Facts: Women's Health in Sub-Saharan Africa
July 2, 2003 National Press Club Briefing

Sub-Saharan Africa has the lowest life expectancy of any region in the world. From 1995 to 2000, nine of every 100 girls and 10 of every 100 boys born in the region died before their first birthday.1 Because of HIV/AIDS, average life expectancy decreased by five years between 1995 and 2000, to 51 years for women and 46 years for men.2 The region's maternal mortality rate is the highest in the world.

Besides AIDS, major health concerns of sub-Saharan African women include obstetric fistula, female genital cutting, and the general lack of reproductive health care of any kind.

HIV/AIDS

• Of the 36 million people affected with HIV/AIDS worldwide at the end of 2002, 29.4 million lived in sub-Saharan Africa, and 58 percent of them were women.3
• In some countries in the region, five times more teenage girls than boys are infected.3
• At least 11 million children in the region have lost one or both parents to AIDS.3 When a parent dies, family responsibilities shift to girls, who must often then leave school.
• A woman's safety from AIDS may be compromised by a man's opposition to condoms, the potential for abuse and violence in the relationship, and dependence on a male partner for economic or social support. At the same time, the woman may bear the blame for spreading the disease, regardless of the circumstances.
• Stigma within families is a pervasive problem for AIDS victims. Widows and orphans may be shunned as though it were their fault.
• Information levels remain low. Research by the United Nations Children's Fund (UNICEF) found that among girls 15 to 19 years old, 70 percent in Somalia and more than 40 percent in Guinea Bissau and Sierra Leone had never heard of AIDS.2

Safe Motherhood

A woman dies in agony somewhere in the world every single minute from complications of pregnancy and childbirth-more than 500,000 deaths per year.4 Another 30 per minute survive but suffer disability or disease. The vast majority of these casualties are preventable at low cost.

• One woman in every 16 will die of these complications in Africa, compared to one in 3,500 in North America, because of disparities in care.4
• More than 80 percent of maternal deaths worldwide result directly from five causes: hemorrhage, infection, unsafe abortion, obstructed labor, and hypertension (eclampsia). These causes are almost always preventable.
• Only 58 percent of women in developing countries deliver with a skilled attendant present (doctor or midwife) and only 40 percent deliver in a medical facility.4
• About one in every four pregnancies is unwanted, and 13 percent of maternal deaths result from unsafe abortions plus lack of skilled follow-up care.4
• Meeting the unmet demand for contraceptives could lower the reported maternal mortality rate by 20 percent or more worldwide.

Obstetric Fistula

This injury to a woman's birth canal causes a constant uncontrollable leakage of urine or feces, or both. As a result, the woman is constantly wet, smelly and infected, and is usually abandoned and ostracized by her community.

• The injury most often occurs when a very young girl is pregnant and experiences a long and obstructed labor. The baby usually dies. The mother, if she survives, suffers tissue damage that becomes an opening between the vagina and the bladder or rectum.
• Once prevalent worldwide, fistula has been virtually eliminated in the developed world by later childbearing and by Caesarean sections. Child marriage and lack of emergency obstetric care are often common in poor areas.
• An estimated two million women are afflicted worldwide, and 50,000 to 100,000 more cases occur annually, but the number is based upon reported incidences. Many women live in shame and hiding, not knowing their injury can be repaired.5
• Some 90 percent of obstetric fistulas can be surgically corrected, for $350 to $450.
• The long-term cure is threefold: prevent marriage and sexual relations for very young girls; provide education and access to emergency obstetric care for all women; and repair physical damage through surgery and emotional damage through counseling.

Female Genital Mutilation

• FGM is practiced in 28 African countries, including all of western Africa, as a rite of female passage aimed at reducing interest in sex. About two million girls undergo it every year.6
• Health risks include painful intercourse, blocked menstruation, recurrent infections, psychological damage, and increased maternal and child mortality during childbirth.
• Laws barring FGM are unevenly enforced. Emigrants bring the practice to their new homelands, and it is now a problem in parts of Europe and the United States.

Sources:
1. United Nations, "The World's Women 2000," New York, 2000, p. 55
2. United Nations, Human Development Report 2000, p. 33
3. Kelly, Margo M.,"Fighting AIDS-Related Stigma in Africa," www.prb.org, Dec. 2002
4. UN Population Fund, www.unfpa.org
5. UN Population Fund, "Costs and Challenges of Addressing Obstetric Fistulas," New York, 2003
6. A Program for Appropriate Technlogy in Health (PATH), "Female Genital Mutilation: Facts in Brief," Washington DC, 1997

For more information, contact: Micheline Carter, 202/326-8710, or go to www.PLANetWIRE.org, a journalist Web site on global population and health.

[show print version] [back]