“The state of women’s health, including their sexual and reproductive health, is an important indicator of development,” states the SADC Gender Protocol Barometer 2014.
The publication observes that although progress has been made in the healthcare sector, much remains to be done.
Health-related targets under the protocol were the adoption and implementation of legislative frameworks, policies, programmes and services to enhance gender-sensitive, appropriate and affordable quality health care by 2015.
This was in line with the SADC Protocol on Health and other regional and international commitments by member states on issues relating to health.
Specifically, SADC states committed to reduce the maternal mortality ratio by 75 percent by 2015, to develop and implement policies and programmes to address the mental, sexual and reproductive health needs of women and men; and to ensure the provision of hygiene and sanitary facilities and nutritional needs of women, including women in prisons.
The African Union conjoined state parties to ensure that the right to health of women, including sexual and reproductive health is respected and promoted.
This includes: the right to control their fertility; the right to decide whether to have children, the number of children and the spacing of children; the right to choose any method of contraception; the right to self protection and to be protected against sexually transmitted infections, including HIV and AIDS; the right to be informed on one’s health status and on the health status of one’s partner, particularly if affected with sexually transmitted infections, including HIV and AIDS, in accordance with internationally recognised standards and best practices; and the right to have family planning education.
Countries pledged to take all appropriate measures to provide adequate, affordable and accessible health services, including information, education and communication programmes to women especially those in rural areas; establish and strengthen existing pre-natal, delivery and post-natal health and nutritional services for women during pregnancy and while they are breastfeeding; and protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus.
The HIV scourge has apparently lowered life expectancy levels with Botswana, Lesotho, South Africa, Swaziland and Zimbabwe in 2011 comparing negatively to 1990.
While life expectancy is higher for women than men in 11 of the 15 SADC countries, this was coupled with lower quality of life.
The Barometer makes a link between gender-based discrimination and various health hazards for women such as physical and sexual violence; sexually-transmitted infections; HIV and AIDS; female genital mutilation; malaria and vulnerability to other communicable diseases and unsafe pregnancy and lack of control over their physical integrity.
The consequences of child marriages have been profiled under the AU campaign which cites related challenges of adolescents having children to include: increased maternal and child mortality; obstetric fistula, premature births, and sexually transmitted diseases (including cervical cancer).
Strategies adopted by the campaign include: supporting legal and policy actions in the protection and promotion of human rights, mobilising awareness of the negative socio-economic impact of child marriage, building a social movement and social mobilisation at the grassroots and national levels; and increasing the capacity of non-state actors to undertake evidence-based advocacy including the role of youth leadership through new media technology, monitoring and evaluation.
Mauritius and Seychelles top the charts in the region in relation to progress made towards achieving the protocol targets.
However, yawning gaps exist among countries, with the poorer SADC countries lagging behind in all indicators.
Mauritius has registered the highest proportion of women accessing contraceptives at 76 percent, with DRC at five percent with the lowest access.
Zimbabwe, with the highest maternal mortality ratio at one time, has drastically reduced from 960 deaths per 100 000 births to 614 deaths per 100 000, according to the World Health Organisation.
In the last two years, Seychelles has registered no maternal deaths while Mauritius has a low maternal mortality ratio at about 37 deaths per 100 000 births.
The Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA) has been adopted and seeks to intensify implementation of the Maputo Plan of Action for the reduction of maternal mortality in Africa.
The Barometer reports that CARMMA has been launched in 14 SADC countries.
The campaign’s slogan is, “Africa cares: No woman should die while giving life”.
Mauritius and Seychelles have achieved 100 percent attendance by skilled personnel for all births. The lowest level of attendance by skilled personnel for births is Madagascar at 44 percent.
Seychelles and Mauritius are very close to total sanitation coverage. The lowest levels of sanitation coverage are still only between 14 percent and 10 percent in Malawi, Madagascar and Tanzania.
Beyond 2015, the Barometer urges SADC countries to: promote good health among citizens; scale up research at the national level; emphasise maternal health; promote healthy lifestyles to reduce cancers, hypertension and diabetes, and encourage prompt management of all these conditions to advance women’s health needs from basic to being a right; not only integrate but prioritise sexual reproductive and health rights (SRHR) in national and local government plans.
While there has been some progress, there is still need for much greater efforts and investment to improve the health of women in SADC.
This has been brought into sharp focus as the region joins other countries in Africa and globally to review progress on the Beijing Platform for Action (BPFA) on critical areas of concern. – First published in The Herald
• Virginia Muwanigwa is a gender activist and chairperson of the Women’s Coalition of Zimbabwe which is the focal point to the SADC Gender Protocol Alliance. She is also the director of the Humanitarian Information Facilitation Centre (HIFC).