African Women Research Articles

From fetchers to decision-makers: exploring the gender dynamics of water access and governance in resource-poor communities of Mbala, Zambia

ABSTRACT Research on African women often emphasizes their traditional roles as water fetchers and caregivers, but their potential role in water governance is frequently overlooked. Here, this research gap is explored with a focus on the sustainability of water access points (WAPs). The latest mWater tool version 3.0. was used to conduct household surveys concerning gender roles in water access in rural Mbala of northern Zambia. Purposive sampling, a non-probability methodological approach, was used to choose respondents. The Empowerment in water, sanitation, and hygiene (WASH) Index (EWI) was adopted to quantify empowerment levels. The analysis revealed significant contributors to disempowerment, such as group membership, control over household goods, work balance, and leadership in WAP implementation. The study also highlighted the critical role of Water Point Committees (WPCs) in sustaining WAPs. An unexpected finding emerges as the data contests the prevalent notion that women, who are primarily responsible for water fetching, are marginalized from decision-making processes. Instead, the results suggest that women's disempowerment is not the primary factor contributing to the lack of sustainability of WAPs. Rather, a general lack of financial commitment within communities is at play. The study highlights the critical, yet previously overlooked, role of community meetings in ensuring the sustainability of WAPs.

Qualitative exploration of the barriers and facilitators to community pharmacy PrEP delivery for UK pharmacists and underserved community members using the COM-B model of behaviour change

ObjectivesExpanding delivery of oral pre-exposure prophylaxis (PrEP) to community pharmacies could improve access, aligning well with the UK government’s goals to eliminate new HIV acquisitions by 2030. Using the Capability,...

Stigma trajectories, disclosure, access to care, and peer-based supports among African, Caribbean, and Black im/migrant women living with HIV in Canada: findings from a cohort of women living with HIV in Metro Vancouver, Canada.

African, Caribbean, and Black im/migrant women experience a disproportionate burden of HIV relative to people born in Canada, yet there is scarce empirical evidence about the social and structural barriers that influence access to HIV care. The objectives of this study is to estimate associations between African, Caribbean, and Black background and stigma and non-consensual HIV disclosure outcomes, and to understand how experiences of stigma and im/migration trajectories shape access to HIV care and peer supports among African, Caribbean, and Black im/migrant women living with HIV in Canada. This mixed-methods analysis draws on interviewer-administered questionnaires and semi-structured interviews with self-identifying African, Caribbean, and Black women living with HIV in the community-based SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment) cohort. Bivariate and multivariable logistic regression using generalized estimating equations (GEE) were performed to estimate associations between African, Caribbean, and Black background and stigma and non-consensual HIV disclosure outcomes. Drawing on a social and structural determinants of health framework, qualitative analysis of interviews elucidated the interplay between migration trajectories, stigma, racialization, and HIV. Amongst our participants (n = 291), multivariable GEE analysis revealed that African, Caribbean, and Black participants (n = 15) had significantly higher odds of recently being outed without consent as living with HIV (AOR 2.34, 95% CI 0.98-5.57). Additionally, African, Caribbean, and Black participants had higher odds of recent verbal or physical abuse due to their HIV status (AOR 2.11, 95% CI 0.65-6.91). Reflecting on their im/migration trajectories, participants' narratives (n = 9) highlighted experiences of political violence and conflict, trauma, stigma, and discrimination associated with HIV in their place of origin and the racialization and stigmatization of HIV in Canada. Fear of disclosure without consent was linked to barriers of accessing care and peer-based supports. Our findings indicate that im/migration trajectories of African, Caribbean, and Black women living with HIV are critically related to accessing HIV care and supports in Canada and compound HIV stigma and discrimination. HIV disclosure without consent complicates access to care and social/peer support, underscoring the need for privacy, confidentiality, and the importance of building trust in the context of clinical encounters. The results of this study emphasize the critical need for culturally sensitive trauma-informed care models rooted in peer-based approaches.

Determinants of birth preparedness and complication readiness practice among reproductive-age women in Africa a systematic review and meta-analysis.

