Addressing Gender Disparities in Public Health Crises in Kenya and Nigeria

Addressing Gender Disparities in Public Health Crises in Kenya and Nigeria
The panelist during the discussion on gender disparities in public health emergencies

By Melisa Mong'ina 

Gender equity and inclusivity in healthcare remain critical concerns, especially for pregnant women. In remote areas, many women struggle to access health services due to long distances to hospitals, leading to the loss of lives and unborn babies. 

During the COVID-19 pandemic, these challenges were amplified. Pregnant women faced immense difficulties accessing health facilities for antenatal care and deliveries. Lockdowns and economic instabilities also triggered a surge in gender-based violence, particularly domestic violence, further compounding the issue.

Catherine Chacha, Chapter Lead at Women in Global Health Kenya, a movement advocating for gender equity in healthcare, emphasized the importance of addressing these disparities. She highlighted that while women make up 70% of healthcare workers, only 25% occupy leadership roles.

“Part of our conversation is on gender equity and inclusivity in health, considering that 70% of healthcare workers are women, but 25% are in leadership spaces,” Chacha noted.

Catherine Chacha, Chapter Lead at Women in Global Health Kenya

She underlined the need to protect healthcare workers, particularly women, from sexual harassment and called for strengthened advocacy for women's rights, especially regarding equal pay.

“We're having a conversation on how we can protect healthcare workers, especially women who are increasingly at risk of sexual harassment. Additionally, we are working on strengthening women's voices in advocating for their rights, particularly on equal pay,” she added.

Chacha also stressed the importance of addressing gender in public health emergencies, advocating for the use of a gender lens to better understand and tackle challenges during such crises. She noted that women are disproportionately affected by disruptions in healthcare services, particularly in areas such as sexual and reproductive health and immunization.

“When you look deeper, you find that women are the most affected in SRHR activities such as childbirth, antenatal care, and family planning. In immunization, most of the people who take children to hospitals are women,” she explained.

During the COVID-19 pandemic, intimate partner violence increased significantly, affecting both men and women. However, Chacha pointed out that men often fail to report such incidents, leaving a significant gap in data. She called for a survivor-centered approach to addressing gender-based violence, emphasizing confidentiality, privacy, and respect for survivors.

“There's a huge gap in men reporting violence issues. We need to have a survivor-centered approach that really ensures confidentiality, privacy, and respect to all survivors,” urged Chacha.

She also highlighted the need for health facilities to be equipped to support survivors of violence during crises like pandemics and lockdowns. Additionally, Chacha drew attention to the accessibility challenges faced by people with disabilities, noting that public health planning often overlooks various forms of disability. She stressed the importance of addressing these vulnerabilities when preparing for public health emergencies.

“We look deeper into the vulnerable populations, including persons with disabilities. We usually put an angle of one form of disability and nobody has ever bothered to ask about other forms. It is important to look at the vulnerability context when doing emergency preparedness,” she said.

Chacha emphasized the importance of collecting gender-disaggregated data to incorporate a gender lens into public health interventions. She called for capacity-building initiatives for healthcare providers and key stakeholders to ensure appropriate responses.

“We need a system that allows us to collect gender-desegregated data, because it brings up the gender lens into interventions. There's also the need for capacity building for healthcare providers and other key stakeholders to ensure they develop appropriate responses,” Chacha stated.

She issued a call to action for stakeholders to prioritize gender equity in preparing for public health emergencies, urging that this issue must be at the center of all discussions.

“My call to action will be the need to have stakeholders prioritizing gender lens in public health emergencies preparation. It is crucial that gender equity is part of this conversation,” she said.

Nafisat Salisu Isa, a community healthcare worker from Nigeria, shared similar challenges faced by women in her country during the COVID-19 lockdowns. 

Nafisat Salisu ISA, a community healthcare worker from Nigeria

The restrictions severely impacted access to reproductive health services, particularly for expectant mothers. She recalled a tragic incident when a pregnant neighbor lost her baby and suffered postpartum hemorrhage because Nafisat lacked the necessary tools to assist her.

“During that period, my pregnant neighbor was in distress and pain,” she recounted. “She was about to give birth, but I did not have any training tools to examine or conduct her delivery. Sadly, she lost her baby and suffered from postpartum hemorrhage. This made me buy some equipment and some delivery items out of pocket, to continue assisting pregnant women.”

Nafisat also noted an increase in gender-based violence during the lockdowns, exacerbated by economic instability and social isolation. Many women who experienced such violence were unable to access health services.

“Due to the lockdown, combined with economic instability and social isolation, many women who experienced gender-based violence could not access support services or reproductive health services,” she explained.

She called for gender inclusivity in responding to public health emergencies and emphasized the need to empower women community health workers with adequate resources and training.

“With these increasingly frequent and complex public health emergencies, gender considerations must be fully integrated into response efforts,” she urged. 

“We also need to empower women community health workers with the necessary resources and training to enhance their capacity to serve during future crises, which will benefit entire communities and also reinforce public health infrastructures.”

Gender inclusivity is essential in public health emergencies to prevent the loss of lives, particularly during pandemics. Both men and women, including people with disabilities, must have equitable access to healthcare facilities.