KEY FACTS

• In Africa as it is worldwide, women live an average four years longer than men.

• For those born in 2021 in sub-Saharan Africa, the average women's life expectancy at birth is 66 years.

• Communicable diseases including HIVAIDS is among the leading causes of death among adolescent girls and women of reproductive age (15 – 49 years) in the region.

• Maternal deaths are a major concern. Almost all (99%) of the approximate 287,000 maternal deaths every year globally occur in developing countries.

• As at 2017, it was estimated that 534 women across Africa will die in childbirth for every 100,000 live births. The figure may just be slightly lower today.

• Non-communicable diseases, especially cardiovascular disease, is the number one killer of older women in the region.

• Breast, lung, cervical and colon cancers are the leading cancer killers among women worldwide as well as in Africa.

 

 

A. Health Issues Of Women: 15 – 59 years

Some of the most prevalent health concerns impacting adult women including those in the reproductive age group, and what you can do to manage your risk are outlined below:

 

1. HIV/AIDS and other infections

According to the WHO, HIV/AIDS is the leading cause of death worldwide in women in the reproductive age group aged 15-44 years with unsafe sex being the main risk factor in developing countries such as in Africa. Other contributory factors include lack of access to information and health services, low socio-economic status and unequal power in sexual relations that expose women, particularly young women, to HIV infection.

Other common infections of women that are of concern include urinary tract and other sexually transmitted infections (STI)

You can take the following actions to manage your infection risks.

For a start, talk to your caregiver and get informed about HIVAIDS and other STIs. Get tested regularly to know your HIV status. Practice safe sex including the maintenance of single partner relationship. Get treated early and adequately with your partner for any diagnosed sexually transmitted infections.

 

2. Maternal death

Maternal deaths are the second biggest killer of women of reproductive age. Every year, approximately 287 000 women die due to complications in pregnancy and childbirth, 99% of them are in developing countries. As at 2017, the World Bank reported an average of 534 maternal deaths across Africa for every 100,000 live births. This figure though slightly lower as at date, still remains very concerning.

Despite the increase in contraceptive use over the past 30 years, many women in all regions still do not have access to modern contraceptive methods. For example, in sub-Saharan Africa, one in four women who wish to delay or stop childbearing does not use any family planning method.

In spite of the major drivers of high maternal deaths in Africa being systemic and institutional, there are steps you can take to manage this risk.

As an individual, you and your partner can reduce your risk of maternal death by talking to your doctor or nurse early about pregnancy and your plans to start or add to your family. This enables you to understand steps you can take before, during and after pregnancy in order to achieve the best outcome for you and your baby. Also, when you get pregnant, attend antenatal care clinics on schedule. Eat a balanced diet, engage in physical activities be sure to have your delivery attended by skilled personnel.

 

3. Tuberculosis

Tuberculosis (Tb) is often linked to HIV infection and is among the five leading causes of death among women of reproductive age in low-income countries.

How can you manage this risk?

Be sure to be immunized against tuberculosis. Get checked up early if you have any of the general symptoms suggestive of Tb infection, including feelings of unwellness, weakness, fever, sudden weight loss and night sweats..

 

4. Injuries

Partner caused and self-inflicted injuries as well as road injuries are among the leading causes of death due to injuries among adult women globally as well as in Africa. Burns in women as well as acid attacks are not uncommon in Africa. Fire-related injuries and deaths are usually due to cooking accidents or as the result of intimate partner and family violence.

What can you do to reduce your risk of injuries?

Be mindful and be proactive about traffic injuries and cooking-related fire hazards. Do not rationalize (i.e., explain away) partner abuse and endanger you well-being by staying unduly in an abusive relationship. Seek help early from family members, support groups and law enforcement in the event of partner abuse.

 

5. Cancers

Cervical cancer is the second most common type of cancer in women worldwide, with all cases linked to a sexually transmitted genital infection with the human papillomavirus (HPV). Other common cancer killers are breast, lungs and colon cancers.

Cancers cause about 14% of deaths in older women aged 60 years and above globally.

Due to poor access to screening and treatment services, more cancer related deaths occur in women living in low- and middle-income countries.

How can you take action to manage your cancer risk?

Get informed about the early signs and symptoms of breast, lung, cervical and colon cancers and present for screening regularly by skilled personnel for early detection and treatment.

 

6. Violence

According to the WHO, 35% of women worldwide have experienced either intimate partner violence or non-partner sexual violence in their lifetime. On average, 30% of women who have been in a relationship experienced some form of physical or sexual violence by their partner. Globally, as many as 38% of murders of women are committed by an intimate partner. These facts confirm that violence against women is widespread around the world and the Africa region is not excluded from this scourge.

Women who have been physically or sexually abused have higher rates of mental health issues, unintended pregnancies, abortions and miscarriages than non-abused women.

Women exposed to partner violence are twice as likely to be depressed, almost twice as likely to have alcohol use disorders, and 1.5 times more likely to have HIV or another sexually transmitted infection. 42% of them have experienced injuries as a result. Increasingly in many conflicts, sexual violence is also used as a tactic of war.

How can you take action to manage domestic violence risk?

Do not rationalize partner abuse by staying unduly in an abusive relationship. Seek help early in the event of partner abuse.

 

7. Anxiety, depression and suicide

Women are known to be more prone to depression and anxiety than men. Anxiety and depression are leading causes of mental health disease burden for women globally. Depression following childbirth, affects 20% of mothers in low- and lower-middle-income countries.

According to the WHO, an estimated 800 000 people die every year globally from suicide and men are in the majority. But attempted suicide, which exceeds suicide by up to 20 times, is generally more frequent among women than men and causes an unrecognized burden of disability. At the same time, attempted suicide is an important risk factor for death from suicide and shows the need for appropriate health services for this group.