Safe motherhood programs must include both readiness for complications and childbirth. Birth preparedness and complication readiness (BPCR) is a comprehensive approach that helps resolve delays in deciding to seek care for obstetric problems. To identify the determinants of BPCR practice among reproductive age group women in Africa. Systematic Review and Meta-Analysis. Preferred Reporting Items for Systematic Reviews and meta-analysis (PRISMA) were followed and databases such as MEDLINE, PubMed, Scopus, Hinari, Google Scholar, and Web of Science were used to find the available studies. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to identify associated factors. I2 statistics, funnel plot, and Egger test were used to assess the studies' heterogeneity and publication bias. In this review, a total of 32 studies with 17,787 sample sizes were included. Knowledge of BPCR (AOR = 2.12, 95% CI: 1.44, 3.13), knowledge of danger signs during pregnancy (AOR = 1.60; 95% CI: 1.37, 1.88), Knowledge of labor and delivery danger signs (AOR = 1.44; 95% CI: 1.28, 1.62), Knowledge of postpartum danger signs (AOR = 1.40; 95% CI: 1.21, 1.63), urban residency (AOR = 1.32; 95% CI: 1.03, 1.70), Antenatal Care follow-up (AOR = AOR = 1.52;95% CI:1.42, 1.63), history of stillbirth (AOR = 1.59; 95% CI: 1.36, 1.86), parity (AOR = 1.76; 95% CI: 1.16, 2.66) and secondary or higher educational status (AOR = 1.51: 95% CI: 1.35, 1.68) were the determinants of BPCR practice. BPCR practice among African women of reproductive age has been greatly affected by antenatal care visits, urban residency, knowledge of danger during pregnancy, labor, and postpartum, history of stillbirth, primiparity, and secondary or higher education. Focused interventions that address the identified factors may enhance BPCR practices and maternal health outcomes in Africa.

Retrospective cohort study on treatment outcomes of early vs late onset gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) affects roughly 14% of pregnancies, its prevalence is increasing, and it is associated with a significant risk of complications for both mother and offspring. A high proportion of women with GDM can be detected early in pregnancy. In Italy, early GDM screening occurs in a selective way, as it is performed only in the presence of important risk factors. It remains to be elucidated not only how and when to diagnose early GDM but especially whether to treat it. This study aimed to compare the characteristics and complications of early vs late GDM as assessed and treated in a real-world setting, according to the Italian guidelines of the Istituto Superiore di Sanità. We conducted a retrospective cohort study in women with GDM delivering singletons between 2017 and 2021. Women with early GDM had higher BMI and a higher proportion of Middle Eastern or African women. Early GDM was independently associated with the use of insulin (p < 0.001). It required also higher doses of insulin, possibly due to the higher BMI. Early GDM was also independently associated with higher post-prandial (after dinner) glucose levels during the 3° trimester (p = 0.04). Nevertheless, early GDM women achieved glucose targets and put on less weight during gestation. Early GDM was independently associated with preeclampsia (p = 0.05). Otherwise, there were no other differences between early and late GDM in terms of pregnancy complications. After delivery, early GDM was independently associated with abnormal glucose tolerance. Early GDM women exhibited more severe GDM features. However, after achieving recommended glucose and body weight targets, there were no substantial differences between early and late GDM in terms of pregnancy complications apart from preeclampsia. These data support diagnosis and treatment of women with early GDM.

Leila Aboulela, Islam, and the trajectory of the African novel

ABSTRACT This article focuses upon Leila Aboulela’s Minaret, arguing that – in the context of the ambivalent relations between Islam and the west – it challenges stereotypes about Muslim African women, excavating Sufi traditions to challenge monolithic western understandings of Islam and Muslim women. The article’s intent is to develop the narrative about the African novel by bringing Aboulela into the debate because she offers an alternative narrative, one which refuses to fetishize difference, instead embracing cultural diversity and normative pluralism. The protagonist is a Sudanese Muslim woman who draws inspiration from indigenous cultures; she positions herself within the Sufi tradition, which challenges both patriarchal and imperialist understandings of Islam, thus finding her place in a secular society that views both Islam and Muslim women as aberrant. Acutely aware of the complexities of colonialism and religion, Aboulela shifts the African novel towards a subtle engagement with urgent questions around gender and Islam.

Between worlds: Cis-and trans-identifying diaspora Middle Eastern and North African (MENA) women in Ontario, Canada on the intersections of gender, sexuality and sexual health.

