During a public talk held recently in Washington DC, Google Chairman, Eric Schmidt, said that the impression that the tech industry advances minorities and women is because the hidden biases that drive white male behavior are difficult to hide in the tech industry.
By Chief K.Masimba Biriwashs | iZiviso Global Editor At Large
HARARE, Zimbabwe – Women parliamentarians, leading African women entrepreneurs, civil society leaders, and development partners from Africa are meeting in Harare over the next two days for the inauguration and launch of the GlobalPOWER Women Network Africa.
The conference, being attended by approximately 300 participants, is aimed at providing a strategic political platform to accelerate game changing approaches to HIV prevention and sexual and reproductive health and rights responses for women and girls. The idea to create an Africa-specific GlobalPOWER Women Network stemmed fom a September 2010 meeting in Washington DC that saw prominent female decision makers come together alongside their US peers to discuss how to accelerate the implementation of the UNAIDS Agenda for Women and Girls.
Participants at the conference are expected to address the key issues affecting girls and women in Africa including eliminating new HIV infections among children, keeping mothers alive and maternal and child health. The meeting will result in the “Harare Call to Action” to advance women’s empowerment and gender equality through HIV and Sexual and Reproductive Health and Rights responses.
President of the GlobalPOWER Women Network Africa and Zimbabwe Deputy Prime Minister, Thokozani Khupe said that women must take an active role in ensuring their empowerment.
“To achieve the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths, it is critical to recognise women and girls as key agents in making this vision a reality – society has to invest in the health of women and girls,” Khupe said.
Addressing the conference, Zimbabwe President Robert Gabrial Mugabe said the launch of the network will take the issue of women’s emancipation and empowerment a step further.
Äfter the launch, the real work will begin and call for the same passion, unity of purpose and consistency in pursuing the goals which have characterized this Women’s Network thus far. Of particular note will be the challenge of giving unstinting support to women candidates of every hue and cry; of varying professional qualifications, driven by different talents and capabilities to realise their potential in the collaborative work of Global Power Women Network, the Africa Union and UNAIDS,”said Mugabe.
In Africa, women and girls carry a disproportionate burden of the HIV epidemic – they constitute 59 percent of all people living with the disease. To make matters worse, gender inequality compounded by gender-based vioence, increase women and girl’s risk of HIV infection.
Ëmpowering women and girls to protect themselves against HIV infection and gender-based violence is a non-negotiable in the AIDS response,”said UNAIDS Executive Director, Michel Sidibe.
“Lord! Give me another chance. I want to live and look after my children. They are still very young.”
Vimbayi (not her real name) repeated this prayer for several nights during her last days. In spite of her desperate prayers, she died at the age of 28, leaving behind two children.
Perhaps the saddest part is that her death was avoidable if she had had the correct information and people to support her.
A relative of Vimbayi, I finally got a chance to see her five months after hearing of her failing health. By that time, she was very weak. I asked her husband whether she had been tested for tuberculosis. He handed me her medical records.
At first, I thought that this was a breach of confidentiality. Later, I realised time was running out and we needed to do our best from an informed position. In my community, before HIV/Aids, people easily shared medical records.
But the Aids stigma changed the way people share information about their health.
The records confirmed that two sputum tests for TB had produced negative results. Unlike her husband, I also realised that Vimbayi had tested positive for HIV. As someone who was working in the HIV/Aids field, I knew the meaning of phrases such as “patient referred to OI (Opportunistic Infection) Clinic” and “post-test counselling done and positive living discussed”.
Prophylaxis treatment had been prescribed but I could not see any signs of it. She told me she stopped taking it two months previously because there had been no improvement.
Although the female condom has been heralded as a way for women to protect themselves from HIV and STI infections, its impact has been severely limited due to several reasons including its design, cost, access, stigma, and lack of political will.
Given the fact that women are the most affected and infected by HIV (in 2007, women represented half of all HIV infections worldwide, and 61% of HIV infections in sub-Saharan Africa) it is an imperative that evidence-based measures be undertaken to reduce their vulnerability.
The female condom is an essential sexual reproductive health tool that women can control but, disappointingly, it remains confined to the fringes of the response to the global AIDS epidemic.
