Published on Investing in Health

Reclaiming the gains for women and girls: Let’s listen to community advocates

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Femmes et mères de la communauté Ndienne au Sénégal. Photo © Dominic Chavez/ Mécanisme de Financement Mondial TBD

Two years into the pandemic, its collateral damage has hit the most vulnerable communities the hardest . Stretched health systems, lockdowns, and financial hardship have made lifesaving health services less accessible and out of reach, especially for women, children, and adolescents. As a result of these disruptions, more women and children have lost their lives, and health equity and gender gaps have widened instead of shrinking.

Ahead of International Women’s Day, we spoke with community leaders and advocates to hear first-hand accounts of what they are seeing, what has worked well and why this is a particularly critical moment in time.  And while there have been devastating consequences, we are also hearing about tremendous country leadership, heroic frontline health workers and the strong voice and active community of youth and civil society organizations.

Rwanda:  Responding to the health system disruptions and empowering women and girls

Nooliet Kabanyana, Executive Secretary Rwanda NGOs Forum on HIV/AIDS & Health Promotion

“Women and girls were hit hardest. Women, who represent the majority of single-parent households and hold more insecure jobs, became unemployed and no longer able to buy nutritious food for their families. They also lost access to essential services, especially to youth friendly services including contraceptive counseling and sexual and reproductive health (SRHR). School closures increased unwanted pregnancies among young girls. The government responded quickly with an economic recovery fund to enable business owners to access loans while local authorities partnered with CSOs to identify people in need and distribute food and sanitary products. But what we saw in communities was that poverty and early birth prevented girls from going back to school and many of them suffered mental breakdowns. CSOs supported by the Global Financing Facility stepped up efforts to share information about SRHR through social media, TV, and community radios, and provided vocational training to empower young girls and counseling for those affected mentally by the crisis. We have seen community efforts change the lives of women and girls, giving them a fair chance to rebuild their futures. We need to be able to scale up this work and that is why we call on urgent action and investment from our partners. 

Ghana: Stepping up efforts within communities to support women and girls

Vicky Okine, Executive Director - Alliance for Reproductive Health Rights (ARHR)

“During the pandemic, women and girls have not been able to meet their needs for lifesaving health services. They were also less likely to seek care due to fear of contracting the virus while visiting health facilities and financial challenges resulting from drops in household incomes. But with the collective efforts of communities, country leaders, and CSOs Ghana has been able to respond to the pandemic while maintaining essential health services . Changes to service delivery models to target high-risk groups such as pregnant women and the use of home-based care including tele-prescription meant more women and girls were able to get the care they needed. The government has also established economic relief and recovery programs while CSOs worked to ensure that vulnerable populations are not left out of critical mitigation interventions, including vaccination. However, there is still an urgent need to make health systems more resilient, equitable and responsive to the needs of women and girls, including prioritizing SRHR services to empower women and girls and improve their health and well-being.”

Uganda: Innovating health service delivery and enabling girls to return to school

Arafat Kabugo, GFF Global youth representative, Program Manager, Naguru Youth Health Network

Uganda’s schools remained closed for over two years. During this time, teenage pregnancies increased, and women and girls dealt with gender-based violence and limited access to health services, especially SRHR . The government took several measures that worked well such as providing food support to poorer communities, especially those in slums, setting up toll-free helplines to address mental health and ensuring access to emergency medical services. With help from partners such as the GFF and UNFPA, the government strengthened innovative service delivery in communities to ensure continuation of services. This included programs for drug refills, especially for people living with HIV, contraceptive delivery and re-distribution, and mobile-based health services and self-care. Recently, the Ministry of Education reformed its guidelines to ensure pregnant and lactating adolescent girls and young women are re-integrated into schools. We need to safeguard this progress with more support from the global health community. We need stronger engagement of youth advocates and CSOs in policy to ensure women and girls voices are heard. And we need more investment in strengthening the frontlines and building community health worker capacity .”

Mauritania: Working with CSOs and communities to support health services for refugees

Zeinebou Taleb Moussa, President of CSO/Mother and Child Health Association of Mauritania, National Department of International Child Protection

“Women and girls have been affected in multiple ways. Many of them, especially those living in poorer rural areas or fleeting conflict, have lost their livelihoods and became more susceptible to violence. Many lost access to lifesaving health services, including SRHR because of health worker shortages. In the regions of Guidimaka and Mberra that are hosting many Malian refugees, lack of resources is making it difficult to implement the national plan for SRHR. In these regions, CSOs were a lifeline for many women and girls. Some GFF-supported CSOs are working within communities to distribute food and hygiene kits, raise awareness, and provide SRHR advice. Now, more than ever, we need to ensure that voices such as youth advocates, parents, teachers, and civil society are included in decision-making and advocacy for women and girls . We also need to strengthen accountability, build capacity and change local mentalities to ensure resources are used for maximum impact.”

Senegal: Empowering community members to help in the response

Assane Diagne, National Coordinator, GFF CSO Coalition

“Disruptions to health services were felt throughout health districts. Nearly 40% of the districts saw antenatal care rates drop during lockdowns and more than half of districts saw safe deliveries plummet. CSOs supported by the GFF acted quickly – they advocated for continuation of services, including SRHR and worked with community members to manage appointments, distribute family planning kits, and facilitate birth deliveries. Combined with government efforts, this worked well to maintain services amid the crisis. But more needs to be done: if we want to reclaim the health and equity gains made in previous years, we need to mobilize more investment to the frontlines and build community capacity .”

German translation of the blog: Fortschritte sichern für Frauen und Mädchen: Hören wir was Aktivistinnen sagen


Nansia Constantinou

External Affairs Officer, GFF

Maty Dia

Senior CSO Engagement Specialist, GFF

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