Youth Sexual Health and HIV/STI Prevention in Middle Eastern and North African Communities (YSMENA) is the first community-based research study in Canada to explore key determinants of sexual health among diaspora Middle Eastern and North African (MENA) women living in Canada. Our objectives were to identify the factors influencing sexual health for MENA youth and grow an evidence base to strengthen the sexual health response for MENA communities. Using mixed- method design, data were gathered through a quantitative socio-demographic survey and qualitative focus groups with 24 women-identifying MENA youth (16-29 years) living in Ontario, Canada. Six (6) focus groups were held virtually via Zoom, with heterosexual, lesbian, bisexual and queer (LBQ), and trans women. Members of each group participated in two sessions as per the sequential critical dialogical method and transcripts were coded in NVIVO. While participants identified with diverse sexual orientations and across the trans-feminine gender spectrum, key commonalities surfaced, namely the pressures to conform to familial expectations and the barriers faced when accessing healthcare. The trans group experienced compounded levels of exclusion given their unique positioning. Although the challenges faced by the group were deeply entrenched in patriarchy, heteronormativity and internalized shame, many participants demonstrated resilience and self-acceptance that enabled them to forge pathways to health. Findings have important and valuable implications for community-based health programs targeting MENA women as well as healthcare practitioners and service providers.

The Impact of Climate Change on Maternal and Fetal Health: An Emerging Crisis

The health risks posed by climate change have extended into maternal and fetal health, with evidence linking changing environmental factors to a rise in conditions such as pregnancy-induced hypertension (PIH), cerebral venous thrombosis (CVT), and physiological jaundice, particularly in winter months. Additionally, post-viral infections and intrauterine infections have become more prominent in the post- COVID era, contributing to an increased risk of congenital anomalies, preterm labor, and intrauterine growth restriction (IUGR). The article also highlights the higher incidence of postpartum cardiomyopathy in African women and the challenges posed by long-distance travel during pregnancy. This article examines these trends and calls for more targeted research and interventions to mitigate these risks.

From caretaking to transaction: Women politicians, motherhood, and political authority in Kenya

AbstractFeminist scholars have noted how motherhood opens avenues for women to access political authority. For African and Black women, scholars have noted how presenting themselves as mothers in the political sphere allows them to capitalize on an identity that traditionally allowed them access to power. However, these perspectives on motherhood and politics privilege a perspective on motherhood that deems the role as selfless and sacrificial. In this article, I propose moving beyond the caretaking dimensions of motherhood when analyzing how women politicians utilize motherhood. Drawing on evidence from research among Kenyan women politicians between 2017 and 2020, I argue that political motherhood often emerges as a transaction. Rather than interpreting the actions of women politicians as an extension of maternalistic impulses into the political realm, I illustrate how women politicians present the benefits of motherhood in exchange for citizens’ votes. By diversifying the meanings of political motherhood beyond caretaking and communal roles, this article counters perspectives that assume women politicians are less corrupt or are the victims of patriarchal politics. Instead, by foregrounding the transactional dimensions of political motherhood, this article illustrates how women politicians strategically use gendered identities to build political authority.

Complex Pelvic Fistulas in African Women: The Challenges and Opportunities of an Ongoing Epidemic.

Complex Pelvic Fistulas in African Women: The Challenges and Opportunities of an Ongoing Epidemic.

Gender parity in African science.

Africa has seen a notable increase in young women's participation in science, technology, engineering, and mathematics (STEM) fields over the past two decades. In 2019, the continent boasted the greatest share of female STEM students globally-47% across 49 universities-according to a report from the United Nations Educational, Scientific and Cultural Organization. Sadly, much of this talent is underutilized. Traditional gender expectations and domestic roles pose substantial obstacles, restricting African women from accessing STEM career opportunities. In sub-Saharan Africa, for example, only 31% of professional researchers are women. Without closing the gender gap in African science, progress on widespread problems such as maternal and child health, and food security, is unlikely.