According to a report by the Center for Health and Gender Equity titled “ Saving Lives Now: Female Condoms and the Role of US Foreign Aid” the US has an important role to play in the procurement, distribution and programming of female condoms.
As a leading provider of funding for HIV and AIDS prevention, treatment and care, and reproductive health supplies worldwide, the US can promote the wider use of the female condom, including reducing the cost which is beyond the reach of many of the affected women.
The report notes that there is little knowledge among policy makers and advocates about what the current US role is and, thus, a lack of understanding of what more the US should do.
“Bureaucratic obstacles, funding restrictions, and a lack of high level commitment to female condoms have significantly hindered the expansion of U.S.-funded female condom distribution efforts,” says the report.
“The U.S. government has no policy guidance encouraging missions or contractors to promote female condoms, which has meant that female condom procurement is dependent on a few field-level champions who are committed to the method,” adds the report.
Currently, international donors and government are investing millions of dollars and energy into promoting initiatives such as male circumcision, and little attention is being paid to promoting female condoms which allow women to initiate protection.
“While the unique nature of female condoms in providing women with their own source of protection should be reason enough for donors and governments to promote the method, female condoms hold other advantages as well. They fill their own niche, as consumers often alternate their use with that of male condoms, thus increasing the total number of protected sex acts,” states the report.
“They can be used by women living with HIV who do not wish to become pregnant, to protect against superinfection and to reduce the chance of HIV transmission to seronegative partners.”
In addition, female condoms also provide an additional option for protection during anal intercourse for men who have sex with men and heterosexuals, says the report.
In spite of the apparent benefits of the female condom, there are still major challenges in promoting its use.
Apart from the fact that female condoms are prohibitively expensive in many parts of the world, users find them noisy, physically unappealing, or difficult to use.
“However, female condoms are a cost-effective mechanism for HIV prevention when measured against thevcosts of potential HIV infections or other HIV prevention mechanisms. Also, as more and more female condoms are produced and purchased, their cost will drop,” states the report.
With greater financial investment and commitment, the design of the female condom can be improved increasing the likelihood of uptake by women.
Furthermore, there is need for educational and social marketing programs aimed at reducing the stigma associated with use of the female condom as well as improving consistent and accurate use.
According to the report, civil society groups can be extremely valuable in developing effective programming because of their access to populations vulnerable to HIV infection and their experience working with these groups.
The report makes the following recommendations to improve US’s role in the distribution and use of female condoms:
- USAID and OGAC should issue policy guidance promoting female condom procurement and programming within US-funded development programs, including PEPFAR. As a signatory of ICPD, the US should promote female condoms as a vital tool to prevent both pregnancy and HIV infection.
- The US should expand technical assistance for female condom logistics and procurement to additional countries to increase HIV prevention efforts.
- The US should apply intensive programming efforts to an additional three countries for scale-up and replication. These efforts could be used to create a more realistic assessment of global female condom needs for scale-up.
- The US should increase HIV prevention efforts by expanding the scope of female and male condom promotion to encompass the general public. Programming for female condoms will depend on each area’s epidemiological profile, and should be free of messages and attitudes that stigmatize condom use.
- The US should invest more funds in female condom promotion and programming. The US should subsidize female condoms for PEPFAR-funded programs.
- At the country level, the US should include civil society, especially women’s health and rights groups, in stakeholder meetings and encourage financing mechanisms that increase government-civil society collaboration in female condom programming.
- Congress should remove all earmarks and funding directives for abstinence-only, abstinence-until-marriage and fidelity prevention programs and fund comprehensive, integrated, and evidence-based HIV prevention programs that include female condoms and that promote and protect women’s health.
Zimbabwean culture, like many cultures in sub-Saharan Africa, places a high value on procreation. Child-bearing is regarded as a rite of passage into becoming a normal adult member of society.
As a result, reproductive health choices and practices often play second fiddle to pressures to reproduce that are exerted by traditional and cultural norms. Usually, these pressures are covert so they tend to be ignored in the design of reproductive health programs and interventions.
Reproductive health generally implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.
But in Zimbabwe, men and women’s ability to exercise this right is curtailed by the unseen force of tradition and culture.
In many parts of the country, a woman is expected to have been married at roughly age 24, and within two years of marriage is expected to have a child. Young women, in spite of their educational status, are under immense pressure to fulfill this social expectation. On the other hand, a man who goes beyond 30 without getting married or having a child attracts significant social ridicule.
