Women & HealthCase study:

Sub-Saharan Africa

PRESENTED BY JULIUS JESSUP, JANET SARPONG, EBERE NDUMELE, CHRISTIAN WEISENBACHER, SAMANTHA WINTER AND KELLY DOWLING

Sub-Saharan Africa

Source: www.google.com/maps/@2.1622467,15.9067952,5z

Economic indicators in AfricaCountry Populati

on size (million)

% Ave. annual pop growth

% urbanized population

Male: female ratio

% of illiterate women

Nigeria 169 2.6 51 1.06

Uganda 38 2.0 16 95.3 42.3

Rwanda 11 2.7 17 1.01 22.0

Sierra Leone

6 2.3 40 0.94 69.7

Kenya 41 2.7 24 0.96 13.1

Cameroon

22 2.6 53 690 82.7

Source: worldbank.org

Health indicators in AfricaCountry % of

pop over 65

% of pop under 15

Fertility rate

MMR % of pop malnutrition U5

Nigeria 3 44 5.7 630 42

Uganda 3 48 6.0 440 14

Rwanda 4 42 4.62 340 20 (W)48 (H)

Sierra Leone 3 42 4.83 860 28.3

Kenya 3 43 4.6 490 33

Cameroon <1 4 4.8 690 22

Source: worldbank.org

Water insecurity: Uganda Water is needed for household purposes, agricultural purposes, personal use, and

for waste management. Uganda is ranked 115 out of 146 countries on HDI inequality. 66.7% of urbanized population live in slums Less than half of the entire population have access to water sanitation facility 67% have access to potable drinking water Water insecurity can lead to

Food insecurity Water and sanitation related problems 10.9 million people live with trachoma GBV, Gender discrimination, Gender inequality High rates of school drop out, especially for girls

Food Insecurity: Uganda Women make up over 50% of the population Over 80% of the population resides in rural part of Uganda Women own about 20% of land. Most widowed women are not allowed to own their late husband’s property.

Cultural barrier-gender discrimination Women provide about 70%-80% of agricultural labor

90% of all food production is labored by women

Fighting water and food insecurity The Uganda’s women’s Movement LEMU-Land and Equity Movement of UgandaQueen Elizabeth Diamond Jubilee Initiative

Helping to eliminate Trachoma in Uganda

Water Insecurity: Sierra Leone

● Water is used for daily activities○ Personal care○ Cleaning○ Production of

food○ Waste disposal

Water Insecurity: Sierra Leone

● Responsibility of collecting water is given mostly to the women of the household along with the children○ In sub-Saharan Africa, Women bear 62 % of

responsibility of collecting water● 2.4 million don't have access to safe water. This is

nearly half of the population.○ Over five million people have poor water

sanitation making up four fifths of the whole population

● During the civil war between 1991 and 2002 Sierra Leone's infrastructure was damaged. ○ Many water points and toilet facilities remain out

of use.

Food Insecurity: Sierra Leone

● Highest inflation of food in West Africa

● Remains in food deficit despite the domestic food production recovering in 2002

● Families spend 62% of earnings on food

● Food insecurity in Sierra Leone is seasonal○ Peaks in August

Solutions: Sierra Leone

● Water Insecurity ○ Water Project: Sierra Leone

■ Focus on restoring and repairing wells ■ Latrines■ Water and Sanitation Solution

● Food Insecurity (https://www.youtube.com/watch?v=AuWEEQfq72I#t=91)○ CARE (Humanitarian organization that fights global poverty)

■ Focused on working with poor women■ Goals for Sierra Leone

● food security● health● economic development

Food Insecurity: Kenya● Majority of Kenya is arid/semi-arid● High risk of crop failure (25-75%) -

Exacerbated by climate change● In 2006, 47% of Kenyans were unable to

meet the cost of buying sufficient calories to meet recommended daily requirement

● Over the last 8 years inflation has increased by about 30% each year; relative prices of food have also risen

● Agriculture accounts for 60% of employment (4 out of 5 Kenyans rely on agriculture for livelihood)

● 56% of poor HH budget is spent on food; 48% for HH above poverty line

● Poor - consumers of food rather than sellers (25% compared to 50% of non-poor)

Water Insecurity: Kenya● Access to improved water - 62%● Water access: Urban (82%), rural (55%)● Women spend 2/3 of their time collecting H2O● Water collection accounts for 25% daily

calorie intake● Access to improved sanitation – 30%● Richest 20% are 5x more likely to have

sanitation

● Global warming – exacerbating issues: increasing prevalence of malaria, chikungunya, dengue fever, cholera, dysentery - diseases frequently associated with access to clean water/basic sanitation

Women Taking On Sanitation: Kenya● In the last year women in informal

settlements in Nairobi, Kenya have taken on the issue of sanitation within their communities

● Supported by Muungano Wa Wanavijiji ● October, 2013 - small group of female

residents suing for land ownership to build sanitation on behalf of Mukuru’s estimated 400,000 inhabitants

● March, 2014 - female residents of Mukuru signed petition urging government to conduct a public inquiry into sanitation

● August/October 2014 - 250/100 women started peaceful marches for sanitation in Nairobi – walking to the Ministry of Health

Water Insecurity: Nigeria● Nigeria has abundant sources for water, but all levels

of the government (federal, state, and local) lack the ability to ensure enough access to safe, adequate, and affordable water.

● Nigeria has a population of 169 million people, representing the 8 most populous nations in the world.

● Less than 30% of the population have access to safe drinking water.

● Water and Sanitation are the primary drivers of public health. Improving water supply infrastructure and creating access to safe drinking water can relieve the burden of disease and improve social well-being.

