When it comes to accessing healthcare services, deeply held social constructs can hinder women’s right to access. In some parts of the country, women must obtain consent before engaging in certain activities including receiving life-saving health services. This also extends to the COVID-19 pandemic as in many low- and middle- income countries, women are less likely to get COVID-19 vaccines than men are. This compounds gender inequality women are already facing in health and decision-making.
I asked a colleague who received the vaccine with me if she first informed her husband or sought his permission before getting the vaccine. She said no with a face that clearly said, “why would I do that?”. Not every Nigerian woman can say this because not all of them have that agency.
Gender inequality is a growing concern and the focus of many advocacies. The 2021 Future of Health Conference organised by Nigeria Health Watch focused on ways that societies devoid of gender inequality can make faster progress to attain the sustainable development goals.
One of the sessions centered on the importance of better-quality women’s health. Professor Agnes Binagwaho, Vice Chancellor, University of Global Health Equity, Rwanda said achieving quality for women should be prioritised at all levels by enshrining inclusivity at all points of care. This requires being holistic about health provision and critically thinking about other factors outside the health sphere that can impact health such as, education and meaningful work for women. An empowered and enlightened woman is less likely to wait for spousal consent before receiving life-saving health care.
The challenge is even more complicated by the disparity between women who are in the health workforce and those in leadership. Dr. Mary-Ann Etiebet, Lead and Executive Director, MSD for Mothers said women make 70% of the global healthcare workforce, but only 10% to 20% of leadership positions are occupied by women. The implication is that they are unable to put in place or follow through with policies that ensure inclusive and equitable distribution of health service to benefit women.
Gender inequality prevents the attainment of the “leave no one behind” goal of the sustainable development agenda because it introduces discrimination on the basis of gender. The consequences can be far reaching for women in accessing health care, especially when they need spousal consent to receive healthcare services such as COVID-19 vaccines.
Equitable access to vaccines to the last mile is integral to ending the COVID-19 pandemic. To achieve this, challenges such as gender inequality, norms and relations that impact vaccine access and demand must be understood and addressed. This can help design context specific solutions that are critical for expanding reach.
The COVAX facility and partners are working hard to reduce vaccine inequities by doing the important work of ensuring vulnerable communities are accessing the COVID-19 vaccine. As of November 2, 2021, COVAX has shipped over 435 million COVID-19 vaccines to 144 participating countries. Nigeria has received 7.9 million doses.
The next important thing is making sure women are not left behind in accessing the vaccines at the last mile as rollout continues. These decisions can’t be made without quality data. The lack of data on COVID-19 vaccine rollout disaggregated by sex makes it difficult to understand how gender impacts the pandemic outcomes.
As Ramatu Ochekliye, founder of Shades of Us media said, it’s undeniable that men influence women’s access to health services such as COVID-19 vaccines. “But even bigger than him are the religious and traditional leaders he follows. If they do not believe, he in turn may not believe and that means the women are prevented from taking the vaccine,” she added.
While she submits that it’s unfortunate that the conversation about men supporting women’s access to healthcare is happening in the first place, she believes it’s the end that justifies the means. The important goal is ensuring everyone has access to the healthcare they need.
Ochekliye said a possible solution is active male involvement in vaccine advocacy, especially in places where men make all the decisions. To complement this, women must be empowered and educated to know their rights, she added. Also, more women in leadership especially in healthcare can proffer and follow through with policies that improve access to quality care for everyone irrespective of their gender.
Chibuike Alagboso is a Health Journalist at Nigeria Health Watch.