Failure to procreate especially in a marriage, even if it is by choice, is interpreted in negative light and is equated to reproductive health failure. For a man, becoming a father is associated with a sense of achievement, and failure to reproduce severely undermines the sense of masculinity. A woman’s place within a marriage is regarded as secure when she reproduces. If she fails to do so, she can become ostracized within the household and community.
“Failure to reproduce can strain family and other social relationships, particularly when the negative views of extended family members are taken to heart,” says a study conducted in Zimbabwe in 2001 titled Culture, Identity and Reproductive Failure in Zimbabwe.
“Generally speaking, about one year after entry into marriage or a stable sexual partnership, others expect there to be a child, irrespective of the reproductive choices of the partners.”
It is clear that traditional and cultural attitudes play a significant role in how both men and women construct their reproductive capabilities and choices.
As Danielle Toppin notes “given the often covert nature of socialization, certain gendered behaviours are often left untouched, resulting in reproductive health policies that fail to meet the specific needs of women, and of men”.
In Zimbabwe, the family, a primary unit of socialization, is often the root of pressure for men and women to prove that they can reproduce. The desire to conceive in order to gain social acceptance is given preference to adopting tools and methods that promote safe sex.
The social pressure on women to become pregnant and give birth leads them into conditions of vulnerability, where they have to acquiesce to their partner’s sexual demands. It can also lead men to have multiple sexual encounters exposing them to a high risk of contracting HIV.
Put simply, the effectiveness of sexual and reproductive health tools is inhibited by culturally and socially constructed layers that define people’s sexual behaviors.
However, instead of being an impediment, culture can be used as a stepping stone to promote reproductive health rights. To have effective reproductive health programs, therefore, a full understanding of a given society’s values and beliefs is required.
There’s need for an approach that is sensitive to contextual, cultural, traditional and gender practices that impact on reproductive health choices.
The traditional, spiritual and cultural beliefs that shape and define sexual identities and attitudes towards sexual and reproductive health need to be given serious attention in the design of programs and interventions. Traversing the cultural and traditional can be very difficult and requires a lot of sensitivity, investment and patience.
It’s imperative to involve the target communities in the design and implementation of reproductive health policy, planning and practice in order to challenge cultural norms that may put women and men at risk.
The natural process of menstruation comes as a big problem to women and girls in many parts of Africa, contributing to both disempowerment and health risks. For young girls, menstruation is an addition to the heap of gender disparities they have to face in life.
In order to stem the flow of monthly periods, the women and girls use anything from rags, tree leaves, old clothes, toilet paper, newspapers, cotton wool, cloths or literally anything that can do the job. Most girls from poor, rural communities do not use anything at all.
Menstruation is perhaps one of the most regular individual female experiences, but in sub-Saharan Africa, the experience impacts general society negatively due to the absence of products required by women and girls to cope with menstrual flow.
To state it bluntly, menstruation has become like a curse not only to the women and girls but to society in general on the continent. Because menstruation is largely a private act, the social damage is hidden and never makes the news headlines. Also, there are cultural and social attitudes that render discussion of menstruation almost impossible.
Affordable and hygienic sanitary protection is not available to many women and girls in Africa, and governments have done very little to address this reproductive health issue which has serious public health consequences.
In sub-Saharan Africa, millions of girls, in particular, that reach the age of puberty are highly disempowered due to the lack of access to sanitary wear. Many of the girls from poor families cannot afford to buy sanitary pads.
Hence they resort to the use of unhygienic rags and cloths which puts them at the risk of infections. Some of the girls engage in transactional sex so that they can raise the money required to buy sanitary pads, putting themselves at the risk of HIV and STI infection.
Alternatively, young girls are forced to skip school during the time they experience monthly periods to avoid both the cost of pads or use of cloths.
UNICEF estimates that one in 10 school-age African girls either skips school during menstruation or drops out entirely because of lack of sanitation.
“Less-privileged girls and women who represent substantial percentage in our contemporary Africa will continue to suffer resulting to school absenteeism and also compromising their right to health care,” says Fredrick W. Njuguna, Program Director of Familia Human Care Trust in Kenya.
