AFRICA

The goal of IWHC's Africa program is to strengthen the movement for women's health through local organizations, and to focus attention on critical or neglected women's health issues. IWHC supports organizations in Nigeria and Cameroun that address:

Since 1988, when the Africa program began, IWHC has identified and supported leaders and health professionals concerned about reproductive health from women's perspectives and has strengthened women's health organizations. The program emphasizes the role that sexuality and women's low status vis a vis men in society play in reproductive health. In addition to financial support, we provide training and technical assistance in project planning and implementation, evaluation, report-writing, and fund-raising, as well as information resources and moral support to our colleagues in Africa.


NIGERIA

Since the inception of our program in Nigeria, IWHC has encouraged and supported the development and fortification of 14 local organizations working on women's reproductive health issues. We are currently working with 11 of these groups, while others are continuing their work with support from other donors. As our colleagues have gained experience, they have begun to address issues which are at the root of women's poor reproductive health, especially sexuality and women's low social status.

Nigeria has been ruled primarily by the military since its independence in 1960. Today, political rights are restricted and economic development is minimal. Still, in this context, the number of NGOs has burgeoned over the last five years. These NGOs undertake a variety of activities including providing services formerly overseen by the government, demonstrating new ways of working on issues, and educating the public.

IWHC colleagues in Nigeria develop and demonstrate ways to address issues on a local level. IWHC also provides extensive informational resources --- primarily books, but also magazines, articles, journals and videos generally unavailable in Africa --- for our colleagues in Nigeria. These resources enable leaders, staff and members to stay up-to-date on the issues they are addressing, ensure the quality of their work, and improve their ability to work on policy locally, nationally, and internationally. The majority of these organizations have resource centers which provide the public with access to the materials as well.


Adolescent Sexuality

In 1990, we made our first grant in Nigeria to address adolescent reproductive health issues. Since that time, the program's emphasis on young people has gradually increased as more and more of our colleagues have identified adolescents as offering the most potential for social change, especially on difficult issues such as sexuality, reproductive health and women's status. IWHC continues to support five Nigerian organizations' work with adolescents.

In Nigeria, 72% of males and 82% of females have had sexual intercourse by the end of their teenage years. The mean age of marriage is 16.5 years; half of all Nigerian women have children by the age of 20. Most adolescents receive little or no sexuality education and many are completely ignorant about their bodies, reproduction, contraception and disease prevention. They are generally unlikely to use sexual health services which are for adults, and services designed for adolescents are extremely rare. As a consequence, rates of pregnancy, STDs and AIDS among adolescents are high. Pregnant adolescents often wind up getting dangerous clandestine abortions that can result in illness, infertility, or death.

For More On Our Colleagues In Nigeria See: Women's Health Matters and News From Our Colleagues: Dr. Bene Madunagu and Girls' Power Initiative, Nigeria




Unwanted Pregnancy and Abortion

In Nigeria, abortion is illegal except to save the life of the woman. Maternal mortality rates for Nigeria are some of the world's highest. Of the estimated 50,000 maternal deaths every year, approximately 20,000 result from the complications of unsafe or induced abortions. Safe abortion is available for those who can pay for and find a trained provider --- but for those who cannot, conditions are extremely dangerous. Of those women admitted to hospitals for complications due to abortion, an estimated 50-60% are less than 20 years old. Contraceptive usage rates remain low, with less than 10% of women of reproductive age using contraception.


STDs and AIDS

It is estimated that between 3 and 4 million Nigerians will be HIV positive by the end of 1996. Of the AIDS cases reported over the last 10 years, 47% were among women. Condom use is low, with only 10% of people reporting that they have used condoms at least once, and 5% reporting that they are currently using condoms.




CAMEROUN

In Cameroun, there are fewer women's health organizations and the resources are more limited than in Nigeria, so the IWHC program has emphasized strengthening existing organizations. IWHC works with four organizations to undertake public education, advocacy and policy work and to strengthen their organizational capacity. These organizations address the fundamental issues of STDs and AIDS, adolescent health and sexuality, violence against women and harmful traditional practices.

The Camerounian government is highly centralized. While small village and ethnic based organizations abound, non-governmental organizations have not traditionally played a major role in national public education or policy formation. Over the last five years, the economic situation of most Camerounians has gotten considerably worse. In 1994, the currency was devalued by 100% causing rapid inflation; salaries of public servants were cut by 70%. Health services are strapped for funds and patients arriving at hospitals must bring all medical supplies (such as cotton wool, cat gut, and syringes) with them. Colleagues report that the use of health care services is declining because people cannot afford to pay for treatment.


STDs and AIDS

Although data on the AIDS epidemic in Cameroun are scarce, it is clear that the disease is spreading. HIV infection has risen from an estimated 2% of the general population in 1995 to 5.5% in 1996. There are an estimated 12,000 known cases of AIDS in Cameroun --- 50% of which are women. Seventy percent of infected women are between the ages of 15-25.

Adolescent Sexuality

A November 1993 study of teenage pregnancy in the rural and urban areas of Cameroun found that 14.7% of pregnancies in the population surveyed occur before the age of 19. The organization that conducted this study determined that the most significant causes of teenage childbearing are the lack of information about reproduction and contraception, lack of education in general, and familial poverty. Although the majority of Camerounians are believed to become sexually active when they are teenagers, most parents do not talk to their children about their bodies or their sexuality.

Harmful Traditional Practices and Violence Against Women

Cameroun has hundreds of different cultural groups, each of which is rich in traditional practices. In 1992, the Cameroun Medical Women's Association undertook focus group research on the ways in which traditional practices affect women's health. Their research covered the predominant ethnic groups in the country's 10 provinces. In general, they found that the different groups had similar practices. Certain traditional Camerounian practices are healthy and empowering, such as prolonged breast-feeding and and complete maternal rest after childbirth. Others are extremely harmful, such as female genital mutilation and blaming women for STD transmission. Although no reliable statistics are available, violence against women is pervasive in Cameroun and affects all categories of women, whatever their age, race, social status, level of education, and religion, and whether they live in a rural or urban area.


For More Examples Of Our Work In Cameroun See: STD/AIDS (Sexual Transmitted Disease)



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