The maternal mortality ratio is unacceptably high in Africa. Forty per cent of all pregnancy-related deaths worldwide occur in Africa. On average, over 7 women die per 1,000 live births. About 22,000 African women die each year from unsafe abortion, reflecting a high unmet need for contraception. Contraceptive use among women in union varies from 50 per cent in the southern sub-region to less than 10 per cent in middle and western Africa" UNFPA

Early and unwanted childbearing, HIV and other sexually transmitted infections (STIs), and pregnancy-related illnesses and deaths account for a significant proportion of the burden of illness experienced by women in Africa. Gender-based violence is an influential factor negatively impacting on the sexual and reproductive health of one in every three women. Many are unable to control decisions to have sex or to negotiate safer sexual practices, placing them at great risk of disease and health complications.

According to UNAIDS, there is an estimated of 22.2 million people living with HIV in Sub-Saharan African in 2009, which represents 68% of the global HIV burden. Women are at higher risk than men to be infected by HIV, their vulnerability remains particulary high in the Sub-Saharan Africa and 76% of all HIV women in the world live in this region.

In almost all countries in the Sub-Saharan Africa region, the majority of people living with HIV are women, especially girls and women aged between 15-24. Not only are women more likely to become infected, they are more severely affected. Their income is likely to fall if an adult man loses his job and dies. Since formal support to women are very limited, they may have to give up some income-genrating activities or sacrifice school to take care of the sick relatives.

For more information on HIV/AIDS and Reproductive health, please visit the following websites:

Source: Devex

KAYA, Burkina Faso — Ramata Sawadogo was eight weeks pregnant when she was chased from her home by gunmen in May of last year. The 30-year-old spent the next few months running from village to village, in search of refuge and health care, in Burkina Faso’s center-north region.

At times, Sawadogo walked for more than a week with her six children to reach another town. Other times, she’d sleep in abandoned schools, all the while concerned that the stress and lack of food and medical care would harm her unborn baby.

“When I walked a lot, I got tired and was worried about the pregnancy,” Sawadogo said. Seated in a health clinic in a makeshift displacement site in Kaya town, where she now lives, she cradled her 7-month-old, grateful he is alive and healthy.

Violence linked to Islamic militants, local defense militias, and the army is escalating across Burkina Faso, killing almost 2,000 people this year, with deaths set to surpass the number of fatalities from 2019, according to the Armed Conflict Location & Event Data Project. Attacks have forced more than 1 million people from their homes and shuttered 12% of the country’s health facilities.

Women are bearing the brunt of the crisis, and attacks have impeded their ability to access sexual and reproductive care, including prenatal and postnatal services and contraception.

“Terrorist attacks constitute a new barrier to access of maternal healthcare services in Burkina Faso,” according to a recent study in The BMJ. The report, considered the first to document the effects of insecurity on health care in the country, found that in the month following an attack, assisted deliveries in medical facilities reduced by almost 4% and multiple attacks had graver consequences, impacting antenatal care and cesarean sections. The problem has been exacerbated by COVID-19, the report said.

On a visit to Kaya in September, Devex spoke with eight displaced women who said they have struggled to get timely reproductive and contraceptive help due to violence. Many were chased to unfamiliar towns where they did not know where or how to access services. In some cases, armed men destroyed pharmacies, making it hard to find medicine.

After Sawadogo was chased from her home, she sought prenatal care in the first small town she fled to. But there were too many patients and too few staff members at the clinic, so she was unable to see a doctor, she said. Before she could return, the town was attacked, forcing her to flee once again. It was not until arriving in Kaya, five months into her pregnancy, that Sawadogo had her first checkup for the baby.

The harder it becomes for women to reach health centers, the more risk they face — specifically for those who have been displaced, aid groups warn.

“These women need to be followed during their pregnancy until full term. If they are not followed, they can have a miscarriage,” said Yvette Yoda, a midwife working with Marie Stopes International, an aid group focused on providing contraceptives and safe abortions for women.

“With the displacement, they are in areas that they don’t know, they have no information,” she said.

Yoda has been with the organization for five years and used to work in rural areas, providing women with contraceptives and raising awareness about reproductive health. But now she says most of those areas are off-limits.

Finding ways to adapt

As violence in the country escalates, aid groups are scrambling to adapt. Last year, Marie Stopes halted most of its activities and readjusted its strategy, relocating staff members from remote and more insecure villages to larger towns, such as Barsalogho and Kongoussi in the Center-North. It also established clinics closer to the displaced population.

