The effect of women's role on health: The paradox

Most societies in Africa are patriarchal in nature. Traditional Africa has allocated the role of nurturing, and ensuring the health of the family and the community as a whole to women. From the age of six, girls begin to work with their mothers, cleaning, sweeping, nursing and caring for the younger children, the aged and the sick. Therefore, the female child is customarily socialized as the custodian of family health. Because women are traditionally responsible for health in African countries and their status in society is low, the status of the health sector has received less attention than other sectors. The paradox of entrusting the woman with the responsibility of health and at the same time denying her the opportunities to influence policies remains a major obstacle. Factors that influence women's health in Africa most commonly include poverty, poor education and poor nutrition. Access to education for African women is a major problem. The impact of a poorly educated mother is passed on to the daughter. In some parts of Africa, female circumcision contributes to the high school dropout rates. Once the girls are withdrawn from school to participate in the ceremonies, they do not return to school. They are encouraged and socialized towards marriage. Africa has the highest fertility rate, the lowest life expectancy (49 years for males and 52 for females, the highest infant mortality rate (114 deaths per 1000 live births); the highest maternal mortality rate and the highest dependency ratio (47% under 15 years and only 3% over 65). The foregoing factors call for urgent attention to health issues, especially those which affect women who are the traditional health providers. There is an unacceptably high rate of unsafe abortion which accounts for up to 30% of maternal mortality in some African countries, and there is growing concern over teenage pregnancies in some African countries. Nearly two-thirds of the cases of septic abortions are in the 15-19-year age group and yet African governments and the legal systems would rather not deal with abortion. The gap between mortality and fertility is widening; it doubled between 1972 and 1994 and is expected to double in 2017. In many African countries, children are the only 'goods' that women are expected to produce. Unless this attitude changes, fertility rates will continue to rise as women continue to search for their place in society and justify their place within marriages and relationships through child bearing. (C) 1997 International Federation of Gynecology and Obstetrics.