What can you do to manage this risk?

If you ever have any of these common signs and symptoms of anxiety;

• Feeling nervous, restless or tense.
• Having a sense of impending danger, panic or doom.
• Having an increased heart rate.
• Breathing rapidly (hyperventilation)
• Sweating.
• Trembling.
• Feeling weak or tired.
• Trouble concentrating or thinking about anything other than the present worry.

or have thoughts of not enjoying life, or of harming yourself, talk early to a friend, family member, care giver or mental health professional to seek help.

 

8. Disability

Disability is more common among women than men. It affects 15% of the world’s population according to the WHO. Women with disabilities have poorer health outcomes, lower education achievements, less economic participation and higher rates of poverty than women without disabilities. Adult women with disabilities are at least 1.5 times more likely to be a victim of violence than those without a disability.

Common disabilities seen in older African women include:

• Poor vision
• Hearing loss
• Arthritis
• Osteoporosis
• Depression
• Dementia

Managing disability risks in women calls for a multi-caregiver and social support approach including patient education, regular medical check-ups and care, social and financial support and care, physical therapy, dietary advise, etc.

 

9. Diabetes

This condition is not exclusive to women, but it increases the risk of heart disease by four times in women.Women are also more prone to diabetes-related complications such as blindness, kidney disease and depression.

Gestational diabetes occurs during pregnancy in which blood glucose level goes up and other complications develop. This occurs in at least 3 in 100 women globally, and treatment may include a careful diet, exercise, blood glucose monitoring, insulin injections and oral medications.

Diabetes can also cause difficulties during pregnancy and delivery, including miscarriage, birth defects and difficult delivery due to oversized baby. Special testing and monitoring may be needed for pregnant women who have diabetes, particularly those dependent on insulin.

To lower your risk for type 2 diabetes, try to maintain a healthy weight, maintain regular physical activity, take your medications as prescribed and quit smoking if you do.

 

10. Chronic obstructive pulmonary disease (COPD)

Tobacco use and indirect tobacco smoke as well as the burning of solid fuels for cooking are major risk factors for chronic obstructive pulmonary disease in women in Africa.

COPD causes 9% of deaths in older women aged 80 years and above.

One third of all of the COPD deaths and disease burden in women is caused by exposure to indoor smoke from cooking with open fires or inefficient stoves.

What can you do to manage this risk?

Seek help to stop smoking if a smoker. Negotiate with your partner to smoke outside your home. If you must use solid fuels for cooking, do so in open environment to facilitate smoke dissipation into the atmosphere. Alternatively, use cooking stoves that rely on clean sources of energy if you can afford to. Get professional care early if you have breathing difficulties or concerns.

 

 

B. Additional Health Issues Of Older Women: 60 years and over

Globally, women represent a higher proportion of older adults. They make up:

• 54% of people 60 years of age;
• 60% of people 75 years and older, and
• 70% of people 90 years and older.

The following non-communicable diseases are additional and significant common health concerns of older African women.

 

11. Cardiovascular diseases

These cause 40% of deaths in older women globally.

(i) Heart disease

Heart attack is among the leading causes of death in older women globally. It is caused by severe reduction or complete cut off of blood flow and oxygen supply to `the heart muscles. This happens when the arteries that supply the heart with blood has been narrowed due to a buildup of fat, cholesterol and plagues. Although the incidence of heart attack in African women is not known, common symptoms include:

• Chest pain or feeling of tightness, especially in the center of the chest that lasts a few minutes or comes and goes
• Shortness of breath with or without chest discomfort
• Breaking out in cold sweats
• Nausea, vomiting and light headedness
• Weakness in arms.

It is not uncommon for women not to recognize their symptoms as a heart attack, and dismiss it as having indigestion. Risk factors that are common after menopause such as higher blood pressure, cholesterol, and lower estrogen may contribute to heart attack in women.

To manage heart attack risks,

• Take your medications as prescribed if you have any of the following conditions; hypertension, diabetes, and cholesterol.
• Stop smoking and use alcohol in moderation
• Reduce stress and exercise moderately.
• Eat a balanced diet and sleep well.
• Get medical attention early if you have any of the symptoms discussed for heart attack.

(ii) Stroke

Each year, stroke affects 55,000 more women than men. There are two types of stroke; hemorrhagic, or bleeding in the brain, and ischemic, or the blockage of a blood vessel that causes reduced blood flow in the brain. Although symptoms may vary depending on the underlying cause of the stroke, hallmark stroke symptoms include:

• Balance issues or loss.
• Eye issues including sudden vision loss, blurriness or double vision.
• Facial numbness and weakness (usually one-sided).
• Arm numbness and weakness
• Speech issues including slurring and difficulty to understand and be understood.
• The time of occurence should be noted and advised to caregivers. Timeliness of care is of essence.

All risk management factors discussed for heart attack are also applicable for managing stroke risks.

 

12. Aging and getting older

Aging is inevitable. It catches up on everyone no matter the gender. Women age faster than men and older women feel its negative effects more. The stress and the painful symptoms of aging can be prevented or reduced by maintaining a healthy lifestyle that includes diet, exercise and good sleep, reducing environmental shifts and shock, and maintaining a healthy heart, mind, and bones. These are important to living a long and healthy life.

 

Take away

Women globally and in Africa face a number of health issues that are partly gender and region specific. Some of these health issues are discussed in this article and the steps that you can take to prevent and overcome the health issues at individual and population health levels are also outlined.

If you or someone you know has any health issues, be sure to talk with your family doctor or other care givers as early as possible.

 

Adapted from: World Health Organisation: Women’s Health

 

 

Published Dec 28, 2022

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