A girl absent from school due to menstruation for 4 days in 28 days (a month) loses 13 learning days equivalent to 2 weeks of learning in every school term.
It is estimated that within the 4 years of high school the same girl loses 156 learning days equivalent to almost 24 weeks out of 144 weeks of learning in high school.
Consequently, a girl child potentially becomes a “school drop out” while she is still attending school. In addition, the girl child has to deal with emotional and psychological tension associated with the menstrual process.
To make matters worse, according to Familia Human Care Trust, many schools in underprivileged areas lack sufficient sanitation facilities which are vital not only during a girl’s period but at all times generally such as water, adequate toilet facilities and appropriate dumping facilities for sanitary wear.
As a result, menstruating girls opt to stay at home due to lack of facilities to help them manage their periods than go to school.
For orphaned girls, the prospect of coping with bodily changes can be a significant challenge because they have no-one to turn to for information or advice. In addition, due to the use of improper methods to contain their menstrual flow, young girls may develop bodily odors that will lead to social exclusion within peer groups thereby impacting negatively on the young girl’s confidence.
The need for affordable sanitary wear for women and girls in Africa is indeed a major public health issue that governments need to prioritize in their planning.
On the other hand, there is need for social innovation around this issue because the need for sanitary wear among girls and women will forever be there, at least in the long term future.
The bottom line is that no girl child must be disadvantaged by the natural process of menstruation, and governments, civil society organizations and other players need to work together to ensure that the appropriate services are made available.
As it is, menstruation has becomes the undeclared basis for the social exclusion of young girls. Sanitary protection is an urgent need among women and girls and needs to be made affordable so that poor and marginalized groups can have access.
Global alliances between women in the rich and poor worlds can be a key solution to the problem of access to sanitary wear. But governments also need to recognize that ensuring women and girl’s access to sanitary wear has positive public health implications.
Access to affordable, sanitary is human right but one that is never discussed in our male dominated world. Whatever the case, the fact remains: every woman should be able to have access to the right products which can enable them to happily experience menstruation.
No woman should be cursed to disempowerment by the natural act of monthly periods.
Tuberculosis (TB) has a major impact on women’s sexual reproductive health and that of their children.
For pregnant women living in areas with high TB infection rates, there are increased chances of transmission of TB to a child before, during delivery or after birth.
The disease, especially if associated with HIV, also accounts for a high incidence of maternal and infant mortality.
Unfortunately, there is little to no attention about women’s vulnerability in the current discussion and media blitz of a resurgent TB internationally, and in particular, sub-Saharan Africa.
In sub-Saharan Africa, TB is threatening to unravel public health developments gains around increased HIV awareness yet the solutions are not easy, particularly where they concern the well-being of women.
There is need for huge financial, human, research and technological investments to fight the problem, but such investments will work only if they radically put women’s health needs at the core.
More importantly is the need to align TB services and sexual reproductive health services, so that men and women know about the implications of the disease to their sexual lives and households.
In sub-Saharan Africa, however, there are pervasive systemic factors driving TB and drug resistance which cannot be ignored in the search of an effective solution to the problem.
A myriad of social and economic factors, as well as weaknesses in the health care system, inadequate laboratories combined with high HIV infection rates are fueling the resurgence of the TB in the region. Food insecurity, poor sanitation and overcrowding also contribute to the easy spread of the disease.
According to WHO, although Africa has only 11% of the world’s population, it accounts for more than a quarter of the global TB burden with an estimated 2.4 million TB cases and 540,000 TB deaths annually.
Governments in the region are grappling with inadequate infrastructure and the increasing threat of drug-resistant strains and co-infection with HIV.
HIV infection increases the likelihood of active TB more than 50-fold. An estimated one-third of the 24.5 million people living with HIV (PLHIV) in sub-Saharan Africa also have TB.
For women in the region, the prospect of a growing TB epidemic is harrowing, but discussion about the disease rarely sheds light nor seeks to address women’s specific needs.
Given the high rates of HIV infection among women in the region – the majority of people living with HIV in sub-Saharan Africa (61% or 13,1 million) are women – it is clear that they are the largest group at threat to develop active TB, and more likely drug resistance.
Even with the availability of TB drugs women’s socio-economic status and gender roles including child-bearing and caring puts them at high risk of both HIV and TB infection.
