Women and Health

Most of the world’s women live in low-and-middle-income countries, and women represent 70% of the world’s poor. Women are less likely to have access to income, education, health care, nutrition, and political voice. This negatively affects families, communities, and countries.

Investing in the health of women impacts society as a whole, for example:

  • As the primary housekeepers and caregivers, women are essential to the survival, growth and development of their children
  • Women make up 40% of the labour force globally, and work 66% of the world’s hours. In sub-Saharan Africa, 60% of agricultural workers are women
  • Girls and women spend 90% of their earnings on their families, compared to men who spend 30%-40%
  • When 10% more girls go to school, a country’s GDP increases by an average of 3%

However, with women being disproportionately burdened with poor health and less access to health care, women cannot achieve their full potential. Cervical cancer is the most common cancer among women in sub-Saharan Africa, and by 2030 it is expected that a half million women will die of the disease. Reducing the global burden of cervical cancer will have a huge impact on improving the health and wellbeing of women, families, and society.

ASPIRE and the Millennium Development Goals

The Millennium Development Goals (MDGs), launched in 2000 by the United Nations, are a roadmap of goals agreed upon by countries and development institutions worldwide. The MDGs have led to considerable gains in reducing poverty and hunger, as well as improving water, sanitation, education and healthcare. With an initial target of 2015, the principles of the MDGs will be carried forward post-2015. The ASPIRE project has made contributions to all areas covered by the MDGs, including:

MDG #1 Eradicate extreme poverty and hunger

The economic and social wellbeing of families hinder on the contributions women make in the household and in the community.

Women spend most of their earnings on their family, provide better nutrition and provide healthcare to children. By protecting the lives of women by reducing the burden of cervical cancer, the whole family has a better future.

MDG #2 Achieve universal primary education

Cervical cancer has a high death rate when not caught early. Without a mother to provide for them, children are less likely to go to school.

When a woman in the household is ill with late stage cervical cancer, she often has to travel far to attend care at one of few hospitals that offer the necessary treatment. As the primary caregiver, she will usually bring the children with her, and out of school.

HPV self collection and subsequently life-saving early treatment can be done within the community where women live. This helps preserve the health and wealth of the mother, allowing children to go to school.

MDG #3 Promote gender equality and empower women

ASPIRE is committed to engaging women at all levels of programming. Not only are women the population we serve through reproductive health and cervical cancer screening, but our leadership team, staff, local council and community outreach workers are almost all women.

Our health education strategy is informed by women in the community to ensure its cultural appropriateness and women-centeredness.

The ASPIRE approach involves task shifting, where self-collection based cervical cancer screening is carried out entirely by peer outreach worker and midwives.

MDG #4 Reduce child mortality

Women with cervical cancer in sub-Saharan African are usually of reproductive age.

Motherless children are up to 10 times more likely to die within 2 years of their mother’s death

By protecting women’s reproduction health through cervical cancer and reproductive tract infection screening, health outcomes for children are improved, and they are more likely to live.

MDG #5 Improve maternal health

Most of the women we reach through ASPIRE do not attend health care regularly. By using self-collection for cervical cancer and reproductive tract infection screening we bring reproductive health care to the women directly at their homes or community places.

Late stage cervical cancer is often untreatable, or treated through measures associated with increased risk of infertility and poor outcomes during pregnancy. This makes early detection through HPV testing an important prevention strategy for maternal health.

MDG #6 Combat HIV/AIDS, malaria, and other diseases

Women with HIV are more likely to be infected with HPV, and infection progresses more frequently and more quickly. As a result women who are infected with HIV are 5-6 times more likely to develop cervical cancer.

HPV infection makes women more likely to acquire HIV.

ASPIRE has been working in partnership with the Infectious Diseases Institute at Makerere University to assess the acceptability of self collection for women with HIV. After a very positive response we have been able to offer self-collection based cervical cancer screening to these women.

MDG #7 Ensure environmental sustainability

The self-collection model for screening & treatment builds on existing infrastructure, with little need for electricity or water, produces minimal waste, and involves locally acquired supplies that are reusable where possible.

MDG #8 Develop a global partnership for development

HPV DNA testing used by ASPIRE is a leapfrog technology that is low-cost, requires minimal infrastructure, and is more effective at detecting pre-cancerous lesions compared to traditional pap smears. This means that through the ASPIRE process, developing countries will benefit from the newest and most effective technologies for cervical cancer screening.

The model takes an intersectoral approach to work with governmental, academic, clinical, non-profit, private, and community sectors to ensure that this is a health priority shared by all stakeholders, and that the intervention is designed in a meaningful and sustainable manner.

We have been collaborating with our community partners in Kisenyi, Kampala since 2007, and have conducted feasibility and pilot studies that have demonstrated that this model is highly acceptable to women.