Class and Ethno-Gender Differences in Education and Labour Market Position—An Intersectional Analysis of Ethnic Integration in the UK

This paper analyses the socio-economic disadvantages of women from different ethnic minority heritages in the UK. Using data from the Labour Force Survey (2014–2023), which contains detailed information on parental class and respondents’ socio-economic conditions, we examine four domains of life chances which are crucial for ethnic integration: educational attainment at the degree level, risks of unemployment, access to professional-managerial (salariat) position and earning power. We proceeded with the gross differences and then examined the differences by ethno-gender status and parental class combinations, controlling for many confounding factors. We also examined the net ethno-gender differences over the life course and the trends of social fluidity over the period covered and across the ethno-gender groups. We found that women from all ethnic origins were doing well in education but faced multiple disadvantages in the labour market, especially in access to the salariat and in earning power. Women of Pakistani/Bangladeshi heritages faced pronounced unemployment risks, especially at the earlier life stages. There is a significant increase in fluidity over the period covered, but this is marked by considerable ethnic and class differences, with Black Caribbean, Black African, Pakistani and Bangladeshi women from more advantaged class origins being unable to secure advantaged class positions and those from working-class families unable to make long-range upward mobility as effectively as White men. Overall, Bangladeshi, Pakistani, Black African and Black Caribbean women are found to be considerably disadvantaged, but there are also signs of social progress.

Conflicts and Restrictions: Flora Nwapa's Visionary Exposé of Women's Struggles in Nigerian Marital Contexts

This paper investigates acclaimed Nigerian Author Flora Nwapa's nuanced literary portrayals of the challenges Nigerian women face within marital roles and relationships. Through textual analysis of characters and events across Nwapa's novels, short stories and folklore centered on women's experiences, the study illuminates critical perspectives on issues of patriarchy, lack of autonomy, rigid gender roles, and socioeconomic restrictions undermining women’s agency and fulfillment. Core themes highlighted in Nwapa's subtle social commentary include anguish over infertility, hardships from prolonged spousal absence, emotional tolls of polygamy, lack of personal choice in partners, limited educational and career opportunities, economic dependence, and domestic violence. Her visionary work gives voice to Nigerian women’s aspirations while exposing oppressive structures. Findings substantiate how Nwapa’s rich depictions of women navigating complex marital terrain reveal an array of postcolonial and patriarchal impediments to female empowerment. Her literary portrayal of restrictions, conflicts and oppression compels critical examination of norms inhibiting women’s advancement. By confronting gender-based inequities and envisioning transformative possibilities, Nwapa leads African women writers in catalyzing legal and sociocultural reforms to promote women’s full flourishing.

Protean Careers: Case Studies of South African Women Working in Music

This qualitative research investigates the career experiences of 14 female musicians in the city of Gqeberha in the Eastern Cape province of South Africa. Findings accord with research conducted in other countries, and like their international counterparts, these musicians find themselves in a complex and precarious industry. They develop their identity or brand, build networks, and pursue lifelong learning while working in non-music fields to sustain their employability. The findings also indicate that a music qualification is not a prerequisite for employment except in the field of music education, and that such formal qualifications are associated with greater job security in this field. These findings offer new insights and a nuanced understanding of how a specific group of music creatives navigate protean careers.

Characterizing clinical and hormonal profiles of acne in north African women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is the leading endocrine disorder in young women of childbearing age. Dermatological issues, particularly acne, are a major reason for medical consultations. The aim of this study is to determine the prevalence of PCOS in patients presenting with acne as their main dermatological complaint and to compare the metabolic and hormonal clinical characteristics of acne patients with PCOS to those with isolated acne. This was a prospective study with analytical aims, carried out in the Endocrinology Department and the Dermatology Department of Farhat Hached University Hospital in Sousse. The study included patients seeking treatment for acne from January 2023 to January 2024, divided into two groups: those with confirmed PCOS (G1) and those with isolated acne (G2). All patients underwent hormonal assessment and ovarian ultrasound. We conducted a study involving 212 patients. We found that 65.6% of acne patients had been diagnosed with PCOS. Nodular lesions were significantly more frequent in 'PCOS' (p = 0.02). Acne was linked with hirsutism, which was more prevalent in 'PCOS' (94.2% 'PCOS' vs. 67.1% 'isolated acne'), as well as androgenic alopecia (51% 'PCOS' vs. 21.9% 'isolated acne') (p < 10- 3). 'PCOS' showed evidence of biological hyperandrogenism, with a mean testosterone level of 0.72 ± 0.27 ng/mL, significantly higher than in 'isolated acne'. The LH/FSH ratio was greater than 1 in 72.7% of cases in 'PCOS', demonstrating a significant difference compared to 'isolated acne', where it was greater than 1 in 24.7% of cases (p < 10- 3). In our study, acne in 'PCOS' appeared to be more severe and was associated with hypertestosteronemia (p = 0.041) and hyperprolactinemia (p = 0.008). According to our results, phenotype A was the most likely to cause severe acne (p = 0.043). Our work is unique in that it brings to light this hidden aspect of the dermatological impact of PCOS, prompting physicians to screen for this endocrine disorder in all adult women seeking acne treatment.

