Zika virus: what about the women?

The initial response to the Zika virus is one in a long list of approaches to health emergencies that seem to fail to consider the gender implications of the crisis.

As we saw with the recent Ebola outbreak in West Africa, it is women and girls who are most affected when these types of emergencies happen, but they are also key actors in trying to prevent and respond to it. Yet, time and again, the most basic gender considerations seem to be missed. We know that prevailing gender norms and values lead to different patterns of exposure to these viruses for men and women and there are gender dimensions in accessing treatment and care as well as in the use of preventative measures.

Womankind and our partners firmly believe that addressing gender inequality and supporting women to protect themselves and lead on actions to address the emergency must be front and centre of any efforts.

Dismay from our partners in Bolivia

In relation to the latest public health emergency, Womankind’s partner organisations in Bolivia have been dismayed at the initial response to addressing the spread of the Zika virus, in particular, the advice to women at risk to avoid pregnancy for the next two years. High levels of violence against women and girls, limited access to health services and contraceptives, restrictive laws on abortion (only if the woman has been raped or the foetus poses a risk to the woman’s health), poverty and vulnerability mean that women face multiple barriers when trying to take sexual and reproductive decisions.

To put it into context, research conducted by Marie Stopes in Bolivia in 2013 found that nearly 50% of women surveyed had had an unwanted pregnancy at some point. It is also estimated that 185 illegal abortions happen every day.

A public health strategy must include human rights

So in the context of much uncertainty and public concern surrounding Zika, simply telling women that they should not get pregnant – when access to contraception is limited and access to safe abortion is highly restricted – will inevitably increase the rate of unsafe abortions and, in turn, the rates of maternal mortality. Any public health strategy that does not have human rights, including sexual and reproductive health rights, at its heart, will at best be limited in its success and lack sustainability, and at worst serve to further violate human rights.

Any approach to address the virus must recognise gender equality and the importance of women’s and girls’ empowerment as a priority. Partner organisations in Bolivia therefore consider that the following need to be in place to combat the virus:

• Guaranteed universal access to high-quality, easy-to-use contraceptive methods and sexual and reproductive health information and services, including prenatal care allowing for early detection of microcephaly.
• Public health awareness-raising campaigns directed at both men and women and recognition that the responsibility for safe sex lies with both men and women.
• The decriminalisation of abortion and elimination of all barriers to it, in order to guarantee access to quality, safe and free abortion procedures without the need for parent or partner consent.
• Support for pregnant women who decide to continue with their pregnancy in Zika-affected areas, so they can reach full term safely with the support of holistic pre- and post-natal care and advice; neonatal care; and therapy, healthcare and education services if necessary, in cases of microcephaly.
• Development of policies and programmes that recognise the intersections between climate change and sexual and reproductive health and rights.
• Implementation of the Sustainable Development Goals particularly related to health and gender equality

On a practical level, Womankind is supporting partners to work with young people in affected areas to know about and access sexual and reproductive health services and rights and to challenge discriminatory beliefs and attitudes around women’s rights.

Learn more about our work in Bolivia.