FACT N°2 – Women and girls face a limited access to social services

Paper author:

Aurore Mathieu

Paper publication date:

Thursday 30 July 2020

From the study: West African women facing COVID

FACT N°2 – Women and girls face a limited access to social services

Inequalities between men and women in accessing basic social services (such as education, healthcare, justice) are structural in a lot of West African countries. These inequalities have been reinforced by the emergence of the COVID-19 pandemic, making it harder for women and girls to access education and healthcare.

Access to health centers was even more limited, mainly in urban areas, because of income losses, restrictions of movements and misinformation. A lot of women decided not to go to health centers, not because these centers were closed or crowded, but out of fear of being contaminated by the virus or fear of being stigmatized by their communities if they tested positive. The geographical distance to reach the health centers in rural settings have made them complicated to access because of the restriction of movements. The implementation of social distancing measures created endless waiting in lines in health centers, discouraging women to come. Women who usually resort to healthcare at a late stage (because of lack of time or out of prioritization of care for children or close family members) are the first ones to be impacted by this lack of access to the health centers. There are huge risks to their sexual and reproductive health, including an increase in maternal and child mortality (as it happened during the Ebola epidemic), an increase in unwanted pregnancies, an increase in sexually transmitted diseases and infections and a decrease in family planning. In the long term, their health could be endangered by the risk of medical complications if they do not treat their diseases correctly. For children, access to vaccination can become more complicated. In some countries, there are cases of husbands forbidding their wives to go to health centers creating an obstacle for women to access healthcare.

Girls are also facing specific risks. For a lot of them, the closing of schools could push them into permanently drop out of school, especially if they are asked to do domestic chores and economic activities. They are also more at risk of child marriage, forced labor, prostitution and sexual violence. Because they have a limited access to healthcare, they could have more unwanted pregnancies and sexually transmitted diseases, especially if they don’t have access to information about their sexual health.

Most of women and girls are having challenges in mitigating this situation. Most of them self-medicate, even though it could constitute a big risk for their health. They also use traditional medicine when they don’t have the opportunity to take loan to pay for healthcare. Pregnant women use matron, traditional midwives, to monitor their pregnancies.

“My child has a cold but I hid him and treated him with traditional medicine to avoid being accused of having caught the disease” relates a woman in a community relays in Guédiawaye, in Dakar surroundings

RECOMMENDATIONS

To tackle this situation, there is an urgent need to create and implement information and awareness campaigns targeting women, girls, and men to communicate about the access to health centers and the rights of women and girls regarding healthcare. Governments must promote the hiring and training of women medical staff, create local sexual and reproductive health centers (and, if not, develop mobile clinics to reach isolated landlocked rural areas), and train community volunteers to give primary care. More generally, women and girls should have access to free sexual and reproductive healthcare, free primary care, and free menstrual hygiene products. In the education sector, governments should at least maintain their education budget and not divert it to other sectors to tackle the crisis and to implement awareness-raising campaigns for girls to go back to school as soon as they reopen.