Reproductive health is a public health concern

OPINION

This opinion was first published in the New Vision on May 4, 2023

Esther S. Busiku

April 7 is recognised globally as World Health Day and is celebrated annually to shine a light on specific health issues affecting populations.

It is an opportunity to promote good health and ensure well-being for people around the world. Good health and wellbeing are essential for the sustainable development of any society. Any strategy aimed at promoting good health, particularly women’s reproductive health and reproductive health rights is integral in achieving Sustainable Development Goals (SDGs).

The World Health Organisation (WHO) defines reproductive health as the state of complete physical, mental, and social well-being in all matters relating to the reproductive system, its functions, and processes, and not just the absence of disease or ailment.

While Uganda has registered some progress in the health sector, a lot still needs to be done regarding women’s reproductive health. The provisions that exist under Article 33(2) of the Constitution of Uganda speak generally to the rights of women and not particularly their reproductive health. Over time the focus has been on reproductive health issues like maternal mortality rate, adolescent pregnancies, sexual health rights and fibroids among others. These of course have long-term effects on the health, education, and economic well-being of women and girls and should be addressed. However, less attention is paid to reproductive conditions like endometriosis and polycystic ovarian syndrome (PCOS) that equally have far-reaching impacts on the social and economic lives of women of reproductive age. They are common conditions that affect women’s reproductive health globally.

Endometriosis is the presence of uterine tissue outside the uterine cavity. The misplaced tissue can grow on the ovaries, behind the uterus, fallopian tubes, on the bowels, bladder or the shoulders causing chronic pain in the abdomen, lower back, shoulders or pelvic areas.

On the other hand, PCOS is a condition that normally affects women with polycystic ovaries. It happens when the ovaries or adrenal glands produce more male hormones than normal and as a result, enlarged ovaries with growths of fluid-filled sacs (cysts) on the ovaries. PCOS is characterised by pelvic pain, excess hair growth on the face, chin, chest, stomach, thumbs or toes, thinning hair and acne. Studies have placed the prevalence of PCOS in sub-Saharan Africa at an estimated rate of about 5.6%. Similarly, the prevalence of endometriosis in Africa is not well documented, but according to a 2017 systematic review of the prevalence of endometriosis among indigenous Africans by Gichuhi J. Wanyoike et al, the estimated prevalence of endometriosis among women of reproductive age is between 2% and 10%.

In Uganda, the prevalence of the duo is not documented due to a lack of reliable data, yet they greatly affect women and girls in Uganda. Endometriosis and PCOS have no cure. The symptoms can only be managed for the duration of the sufferer’s reproductive years.

The average Uganda female experiences her first period at the age of 12 and hits menopause at 48 years. This means roughly 36 years of suffering during a time these women and girls are expected to enjoy their youthful productive years.

To spread awareness of endometriosis and its symptoms, Bump Love, a TV show on motherhood, produced an episode on endometriosis on January 27, 2023 during which Ms. Sheila Nabuuma shared her journey.

“Endometriosis is a condition that is not openly talked about nowadays and yet it greatly affects the reproductive health of the sufferer,” Mrs Rachael Mwine said on that episode of Bump Love.

According to Nabuuma, a stage 4 endometriosis sufferer, like menstruation, the misplaced tissue sheds every month but outside the uterus (pelvic cavity) with no exit point for the blood which causes inflammation from the build-up over months hence the pain.

Sandra (not her real name) while speaking about her struggle with both PCOS and endometriosis, said she experiences excruciating pain in the shoulders every month during her menses, a different shoulder every month, and that for years doctors had failed to ascertain what the cause of the pain was.

The Government must take the necessary steps to address these health challenges.

Read the full version at www.newvision.co.ug

The writer is a policy analyst