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One of the specific challenges in the past six months has been that women have been dying from a range of ailments during COVID-19, because they were afraid to access hospitals. This was reflected through statistics such as the South Africa cesarean rate dropping because of COVID-19 - because women were not going to hospitals, and neo-natal care dropped. The region also saw a rise in teenage pregnancies, because of school closures, posing another challenge.
Furthermore, as Dr Iman Eweis, a radiologist specialising in breast imaging at a woman and foetal imaging clinic in Cairo, explains, during the height of the pandemic breast cancer radiology services were held back in Egypt:
“We experienced fewer working hours and limited personnel at the clinic. We could only deal with one case at a time. Also, patients didn’t want to leave the house due to the fear of contracting the virus. This reflected in some of the patients' results when they came in later for their routine screening. In some cases, this delayed intervention for a palpable abnormality, and we found many patients with a later stage of the disease at presentation, so COVID-19 has had a significant impact on our practice and patient outcomes.”
She observes that many women at a younger age are prone to breast cancer and that Egypt has a lower age threshold compared to other countries in the world: “Breast cancer is a public health problem in Egypt.”
Another challenge comes in the form of ethical issues raised by COVID-19. Arguments range around personal liberty and right of movement - and some measures that limit access to healthcare.
Another similar example can be seen when women have been unable to continue the vaccination of their children. While governments were concentrating on COVID-19, leaders were not thinking of the routine immunisation of children that needed to be done and it was completely stopped.
Therefore, most women have needed to create space for themselves, as the pandemic "pushed them further into the background" because of perceptions that the crisis required strengths (associated by men with men). They have had to do their own situation analysis, and provide solutions to gaps, comments Dr Mary Eyram Ashinyo, Deputy Director – Quality Assurance - Ghana Health Service HQ.
Njide Ndili, Country Director – PharmAccess Foundation suggests that while a large percentage of doctors are women, not all are decision-makers.
The issue of access and how to level the playing field needs to be addressed, and that's why innovation in Africa is critical.
The majority of people accessing healthcare are women and children - something they are now fearful to do. Ndili's organisation, PharmAccess Foundation, has made a concerted effort to support the state government in putting out correct information to allay fears.
Prof Maswime, Head of Global Surgery – University of Cape Town, observes that pregnant women in South Africa are anxious during these times as a result of the pandemic,
adding that they require more support. Some are having to give birth alone for example.
Listen to Prof Maswime explain how the pandemic has affected Africa's pregnant women in the following Patient Talk podcast episode - click below:
Meanwhile, Dr Elizabeth Wala, Global Advisor, Health and Nutrition –Aga Khan Foundation, shines a spotlight on how far the challenges reach, revealing that many community workers, the majority of whom are women, fear entering houses due to a lack of PPE.