For many women in the region, the costs required to access health care centers for TB treatment are usually out of reach due to poverty and undermined socio-economic positions.
The social stigma associated with a TB diagnosis and its association with HIV forces both men and women to delay going to get tested for the disease. In some cases, when men in marital relationships test positive for TB, they are likely to withhold the information, thereby increasing the likelihood to spread the disease to both their partner and children.
Moreover, women in the region are largely responsible for the upkeep of the family, including looking after children, which may also affect consistent uptake of TB drugs. When a woman is infected with TB, the likelihood of spreading the disease to young children is very high.
An additional concern for women is that the uptake of TB drugs interferes with contraceptive use, pregnancy, and fertility.
According to researchers, Rimfampicin, a key component of TB treatment can reduce the effectiveness of oral contraceptive pills and possibly other hormonal methods, such as implants, injectables and emergency contraception.
TB in pregnant women not only increases the rate of maternal mortality, but is also a major factor contributing to the risk of mother-to-child transmission of the disease.
A study conducted in South Africa revealed mother-to child-transmission of TB in 15% of infants born to a study cohort of pregnant women in which 77% were HIV-infected. Maternal HIV/TB coinfection also increases the risk of mother-to child transmission of HIV.
Screening and treatment for TB in pregnant women at antenatal clinics must therefore be a major public health priority in the region. Information about TB needs to be an integral component of sexual reproductive health services.
To be precise, women infected with TB need to be empowered so that they can take control of their own care and lives.
Populations that are displaced as a result of conflict face reproductive health challenges that require existent service delivery models to be adapted to suit their needs, especially those of women and girls.
In many parts of the world, women and girls in conflict zones find themselves victims of a silent war that infringes their sexual and human rights.
According to statistics, 80% of the approximately 37 million refugees and displaced persons globally are women and children, yet little funding and programming goes into addressing their requirements.
A UN report titled – The Shame of War: Sexual violence against women and girls in conflict, released early 2007 – says that “of all the abuses committed in war, rape is one specifically inflicted against women”.
“The brutality and viciousness of the sexual attacks that are reported from the current conflicts in Democratic Republic of Congo, Myanmar, Iraq and Sudan, and the testimonies from past conflicts in Timor-Leste, the Balkans and Sierra Leone are heartbreaking,” writes Yakin Ertuk, UN Special Rapporteur on Violence against Women in the foreword to the report.
“Girls and women, old and young, are preyed upon by soldiers, militia, police and armed thugs wherever conflict rages and the parties to the conflict fail to protect civilian populations.”
The victims are often afraid to report of their rape due to social stigma and shame, threat to personal security, or simply because there are no services available.
As the report notes, women and girls lose their family and community after experiencing rape due to feelings of shame and discriminatory attitudes. Their only option may be further victimization through sexual exploitation.
A major condition for the well-being and development of women and girls is their ability to exercise control over their sexual and reproductive lives.
World Health Organization (WHO) describes sexual health as a state of physical, emotional, mental and social wellbeing in relation to sexuality; and not merely an absence of disease, dysfunction or infirmity. It implies pleasurable and safe sexual experiences that are free of coercion, discrimination and violence.
For women and girls in conflict zones, the consequences of rape are many: sexually transmitted infections and reproductive health problems, unwanted pregnancy, fistulae, maternal mortality, and HIV/AIDS, says the report.
Female sexual vulnerability poses a grave public health problem, during the conflict and post conflict period.
Women and girls in conflict areas have a myriad of reproductive health needs that policymakers at national and international levels need to take into account in the design of programs.
Programs may involve working with community leaders, men’s and women’s groups and the military to sensitize about the need to prevent the problem of sexual violence. Women and girls need to be empowered to be able to prevent themselves from becoming victims of sexual violence through economic empowerment and access to reproductive health services.
As Theresa McGinn, 2001, succinctly puts it: “Understanding the ways in which refugee women’s reproductive health problems are both similar to, and different from, those of women in settled populations can help policy makers and programmers.”
Women and girls in conflict zones must have access to medical treatment, including access to drugs that can prevent sexually transmitted infections, psychosocial and legal support and access to abortion services to terminate forced pregnancies.
With conflicts popping up in every corner of the globe, there’s need for more public discussion about how to bring much needed reproductive health and psychosocial support services to women in conflict areas.