Report on Maternal Health and Gender Equality Challenges in Africa in the Context of the Sustainable Development Goals

In observance of the International Day for Women and Girls of African Descent, this report analyzes critical challenges to women’s rights in several African nations, focusing on maternal mortality and Female Genital Mutilation (FGM). These issues represent significant barriers to achieving the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality).

Addressing Maternal Mortality: A Challenge to SDG 3

The high rate of maternal mortality in Sub-Saharan Africa directly contravenes SDG Target 3.1, which aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. Non-governmental organizations are actively working to address this crisis through targeted interventions.

Current State of Maternal Health (SDG Target 3.1)

• The maternal mortality ratio in Sub-Saharan Africa stands at 447 deaths per 100,000 live births.
• In Nigeria, the ratio is significantly higher, with approximately one woman dying for every 100 live births.
• In Chad, the risk is so profound that a common saying states, “A woman who is pregnant has one foot in the grave.”

Contributing Factors to High Mortality Rates

Several interconnected factors hinder progress towards SDG 3 and SDG 5:

1. Poverty and Inequality (SDG 1 & SDG 10): Extreme wealth disparities, particularly noted in Nigeria, mean that women die for lack of inexpensive medication.
2. Weak Institutions and Corruption (SDG 16): Inadequate government provision of healthcare and corruption are significant barriers.
3. Lack of Access to Healthcare (SDG 3.8): A critical shortage of essential medicines, such as misoprostol for postpartum hemorrhaging and magnesium sulfate for eclampsia, leads to preventable deaths.
4. Insufficiently Trained Personnel: A lack of properly trained midwives results in fatal complications during childbirth, such as mishandled breech deliveries.
5. Harmful Gender Norms (SDG 5): A cultural acceptance that maternal death is “God’s will” disempowers women and normalizes a preventable crisis, reflecting a low status for women.

Interventions by Life for African Mothers (LFAM)

The nonprofit organization Life for African Mothers (LFAM) is implementing strategies to improve maternal health outcomes in line with SDG 3:

• Provision of Essential Medication: LFAM supplies misoprostol, a key drug to prevent postpartum hemorrhaging, the leading cause of maternal death.
• Capacity Building: The organization trains local midwives in proper delivery techniques, directly improving the quality of care.
• Partnerships for Progress: In Sierra Leone, collaboration between LFAM and the government has contributed to a significant reduction in the lifetime risk of maternal death from one in seven to one in 74. At the Koobay Health Center in Freetown, which receives support from LFAM, there have been no maternal deaths since 2015.

Combating Female Genital Mutilation (FGM): An Imperative for SDG 5

The persistence of Female Genital Mutilation (FGM) is a severe violation of human rights and a direct obstacle to achieving SDG Target 5.3, which calls for the elimination of all harmful practices.

Prevalence and Health Consequences (SDG Target 5.3)

FGM has devastating effects on the health and well-being of millions, undermining SDG 3.

• In Somalia, 98% of women and girls aged 15-49 have undergone FGM.
• Globally, over 230 million women and girls are victims of the practice.
• Health consequences are severe and include kidney failure, chronic pain, depression, childbirth complications, and death from bleeding.

Socio-Cultural Drivers and Institutional Barriers

Efforts to eradicate FGM face significant resistance rooted in cultural and institutional challenges:

1. Cultural Normalization: FGM is often perceived as a normal, intergenerational tradition, leading to community pushback against activism.
2. Religious Misinterpretation: Although not a religious requirement, confusion and conflicting messages from some religious leaders perpetuate the practice.
3. Legislative Failure (SDG 16): In Somalia, efforts to pass a bill criminalizing FGM have been stalled for over a decade, highlighting a lack of institutional will to protect women’s rights. Activists argue that national security cannot be achieved without ensuring fundamental rights for women.

The Ifrah Foundation’s Advocacy and Awareness Campaigns

The Ifrah Foundation, led by FGM survivor Ifrah Ahmed, is working to change norms and advocate for legal protections:

• Raising Awareness: The foundation has successfully increased media and public discourse on FGM, moving it from a taboo subject to a public issue.
• Community Engagement: The “Dear Daughter” campaign has secured over 100,000 pledges from community members to not subject their daughters to FGM.
• Political Advocacy: The foundation continues to push for the passage of the FGM bill in Somalia, linking the protection of women to the overall stability and justice of the nation (SDG 16).

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article primarily addresses issues related to two main Sustainable Development Goals, with connections to a third goal concerning inequality.