“Abandoning her nature as a woman”: Ṭaytu Bǝṭul and the Ethiopian paths for female empowerment

ABSTRACT This essay centers on one African woman, Ṭaytu Bǝṭul (1851–1918), and argues that her path to empowerment has a significant African and Ethiopian precedent. African scholars write about how African women have obtained authority through shifting aspects of their identities through the religious, economic and political spheres. The Ethiopian precedent is seen in the lives of historical Ethiopian women like Mǝntǝwwab, Mänän, and Wällätä Petros. Using the relevant primary and secondary sources, I continue to argue that Ṭaytu used the strategies that served these women in the past, such as the prominent position of women in African religions, imperial marriages of her relatives throughout her and her husband’s growing Empire, and her central place in her husband’s inner circle to create, maintain and expand her influence culminating in her governing the nation for years after a series of strokes incapacitated her husband Mǝnilǝk II.

Preferences for oral and injectable PrEP among qualitative sub-study participants in HPTN 084.

HPTN 084 compared the safety and efficacy of long-acting injectable cabotegravir (CAB) to daily oral TDF/FTC for prevention of HIV-1 in uninfected African women. Like a similar trial in MSM/TGW (HPTN 083), the trial was stopped early for efficacy, expediting the need to consider introduction strategies for different populations. We examine survey and qualitative data from a four-country sub-study to examine oral and injectable PrEP acceptability and considerations for CAB access among African women. Participants completed baseline and follow-up surveys on HIV risk perception, sexual behavior. product acceptability and adherence during the blinded trial. Additionally, up to two in-depth interviews each with 73 sub-study participants explored product use and trial-related experiences, during the blinded and unblinded study periods. Using survey data, we classified participants as: engaged in female sex work (FSW), having multiple non-transactional partners, or monogamous. A study statistician identified participants' assigned study arm. We followed a thematic analysis process to read transcripts, develop a codebook and apply codes in NVivo to transcripts with intermittent intercoder reliability checks; using Excel matrices to explore differences across risk categories and study arms. Participants overwhelmingly preferred injections to pills, appreciating the ease, convenience, and privacy of a long-acting formulation. Many participants described challenges with contraceptive and/or study pill adherence, impeded by late night work, unexpected travel, or heavy drinking. Women in the TDF/FTC arm were more likely to describe side effects, compared to those in the CAB arm. Pain also varied widely by study arm. When considering post-trial access to CAB, limited PrEP knowledge, cost and concerns around stigma and poor service quality were potential access barriers. Women's desire for privacy and ease of use outweighed injectable concerns, resulting in a strong preference for CAB. Cost and accessibility will need to be addressed by implementation programs.

Remembering the Disremembered

Abstract This article reads Abubakar Ibrahim’s short story “The Book of Remembered Things” as an anti-jihadist narrative that meditates on the traumatic effects of violent jihadism on the postcolonial Muslim domestic space and a counternarrative to the dominant body of Western fictional responses to the 9/11 terror attacks. Situated at the intersection of Spivak’s “Can the Subaltern Speak?” and postcolonial trauma theory, the article argues that Ibrahim mourns and remembers the traumas of the disremembered postcolonial subaltern African Muslim woman elided in the dominant discourses on the WoT and also subtly critiques fundamentalists ideologies like Boko Haram. Ibrahim shows that Jihadists’ quest for an Islamic theocracy or caliphate is doomed to fail because it revolves around a sacrificial structure wherein the Muslin woman is sacrificed on the altar of ideological incoherence. By focusing on the nexus between WoT and gendered trauma, the article explores how Ibrahim reclaims the subaltern woman’s voice in the wake of violent jihadism.

