Ahead of World AIDS Day, a Malawian woman is drawing attention to the lack of women’s rights which fuels the spread of HIV and constrains women’s livelihoods.
Ahead of World AIDS Day (1 December), a Malawian woman is drawing attention to the lack of women’s rights which fuels the spread of HIV and constrains women’s livelihoods.
Vanessa Lichapa, 22, is a woman who feels the decision of whether to have more children or not is out of her hands. She lives in Thyolo district in southern Malawi, and she only discovered her HIV status when she went for a prenatal checkup during her first pregnancy.
A report by Just Association (JASS) published in August 2013, shows that in Malawi and other poor African countries, women have extremely limited access to and control over resources like land, which are very important for their health. In particular, women’s lack of independence has a huge impact on their reproductive health, as husbands control the number of children women bear and the frequency of pregnancies.
A demographic health survey conducted in Malawi in 2010 indicated that fewer women than men are educated, which can make it even more difficult for women to understand issues affecting them, including family planning, reproductive health and HIV. The national adult literacy rate in Malawi is 67.3 per cent for women and 76.5 per cent for men, so many women also have difficulty reading health information.
Government intervention
In Malawi, the debate around legalising abortion has been going on for a decade. Currently, there is a law which punishes any person who performs an abortion, except when the woman’s life is in danger. Such laws limit women’s reproductive rights.
According to Ministry of Health spokesperson Henry Chimbali, Malawians are able to access family planning services in health facilities across the country, as well as through some door-to-door services.
“As a country … the services we offer to the population are effective and safe and the methods are free in all government hospitals. More people and families are accessing them and enjoying their benefits,” stated Chimbali.
“The uptake for modern contraception has been increasing over the years and currently stands at around 42 per cent. We therefore hope to see an increase when we do another demographic health survey.”
Fighting for survival
Chimbali further explained that the government is working to prevent mother-to-child transmission of HIV.
“We are currently implementing Option B+, where every pregnant and breastfeeding woman who tests HIV positive is immediately put on treatment. In most sites we offer ART [antiretroviral treatment] services. We are also currently offering family planning services, too. This is one way of improving access to family planning services to people who are HIV positive,” he said.
When Lichapa got divorced she was left with two children to take care of. “Nurses at the hospital advised me on how I could deliver without transmitting the virus to the children,” she said. “For both of my pregnancies, I followed advice from the nurses, and this helped me to deliver children who are HIV negative.”
But maintaining a successful livelihood is not easy for a single mother in Malawi and Lichapa is struggling to support herself and her children. She says she will get married the moment she finds the right partner. When asked whether she intends to have more children in the future, she says: “I know it is not good for my health, but if the man wants one or two, well, what can I say then?”
Broader picture
The Malawi demographic survey shows that although a majority of women deliver under the supervision of a nurse or a midwife, only half of them attend all the days prescribed at a postnatal clinic, putting the lives of women and newborns at greater risk of infection and poor health.
According to the United Nations Population Fund (UNFPA), HIV is integrally linked to sexual and reproductive health since most HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. UNFPA further states that both HIV and poor sexual and reproductive health are driven by similar root causes, including poverty, gender inequality and social marginalisation of the most vulnerable people.
The president of Malawi pressed this point home while addressing heads of states at the UN Summit on the Millennium Development Goals last September, stating that gender inequality and lack of women’s empowerment are the main constraints limiting progress towards achieving the MDGs.
Vanessa Lichapa represents a dilemma that many African women living with HIV have to contend with: lack of choice over their reproductive health and absence of laws and policies to protect them.
When asked what she would like the world to know, Lichapa said: “As someone who lives with HIV and is of reproductive age, I would ask the world to protect my right to access reproductive health and family planning services.”
Read more stories on HIV and human rights
Picture credit: Nell Freeman for the Alliance
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