International Women’s Day … and malaria

For 99 years International Women’s Day (8 March) has been “a global day celebrating the economic, political and social achievements of women past, present and future.” According to the UN Special Envoy for Malaria, Ray Chambers

The disease strikes infants, children under five and pregnant women in astonishing disproportion, as these segments of the population account for 90 percent of malaria deaths. Given the dual role of women as both victim and primary protector of victims, malaria clearly belongs under the umbrella of traditional women’s health issues.

dscn7760sm.JPGThe protective role of women in the fight against malaria extends beyond the household. In endemic most countries the majority of front line health workers who treat malaria patients and give out bednets are women.  Women also play a major community role when they volunteer as village health workers and bring malaria treatment and prevention to the grassroots as seen in Ethiopia‘s “scheme to train thousands of young women in malaria fighting tactics.”

Although women may not have equal numbers of positions compared to men when it comes to malaria policy making and program management, it was impressive at the November meeting of the RBM Harmonization Working Group to be addressed by the women who were directors of the national malaria control programs of Kenya, Nigeria and Ghana.

The World Gender Gap Report (2008) considers economic opportunity and participation, educational attainment, political empowerment, and health and survival of women in each country.  130 countries were scored, and at ten of the lower 30 on the list are endemic for malaria compared to only 3 in the top 30. This does not mean that malaria per se creates inequality, but may have a harder time accessing malaria prevention and treatment where gender equality is highest.

Provision of Intermittent Preventive Treatment for pregnant women (IPTp) during antenatal care is an example of neglected services for women. The World Malaria Report roughly estimates that no around 20% of pregnant women in areas of stable malaria transmission in Africa received the minimum two doses of IPTp even though the target for 2005 was 60%.  The RBM website’s country facts show that coverage with two doses can be as low as 3% in Angola and 5% in the Democratic Republic of the Congo. Only one country appears to have broken the 60% ceiling, Zambia.

Countries need to step up and close the gender gap in malaria services. Resources are available from Jhpiego to help countries assess their current malaria in pregnancy program implementation status, update their malaria policies to reflect the needs of women and train health workers to deliver better malaria services to women.

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