Women in sub-Saharan Africa face some of the greatest sexual and reproductive challenges in the world. African women have the highest fertility, highest HIV infection rates, highest risk of dying during childbearing and they have the highest unmet need for contraception. Thirteen years after Cairo, there has been progress in reproductive health globally, but variations across countries persist, with the poorest countries in Africa still exhibiting some of the worst reproductive health indicators. In part progress has been hampered by the HIV epidemic. Programmes for reproductive healthcare and those for HIV prevention and mitigation have adopted vertical approaches although the main causal factors and determinants of poor reproductive health and HIV infection are the same. Efforts to integrate family planning in HIV programmes and vice-versa are woefully inadequate given the scale of the epidemic and the high unmet need for family planning among both HIV positive and negative women. Another recent development is the reduction in funding for family planning, resulting in stagnation or reversal in fertility trends in some African countries.In this paper, I use multiple sources of data to show trends in some reproductive health outcomes (unmet need for family planning, maternal mortality, and HIV prevalence rates). There has been progress in some of these indicators and lessons must be learnt from those countries that are making progress. However, for most of the continent, the challenges are many and the continent needs to take advantage of opportunities to ensure that reproductive health care improves. I argue that a synergistic approach to HIV prevention and reproductive health especially family planning will lead to improvements in women's health. I also argue that moving towards gender equality and improving female education are important for healthier women and families.
In: The Abstracts of the 5th European Congress on Tropical Medicine and International Health 24-28 May 2007 Amsterdam, the Netherlands. Invited speakers. Tropical Medicine and International Health 12 (suppl 1) 1-24 [doi:10.1111/j.1365-3156.2007.01865.x]