In Kaya — where the government estimates nearly 500,000 displaced people have sought refuge, according to Boukare Ouedraogo, the town’s mayor — Marie Stopes set up four clinics adjacent to makeshift displacement sites. The group also has mobile teams that visit a different town each week, depending on the needs.

“These women need to be followed during their pregnancy until full term. If they are not followed, they can have a miscarriage.”

— Yvette Yoda, midwife, Marie Stopes International

The group’s biggest shift, however, was to expand its services, said Sylvain Ricard, Burkina Faso country director for Marie Stopes. Prior to the violence, the organization almost exclusively offered family planning services, such as those for contraceptives, but today it provides cervical cancer screenings, testing, and treatment for diseases spread through sex, including HIV/AIDS, as well as gender-based violence counseling.evelopment's most important headlines in your inbox every

“When you see people coming to Kaya with a lot of needs — food, shelter, water and sanitization, health — it’s difficult only to provide family planning,” Ricard said. Even though the organization is not able to access remote villages as easily, more people have been helped since it moved services closer to those displaced, he said. As of August, more than 100,000 people accessed Marie Stopes services this year, compared with 96,000 people at the same time last year, he said.

Other aid groups say the violence has made it harder to reach women, particularly those who never used the services before and might not know they exist.

Pathfinder, an international aid group providing women with access to sexual and reproductive health services, has largely been cut off from certain areas, especially in the hard-hit eastern region. Motorcycles purchased when the country was calmer cannot be used anymore because they are associated with motorcycle-riding attackers who target villages, said Lydia Saloucou, country director for Pathfinder in Burkina Faso.

“Our plan was to talk with more women, and we’re not able to do this,” she said.

Her team has tried to adapt by personalizing its approach, giving phone numbers of health workers to women in case they need help and relying more on the community health system to communicate information about reproductive services, she said.

Pathfinder is working with the Ministry of Health to find longer-term solutions to make it easier for women to get help closer to home. “This insecurity will not end early, and we need to adapt,” Saloucou said.

Compounding crises

Even in safer, easier-to-reach parts of the country, health workers are struggling to cope because the influx of displaced people is overwhelming clinics.

Insecurity has shuttered five health centers around Kaya, forcing the area’s main health center to provide care for eight times the usual number of patients, the International Committee of the Red Cross told Devex during a visit to the town in September. ICRC is helping the health facility by providing beds and training for health workers, yet nurses at the hospital’s maternity ward told Devex they have to discharge women 24 hours after giving birth instead of the required 48 hours, because there is nowhere for them to rest.

“There isn’t enough space for everyone,” said Issa Sawadogo, the nurse in charge of the center. At least 80% of the women she sees are displaced, she said.

Coronavirus restrictions imposed by the country in March, such as closing public transport and restricting movement between cities, have further reduced women’s access to care.

The amount of people getting tested for HIV and other sexually transmitted diseases and using family planning services has decreased by approximately 15% between the last half of 2019 and the first six months of this year, said Boureihiman Ouedraogo, director for the Burkinabe Association for Family Well-Being, a local aid group.

For women already impacted by violence, the virus is just another challenge to overcome.

Last year, 26-year-old Fatimata Sawadogo fled to Kaya when her village was attacked. It took time for her to find a health clinic that could remove the contraceptive implant from her arm, which was not working, she said. But by the time she figured out where to go, she was told not to leave her house due to coronavirus restrictions.

Not wanting to get pregnant, while already struggling to feed and shelter her two children at the displacement site, she refused to have sex with her husband until she could get a new implant.

“I’d prefer not to be pregnant now,” she said. “We already have enough concerns.”

Source: Nyasa Times

Some chiefs in the Southern Region have backed an amendment of the abortion law that allows for the termination of unwanted pregnancies under certain conditions and are persuading members of Parliament to pass the Termina pf Pregnancy Bill when it is tabled for debate during the current sitting of the National Assembly.

Source: New Zimbabwe

THE High Court Wednesday ordered the Harare City Council and government to re-open 42 local clinics that had been closed without notice recently.

