The researchers found that in the Farafenni region, more than 50 percent of the women were anemic, nearly 50 percent had damage to their organs from child-bearing, nearly a third had genital herpes, and nearly half had reproductive tract infections—conditions that can impair fertility.
Yet cultural practices and attitudes tend to inhibit Gambian women from seeking out health care services.
Public Policy Implications
Initiatives begun by the United Nations in the mid-1990s have drawn worldwide attention to the importance of providing reproductive health care services for women.
"I've seen women bleed to death after childbirth because the husband couldn't be found to give permission for her to be transferred to a hospital," Walraven said. "We need to empower these women and make services more women friendly."
In many regions, the culture of silence surrounding disorders of the reproductive organs is more likely to be broken if the focus is on the risks of infertility rather than the threat of acquiring AIDS, Walraven and his co-authors concluded.
"We need to educate both the men and the women to change community attitudes," he said. "And more money needs to be spent. And realistically, it is not going to come from the governments of these countries."
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