1. SDG 3: Good Health and Well-being

   This goal is central to the first half of the article, which focuses extensively on the high rates of maternal mortality in Sub-Saharan Africa. The work of the organization Life for African Mothers (LFAM) directly targets improving maternal health outcomes, a key component of SDG 3.

2. SDG 5: Gender Equality

   This goal is addressed through two main issues: the fight against female genital mutilation (FGM) and the underlying theme that high maternal mortality is a gendered issue. The article quotes an activist saying, “This is about the status of women. They are expendable,” which directly points to gender inequality. The work of the Ifrah Foundation against FGM in Somalia is a clear effort to eliminate a harmful practice and a form of violence against women, which is a core target of SDG 5.

3. SDG 10: Reduced Inequalities

   The article connects the health crises to broader inequalities. It mentions that in Nigeria, “mega, mega, mega rich people” coexist with “women dying for 50 pence worth of medication,” highlighting the extreme wealth disparity that impacts access to healthcare. This points to inequalities within a country that prevent the achievement of health and gender equality goals.

2. What specific targets under those SDGs can be identified based on the article’s content?

Several specific targets can be identified from the article’s discussion:

• Target 3.1: Reduce global maternal mortality

  The article is built around this target. It explicitly discusses the mission of LFAM “to reduce maternal mortality in Sub-Saharan African countries.” It provides statistics such as the maternal mortality ratio in the region being “447 maternal deaths for every 100,000 live births” and highlights the progress in Sierra Leone, where the lifetime risk for maternal death has been reduced.

• Target 3.2: End preventable deaths of newborns

  This target is implied in the tragic anecdote about a breech delivery in Chad where the midwife’s lack of training led to the death of a “beautiful term baby who should never have died.” This highlights the issue of preventable neonatal deaths linked to the quality of care during childbirth.

• Target 3.c: Increase health workforce and training

  The article directly addresses this target by describing how LFAM “trains local midwives.” The story of the fatal breech delivery is used to illustrate why well-trained health workers are critical. The success at the Koobay Health Center, where a trained midwife reports “no maternal deaths,” further supports the importance of this target.

• Target 5.3: Eliminate all harmful practices, such as… female genital mutilation

  This target is the primary focus of the second half of the article. It details the work of Ifrah Ahmed and her foundation to stop FGM in Somalia, where “Ninety-eight percent of women and girls between the ages of 15 and 49 have experienced female genital mutilation.” The article describes FGM as a “brutal practice” and a “cultural issue” that activists are fighting to eliminate.

• Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights

  The entire article is fundamentally about this target. The fight to make childbirth safe and the campaign to end FGM are both essential components of sexual and reproductive health and rights. The article notes that FGM causes severe health problems, including “problems with childbirth,” directly linking the two main issues discussed.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article provides several quantitative and qualitative indicators that align with the official SDG indicators.

• Indicator 3.1.1: Maternal mortality ratio

  The article provides precise data for this indicator. It states the ratio for Sub-Saharan Africa is “447 maternal deaths for every 100,000 live births.” It also gives country-specific data, noting that in Nigeria, it averages “about one woman’s death for every 100 live births.” It also tracks progress by mentioning the global annual death toll has dropped from “over half a million” to “about 300,000 deaths per year.”

• Indicator 5.3.2: Proportion of girls and women aged 15-49 years who have undergone female genital mutilation/cutting

  The article gives a direct statistic for this indicator, stating, “Ninety-eight percent of women and girls between the ages of 15 and 49 have experienced female genital mutilation in Somalia.” It also provides a global figure that “more than 230 million women and girls are victims of FGM.”

• Indicator of Access to Essential Medicines (related to Target 3.8)

  While not a formal SDG indicator number, the availability of essential medicines is a key measure of health system strength. The article implies this by highlighting the lack of “magnesium sulfate” to treat eclampsia and the importance of providing “misoprostol, which prevents postpartum hemorrhaging,” showing that tracking the supply and use of these drugs is a crucial progress measure.

• Indicator of Changing Social Norms (related to Target 5.3)

  The article implies a way to measure progress through changes in social norms. The “Dear Daughter” campaign, which has gathered “more than 100,000 pledges made by members of the Somali community to not cut their daughters,” serves as a direct indicator of community commitment to abandoning FGM.

• Indicator of Legal Frameworks (related to Target 5.3)

  Progress is also measured by legal action. The article notes the ongoing effort “to get an FGM bill passed in Somalia,” indicating that the existence and enforcement of laws prohibiting FGM is a key indicator of progress.

4. Summary Table of SDGs, Targets, and Indicators

Source: themedialine.org