1. Women & Health
Case study:
Sub-Saharan Africa
PRESENTED BY JULIUS JESSUP, JANET
SARPONG, EBERE NDUMELE, CHRISTIAN
WEISENBACHER, SAMANTHA WINTER AND
KELLY DOWLING
3. Economic indicators in Africa
Country Populatio
n 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
4. Health indicators in Africa
Country % 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
5. 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
6. 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
7. Fighting water and food insecurity
The Uganda’s women’s Movement
LEMU-Land and Equity Movement of Uganda
Queen Elizabeth Diamond Jubilee Initiative
Helping to eliminate Trachoma in Uganda
8. Water Insecurity: Sierra Leone
● Water is used for
daily activities
○ Personal care
○ Cleaning
○ Production of food
○ Waste disposal
9. 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.
10. 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
11. 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
12. 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)
13. 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
14. 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
15. 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.
16. 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
17. 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.
18. 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
19. 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
20. 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
21. 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
22. 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
23. 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
24. Rwanda’s Economic Development and Poverty
Reduction Strategy
Then: Vision 2020 Issues
1 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 Goals
Reconstruct social capital through good governance
Transform agriculture into a market sector
Private sector development
Human resource development
Now: EDPRS2 Issues
Generally unchanged!
Now: EDPRS2 Goals
Rapid 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
25. 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