Health Implications of Water Insecurity: Nigeria

Health implications associated with poor sanitation and unsatisfactory drinking water include:

●Diarrheal diseases (cholera, typhoid fever)- The third most common cause of death in Nigeria, claiming 1.8 million lives each year.

●malnutrition and dehydration- most important clinical factor influencing the pregnancy outcome and child’s health condition

●Parasitic Infections●Poor Hygiene

Others Issues Due to Water Insecurity: Nigeria

● Country’s Workforce- People in the working class lose thousands of man-hours due to sickness associated with an unsatisfactory water supply

● Education- girls must often skip school when there is a lack of water and sanitation facility, especially when menstruating

● Agriculture- provides income for families; clean water is essential.

● Violence, Sexual Violence- Can occur during walks to gather water when access is not convenient.

Women’s Rights Advancement and Protection Alternative (WRAPA):

Nigeria● Overview○ 2011: 74.4% population has access to clean drinking water

■ Approximately 5.6 million people do not have access○ Water use:

■ 1987: 35% water used for agriculture, 46% for domestic uses■ 2010: 76% water used for agriculture, 7% for domestic uses

● 50% increase in total population during this time■ Water shortages are common

○ No national governmental water authority until recently● Health Impacts

○ People forced to choose between thirst or risk of water-borne illness○ Cholera, sleeping sickness, intestinal worm infections

■ 70% of household health expenses from 2003-2006 spent treating water-borne illnesses

○ 47.8% population has access to improved sanitation

Water Insecurity: Cameroon● Overview

○ 2011: 74.4% population has access to clean drinking water■ Approximately 5.6 million people do not have access

○ Water use:■ 1987: 35% water used for agriculture, 46% for domestic

uses■ 2010: 76% water used for agriculture, 7% for domestic

uses● 50% increase in total population during this time

■ Water shortages are common○ No national governmental water authority until recently

● Health Impacts○ People forced to choose between thirst or risk of water-borne

illness○ Cholera, sleeping sickness, intestinal worm infections

■ 70% of household health expenses from 2003-2006 spent treating water-borne illnesses

○ 47.8% population has access to improved sanitation

Food Insecurity: Cameroon

● 1.7 million people are food insecure● 40% reduction in planted areas

○ Recurrent floods■ Inadequate water infrastructure

○ Poor rainfall● Far North region worst affected

○ Densely populated○ High rates of poverty

● 32.5% children under 5 are malnourished

Women’s Land Ownership Movement: Cameroon

● Loose collection of NGO’s, Cameroonian women’s groups● The issue:

○ Women face obstacles in owning property○ Women are often pushed out of property rental or ownership if they

do not have a husband● Goals:

○ Gender equitable land rights legislation○ Simplification of land purchasing requirements○ Lower cost of acquiring land certificates○ Create shift in gender roles and traditional women’s work

Water Insecurity: Rwanda

Topography: Rwanda’s hilly topography makes obtaining water difficult even when it not far away

1.1 Million People have new access to water

New water networks are now available to an estimated additional 1.1 million persons in rural communities since the last survey, but despite the increase in availability and general proximity to the new and safer resource, a large number of persons still prefer to use non-networked sources and travel twice as far to fetch their water. In rural communities with community networks available one in four persons still obtain most of their water from an unsafe source. This has remained the same between the surveys.Source: EICV Poverty Analysis for Rwanda’s Economic Development and Poverty Reduction Strategy

Food Insecurity: Rwanda

1/5(21%) of Rwandan households are food insecure

4% Poor Food Consumption

17% Borderline Consumption

At 43%, Rwanda has some the highest chronic malnutrition in its region

Boys are more stunted than girls

Rwanda’s Economic Development and Poverty Reduction Strategy

Then: Vision 2020 Issues1 Hectare for every 9 Rwandans

Diminishing with high birth rates

Only 350,000 hectares of low quality pasture land

“This results in intense exploitation of the land, with no simultaneous application of corrective measures, most notably through fertilizer use.“

Then: Vision 2020 GoalsReconstruct social capital through good governance

Transform agriculture into a market sector

Private sector development

Human resource development

Now: EDPRS2 Issues

Generally unchanged!

Now: EDPRS2 GoalsRapid growth targeted at 11.5%

Fast poverty reduction (15% points) to less than 30%

Close trade balance with rapid growth of exports (28%)

Increased private sector investment

Heavy infrastructure investment

General Solutions to conquer food/water insecurity

UN-Water UNICEF - WASH and Women UN-Zero Hunger Challenge World Health Organization Partnership for Maternal, newborn, and CHild Health (PMNCH)

THEY PARTNER WITH A HOST OF ORGANIZATIONS TO ELIMINATE GENDER DISPARITY

Source: worldbank.org

References http://www.aho.afro.who.int/profiles_information/images/f/fb/Uganda-Statistical_F

actsheet.pdf?ua=1 http://www.who.int/pmnch/knowledge/publications/summaries/en/ http://www.unwater.org/topics/water-security/en/ http://www.uwonet.or.ug/programs/networking-capacity-building/ https://content.sakai.rutgers.edu/access/content/group/1b6a9eaf-4015-440b-9358-8c66a32a94ca/Week05_water/UN_

Gender_Water_Sanitation_2005.pdf

http://eujournal.org/index.php/esj/article/view/288/319http://www.soawr.org/en/soawrmember/womens_rights_advancement_and_protection_alternative_wrapa/

http://www.care-international.org/where-we-work/sierra-leone.aspx#prettyPhoto

http://thewaterproject.org/wells_for_sierra_leone https://www.wfp.org/countries/sierra-leone/food-security/overview http://www.tradingeconomics.com/uganda/population-female-percent-of-total-wb-data.html