Gender role in food rights and sovereignty in West Africa: A rapid review

Recognizing the critical role gender plays in food systems within West Africa, this review paper explores the contributions women make throughout the food value chain and the challenges they face in achieving food and nutrition security. A search across the databases; Hinari, Ovid MEDLINE, Scopus and Web of Science targeted peer-reviewed articles reporting on studies published between 2000 and 2023 in English or French and focused on women in West Africa. Data were extracted using a predefined form in Covidence and a narrative synthesis was used to summarize women’s roles and challenges within food systems. Thematic analysis of 69 peer-reviewed articles out of a total of 9,789 screened revealed West African women as central figures in regional food systems. Beyond their well-documented roles in land preparation, planting, and harvesting, women actively engage in processing, distribution, marketing and household consumption of diverse food crops (fruits, vegetables, grains and tubers) across rural and urban agri-food systems. This multifaceted engagement extends far beyond production, demonstrably impacting key socio-economic and nutrition metrics including food security, food sovereignty, and sustainable livelihoods of countless communities across the region. Nonetheless, women are disproportionately affected by challenges such as unequal access to resources, limited decision-making power, and restrictive cultural norms and education. These factors hinder their participation in different activities within the food system. To address these gendered disparities and promote equitable food systems, targeted interventions are crucial. These interventions must prioritize education and training to equip women with knowledge, skills, and modern technology. Additionally, policy changes are necessary to promote equitable access to resources, financing and land ownership. Furthermore, dismantling discriminatory cultural norms and promoting gender equality are essential steps along with implementing infrastructure and technologies that address women's specific needs. By prioritizing women's empowerment through a combination of education, policy changes, technological upgrades, and collaborative efforts with stakeholders, West Africa can strive towards a more sustainable and equitable food system for all. Key words: food sovereignty, food rights, food systems, gender dynamics, West Africa

Krukenberg tumour in a 46-year-old black African woman with a background of ovarian fibroma- A case report

BackgroundTumours that metastasize to the ovary can occur in conjunction with other ovarian lesions, including benign sex cord stroma tumours like fibroma or fibrothecoma. This case report presents a unique instance of metastatic signet ring carcinoma involving the ovary in a background of fibroma in a Black African woman.Patient presentationA 46-year-old gravida 3, para 0 (2 alive), patient was referred from the general outpatient clinic to the gynecology clinic due to progressive abdominal swelling over the past eight months. Abdominal examination revealed marked distension with massive ascites. Physical examination of the chest demonstrated dullness to percussion over both lung bases, with increased dullness noted on the right. Auscultation revealed decreased air entry in the right middle and lower lung zones, with normal to increased air entry in the remaining lung fields. Abdominopelvic ultrasound revealed a large irregularly marginated homogeneous solid mass in the right adnexa measuring 16.4 × 11.7 × 12.7 cm. An abdominal CT scan revealed bilateral pleural effusion, which was more pronounced on the right, ascites, and evidence of pulmonary and hepatic metastasis. Serum chemistry revealed abnormal levels of several analytes, including elevated CA 125 at 1,108.8 (normal range 0–35) U/L and CA 19–9 at 63.8 (normal range 0–35) U/L. She subsequently underwent staging laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy, without any postoperative complications. The histologic sections of the right and left ovaries revealed a moderately cellular lesion composed of intersecting bundles of spindle cells in a fascicular and storiform pattern. Additionally, pockets of small round to oval-shaped cells with intracytoplasmic clear vacuoles pushing the nucleus to the periphery (signet ring cells) were identified in a few foci. These cells were initially thought to be ovarian stroma or theca cells. Microscopic examination revealed signet ring cells with cytoplasmic positivity for periodic acid-Schiff (PAS) staining. The histopathological diagnosis was metastatic signet ring cell carcinoma involving the ovary, with an underlying ovarian fibroma.ConclusionsOvarian metastatic signet ring carcinoma in a background of fibroma can pose a significant diagnostic challenge, as signet ring cells can mimic the ovarian stroma or theca cells, especially if they are only observed in a few foci of the sections.