The challenges for women’s health in sub-Saharan Africa: Lessons learned from an integrative multistakeholder workshop in Gabon

29 Sep 2021
Marrium Habib, Ayola Akim Adegnika, Josiane Honkpehedji, Stefanie J Klug, Silvia Lobmaier, Kathrin Vogg, Amaya L Bustinduy, Andreas Ullrich, Jutta Reinhard- Rupp, Meral Esen, Clarissa Prazeres da Costa

The sub-Saharan African (SSA) region is home to more than 230 million females of reproductive age who face multiple intersecting health, social, gender and economic challenges [1]. Neglected tropical diseases (NTDs) are a group of chronic disabling, almost exclusively communicable diseases affecting the poorest of the poor, especially in Africa, which alone bears about 40% of the global burden of NTDs [2-4]. While both men and women are impacted, biological and sociocultural biases mean that NTDs disproportionately affect women and girls [5]. In recent decades, there has been a global shift from communicable toward non-communicable diseases (NCDs), which cause almost 32 million deaths in low- and lower-middle-income countries (LMIC) [6]. It is expected that by 2030, 85% of NCD-related deaths among women will occur in LMICs, including many countries of SSA region [7]. For women older than 50, NCDs are the leading cause of both death and disability-adjusted life years (DALYs) [8]. Important disparities persist in access to maternal and reproductive health services both within and between countries in SSA [9]; it is estimated that almost half of the women in SSA do not have access to essential health care during pregnancy and childbirth. In 2017, SSA accounted for roughly two-thirds of all maternal deaths in the world [10]. Hence, it is evident that many, if not most, women and girls in SSA carry a triple burden of vulnerability to NTDs, NCDs and poor reproductive health outcomes. Here, we report on the outcomes of an integrative, multistakeholder workshop held in Gabon, Central Africa, to help develop a framework for synergistic, sustainable and gender- and context-appropriate interventions to manage the NTD-NCD complex and additionally reproductive health.

Rationale for tracer conditions

This workshop identified female genital schistosomiasis (FGS), cesarean section (CS) and cervical cancer (CC) as tracer clinical conditions for the key themes of NTDs, NCDs and reproductive health respectively because they constitute major women’s health challenges in the SSA that demand collaborative solutions. Here we would like to highlight that while integrative solutions for the NTD-NCD complex have been attempted, we go one-step further to integrate reproductive health into our framework.


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Female Genital Schistosomiasis