Source: Pregnancy Help News

The current abortion laws in South Africa are pretty liberal and are even hailed as some of the most progressive abortion laws on the books. Yet, many doctors and healthcare providers will refuse to do legal abortions or even give a referral for one for reasons of religion or conscience. In fact, the general population is also opposed to abortion, with over half the population thinking abortion is always immoral in cases of family poverty, fetal anomaly, or both.

Source: Swazi Media Commentary

A High Court judge in the deeply conservative kingdom of Swaziland (eSwatini) has started a debate about legalising abortion.

Judge Qinisile Mabuza heard a case involving a 26-year-old woman who was accused of causing the death of her four-year-old son, by drowning him in a river.

The eSwatini Observer reported that the child’s father had denied paternity, leaving her to rise the child herself. This prompted the judge to question what provisions were available for women who found themselves in similar situations.

The Swazi Constitution provides that abortion might be allowed on medical or therapeutic grounds, including where a doctor certifies that continued pregnancy will endanger the life or constitute a serious threat to the physical health of the woman; continued pregnancy will constitute a serious threat to the mental health of the woman; there is serious risk that the child will suffer from physical or mental defect of such a nature that the child will be irreparably seriously handicapped.However, no law exists to put the constitutional provisions into effect. 

According to the Observer, ‘In her subsequent remarks, she [Judge Mabuza] hinted that she viewed the current situation as shackling women’s autonomy, making an undertaking to tackle the current ban on abortion before she retires from the bench.

‘In fact, the learned judge believes it would be reasonable to allow women to make a decision on whether to perform an abortion.’

The Observer reported, she added some of the rights of women had been addressed through the 2018 Sexual Offences and Domestic Violence Act and it was time that society explored the possibility of legalising abortion as well.

Later, a number of representatives from organisations within Swaziland supported the idea of a debate. Acting Director Bongani Msibi of the Family Life Association of Swaziland (FLAS), a leader in Sexual and Reproductive Health and Rights delivery and youth programming in Swaziland, said the illegality of abortion often posed serious risks to women, and that legalisation could help to protect their reproductive and health rights.

Acting Director Zanele Thabede of Women and the Law of Southern Africa (WLSA) said abortion law reform should be discussed. She told the Observer it was important to have meaningful conversations whatever your beliefs about abortion.

Head of the Human Rights  and  Integrity Commission Sabelo Masuku said the group was in support of the call by the judge to have Swaziland revisit its position on abortion.

Because abortions are illegal in Swaziland it is difficult to say accurately how many are performed in the kingdom. However, in August 2018 the Times of Swaziland reported that every month, nurses at the Raleigh Fitkin Memorial (RFM) Hospital in Manzini attended more than 100 cases of young women who had committed illegal abortions.

The IRIN news agency, quoting FLAS reported that in October 2012 more than 1,000 women were treated for abortion-related complications at a single clinic in Swaziland.

Source: NATION

The focus on containing the spread of coronavirus has hit crucial mother-to-child health care services, including family planning and immunisation, research has shown.

Source: CSJ NEWS

Government has an obligation to ensure that no woman should die due to pregnancy-related causes, Chairperson of the Parliamentary Committee on Health, Matthews Ngwale has said.

Source: The Namibian

HEALTH minister Kalumbi Shangula says he can push to legalise abortion in Namibia if he gets enough support from women.
Shangula made these comments in a telephone interview with The Namibian yesterday when he was asked about his stance on legalising abortion in Namibia.
The minister said the issue of legalising the termination of pregnancy on demand must be championed by women themselves because it is their right.

Source: African Feminism
Growing up, I was taught that menstruation was a private affair. I learnt that no one was supposed to know when I was on my period. Everything about how I handled myself during my periods had to be discreet. Nobody was supposed to see my pads; I was to handle them like contraband goods. In-fact supermarkets still wrap pads in newspapers for secrecy. 

Source: Daily Nation
Widowed and with four children, Ms Florence Atieno has been living positively with HIV for 10 years now.

Before the Covid-19 pandemic hit the country, Ms Atieno, who lives in Nyalenda slums in Kisumu County, could easily access her antiretroviral therapy drugs (ARVs).

As a registered client at the Kisumu County Referral Hospital, she would pick up her drugs on a monthly basis.

Source: Inter Press Service

It was only when 17-year-old Eva Muigai was in her final trimester that her family discovered she was pregnant. Muigai, a form three student who lives with her family in Gachie, Central Kenya, had spent her pregnancy wearing tight bodysuits and loose-fitting clothes that hid her growing baby bump.

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