Comprehensive, sustainable efforts must be taken in Sub-Saharan Africa to improve women’s reproductive and overall health, said the associate director for the Center for Global Health at Northwestern’s Feinberg School of Medicine at a campus lecture Wednesday.
With 600,000 mothers lost annually to pregnancy-related causes and 80 percent of these deaths occurring in Sub-Saharan Africa, this is an important issue to address, said Carolyn Baer, who has worked with organizations such as the Centers for Disease Control and the Peace Corps program. 21.1 million AIDS orphans have died in Africa and 4.2 million unsafe abortions occur in Sub-Saharan African each year, she said.
It is important to remind the public this is an issue that affects everyone, Baer added. “Reproductive health is not just a woman’s issue,” she said. “It is a husband’s issue, a son’s’ issue, a father’s issue, a community’s issue.”
The best ways to ensure a higher rate of survival is to invest in the education of boys and girls, train health care workers, end harmful practices, expand access to birth control methods, make abortion legal, safe and accessible, and improve and expand access to obstetric care, she said.
She focused specifically on four steps that can be taken within communities to address reproductive health: Safe motherhood services, prevention of rape and violence, provision of family planning, and prevention and treatment of sexually transmitted diseases. Safe motherhood services include providing prenatal care, ensuring clean and safe delivery and then offering postnatal services.
“It is that first 24 hours during labor that is the most critical,” Baer explained.
Communities can also establish a referral system to get a woman in labor from home to a health care facility quickly. “Clean delivery kits” which include items such as soap, clean latex gloves and a plastic sheet, are another easy and doable precaution and can easily be gathered in local environments.
“Simple steps can yield big benefits,” Baer said.
Sexual and gender-based violence within communities is another important area that needs to be addressed. But it is important to work within communities to see what they consider to be the biggest issues of violence instead of imposing a preconceived agenda on them, she cautioned. Once definitions and concerns have been established, it is possible to put together medical services, including psychological support and counseling, as well as provide emergency contraception, Baer said.
“A lot of people are so shamed and the stigma is so great, a lot of people don’t want to talk about it,” she explained. “Communities need to figure out how to help.”
Improving family planning services means making contraceptives readily available and accessible, as well as offering patients a choice of which type is best for their lifestyle. Health care workers must also ensure confidentiality, she said.
“Gender relations needs to be considered,” she said. “And people need to be empowered to choose what works for them.”
Because in Sub-Saharan Africa access to laboratory equipment is limited, The UN recommends diagnosis of STIs be done using a syndromic approach, she said. Syndromic means asking what the patient’s symptoms are such as fever, swollen belly, etc and diagnosing according to those signs and symptoms.
“Treatment protocol based on syndromic case management should be prepared and adopted,” Baer said. “And the most effective drugs should be used at first encounter.”
All of these steps should be taken when possible to ensure better reproductive health in Sub-Saharan Africa, Baer said. “Healthy families and communities need healthy moms,” she said.