National Women’s Day 2019
National Women’s Day is celebrated annually in South Africa on 9 August in honour of the 20 000 women of all races who marched to the Union Buildings on 9 August 1956 to protest against apartheid pass laws. The theme for 2019 is ‘25 years of democracy: Growing South Africa together for women’s emancipation’. The theme is a call to South Africa to reflect on the country’s attempts at achieving gender equality across all sectors: the arts, sport, politics, the economy, health, land ownership, entrepreneurship and gender dynamics. Although statistics have shown that women are making substantial progress in business, politics, academic and economic careers, there are several challenges related to women’s health and rights that require increased and sustained advocacy.
The International Federation of Gynecology and Obstetrics (FIGO) has called on all member countries to increase their commitment to women’s sexual and reproductive health, rights and gender equality. FIGO recognises that all women and girls have a right to life, liberty and security, freedom from violence, that is, the right to control one’s health and body. Women have the right to choose when and how many children they may elect to have with voluntary access to modern contraceptive methods, the right to prevention and treatment of sexually transmitted infections, and the right to prevention and treatment of cervical cancer and HIV/AIDS.
The World Health Organisation (WHO) and FIGO have prioritised the following to promote women’s health and well-being:
Human rights and health
A rights-based approach to health requires that health policy and programmes must prioritise the needs of those most disadvantaged first, towards greater equity – a principle that has been echoed in the recently adopted 2030 Agenda for Sustainable Development and Universal Health Coverage.
Approximately 830 women die globally each day from preventable causes related to pregnancy and childbirth. Ninety-nine percent of all maternal deaths occur in developing countries. Between 2016 and 2030, as part of the Sustainable Development Goals, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births.
Around 25 million unsafe abortions take place worldwide each year. Unsafe abortion contributes to 4,7%–13,2% of global maternal deaths annually.
Approximately 16 million girls aged 15 to 19 years and 2,5 million girls under 16 years give birth each year in developing countries. Complications during pregnancy and childbirth are the leading cause for death for 15-to-19-year-old girls globally. Adolescent mothers (ages 10 to 19 years) face higher risks of eclampsia, puerperal endometritis and systemic infections than women aged 20 to 24 years.
About 200 million women of reproductive age in developing countries who want to avoid pregnancy are not using a modern contraceptive method. Contraception reduces the need for abortion and reinforces people’s rights to determine the number and spacing of their children.
Violence against women
Violence against women – particularly intimate partner violence and sexual violence – is a major public health problem and a violation of women’s human rights. Global estimates published by the WHO indicate that about one in three women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.
Cervical cancer is the second most common cancer in women living in less developed regions, with an estimated 570 000 new cases in 2018. Approximately 311 000 women died from cervical cancer in 2018; more than 85% of these deaths occurred in low-and middle-income counties. Comprehensive cervical cancer control includes primary prevention (vaccination against HPV), secondary prevention (screening and treatment of pre-cancerous lesions), tertiary prevention (diagnosis and treatment of invasive cervical cancer) and palliative care. Vaccines that protect against HPV 16 and 18 are recommended by the WHO and have been approved for use in many countries.
Prof Priya Soma-Pillay, Department of Obstetrics and Gynaecology, University of Pretoria and Steve Biko Academic Hospital. Honorary secretary of the South African Society of Obstetricians and Gynaecologists and Executive Board member – International Federation of Gynecology and Obstetrics (FIGO).