that aim at offering equal opportunities to both men and women ensure that women do not feel like they have a lower status as compared to men. In Sub-Saharan Africa most women are not given equal opportunities as men this has resulted in them being denied quality healthcare by some institutions. Gender inequality affects women mostly, maternal and reproductive healthcare for women living in Sub-Saharan Africa is inadequate and can barely meet the goals set globally as told by Pons-Duran et al, (2019).
In socioeconomic in African countries, most women are not given job opportunities and they are denied access to some public resources like hospitals. This prevents them from accessing medical care. In some countries like the UK, those from Black and other minority ethical groups experience challenges in accessing healthcare and social care services. The other socio-economic condition is poverty. According to Alamneh et al (2022 p.1), the main barrier to access to healthcare services in Sub-Saharan Africa is the high level of concentrated poverty. Socio-economic inequality as a barrier to access to healthcare in the region was is mainly determined by wealth index, the education level of the husband, area of residency, and a woman’s education level. Given that women are not allowed access to education as they are married off at an early stage in most African countries it becomes hard for them to even attain the education level required to have easy access to healthcare services.
According to the OECD, (2022) some Sub-Saharan African Countries have implemented policies like quotas that inspire the fight for eradicating gender inequality. The number of women participating in making decisions and leadership in these regions has increased. The quotas policy seems to be working since the representation of women in leadership in the countries that have adopted the policy has risen by 10%. Some countries approved the legislative reforms between the years 2014 and 2020. The reform supports the access to finance and ownership of land by women and it addresses gender-based violence. Women’s literacy rates in Africa have a history of being low as compared to that of men. Policies that aimed at reducing the inequality level in the education sector in most countries have been successful. Achieving equality in educational outcomes is a significant achievement, it lays the foundation for the development of African countries and it shows progress in trying to eradicate gender inequality. Despite the government’s effort to try and bridge the education gap, the literacy rate for boys is high as compared to girls. In some African countries, girls are married off at an early age and therefore they cannot enroll in primary schools this is one of the reasons why the gender gap keeps on widening.
Over the years African countries have been known to have a high number of deaths related to maternal births (Pons-Duran et al 2018). Most countries in Africa have tried over the years to reduce maternal mortality ratios and this is seen as an achievement in these regions. The maternal mortality ratio has reduced by 49% per a hundred thousand births and according to the World Bank’s WDI data. However, at this age and time, most maternal mortality is due to abortion, infection, and extreme bleeding after childbirth. Policies that have been set that have helped lower the maternal mortality ratio in Africa have failed since most of this access is experienced by those residing in rural areas. Females in these regions have limited access to skilled personnel and healthcare facilities. Those who lack education and cannot secure any jobs face the risk of maternal deaths due to poverty. Despite the effort of the government, dismal changes have been made in the health sectors in African Countries.
The quotas policy has been successful and we see that many African countries have women as prominent leaders. The government now consists of political leaders who are associated in making decisions that governs the country. These women should encourage the government to formulate policies that protect the girl child and women against disparities. These women are now involved in making laws that govern these regions they should use the opportunity to help women who are vulnerable that is women who reside in rural areas, women who face poverty in their day to day lives, uneducated women, and those who cannot access healthcare services easily.
African countries should strive to enforce the policy that aims at eradicating inequality in the education sector. The government should implement laws that protect young girls from being married off at an early age. This will promote an increase in girls being enrolled in primary schools. In countries like Mali, we see that most young girls are married at an early age. This prevents them from enrolling in school and the number of boys being enrolled in the country is high (Efevbera and Bhabha, 2020, p.1). In such countries, you’ll find that women have a lower status as compared to men. Global organizations like the United Nations International Children’s Emergency Fund (UNICEF) should enforce the policies they have put in place that aim at protecting young girls from early marriages and ensuring that they get an education.
The African Development Bank Group (2018) has come up with gender strategies that aim at eradicating inequality. The first pillar is property rights and legal status. This policy will help in identifying the property rights of women and their legal status. This will help in promoting equality and growth in African countries. The second pillar is the economic empowerment of women which will help in increasing gender equality by giving access to infrastructure, financial resources, and public services to women. The third pillar is capacity building and knowledge management. This strategy will over technical assistance in the management of knowledge for gender equality and promote mainstream policies that will help Sub-Saharan African countries in eradicating inequality. If these strategies are properly executed it will only be a matter of time before the issue of gender inequality in the African region is eradicated. Unlike some of the policies set there before that were not properly executed and have failed.
Despite some progress in the healthcare department, maternal health opportunities in Sub-Saharan Africa are still inadequate and most of them do not receive quality healthcare services. If policies that are aimed at eradicating disparities in healthcare sectors are properly executed, the issue of inequality in healthcare services will reduce, and eventually, they will be eradicated. If countries like DRC Congo and Mali enforce laws that will protect the girl child from early marriages it will ensure that these girls are enrolled in schools at the same time as boys and this will encourage women to strive more to achieve their goals and not feel like they are at a lower status than men. When the Sub-Saharan African government in conjunction with policymakers strives to eradicate gender inequality, African countries will develop at a rapid rate and the maternal mortality ratio will reduce.
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