Health care for women is often conditioned by multiple factors, such as the feminization of poverty, gender norms and values that place women at a disadvantage for societal resources, and certain cultural meanings associated with illness that may negatively influence prevention, early diagnosis of disease, and treatment. Women across Kenya suffer from preventable illnesses that pose an enormous health burden on them, their families, their communities, and their country. In rural communities, these problems are exacerbated due to lack of health education, difficult access to medical care, and community mistrust towards the government medical system.
A 2009 health needs assessment for women in four rural communities in South-East Kenya, conducted by Dr. Ishmael Mwangi, of the Lunga Lunga Health Center District of Kwale, and Dr. Araceli Alonso, of the University of Wisconsin-Madison (UW-Madison) in the United States, identified six major health concerns. 1) Life expectancy of women had dropped from 60.1 years in 1990 to around 45.6 years in 2009, primarily because of the HIV/AIDS pandemic and lack of information and health care to treat it. 2) Early marriage and teenage pregnancy had contributed to high infant mortality and maternal death rates, as well as serious health complications such as severe vaginal perforation. 3) Pregnancy, especially in adolescents, put women at higher risk of malaria infection than any other adult group. Because pregnancy reduces immunity to malaria, it makes women more susceptible to malaria infection, increasing the risk of illness, severe anemia and death. For the unborn child, maternal malaria increases the risk of spontaneous abortion, stillbirth, premature delivery and low birth weight. 4) Female genital cutting put young women at risk of acute health problems such as hemorrhage, shock, bacterial infection and failure to heal, tetanus, trauma to adjacent tissues, urinary retention, and HIV infection. 5) Cultural myths and misconceptions had serious preventable health consequences. For example, some women claim that malaria is a disease caused by supernatural evil forces that produce degedege or severe convulsions in a child, which must be treated by a witchdoctor. These cases are medically diagnosed as cerebral malaria, and they are often too advanced for any form of anti-malarial therapy. 6) Basic medications such as multivitamins were out of the reach of women; most pregnant women chew on soft stones or pieces of dry mud to satisfy their craving for iron. The stones, however, caused kidney and liver damage when not taken with enough fluids; dry mud contributed to intestinal parasite infections since it often contains live larvae.
Before N-HbM, women had to travel long distances, often by foot or bicycle, to access the one government clinic. In addition, two thirds of the population live below Kenya’s poverty line and cannot afford the government medical fee. Preconceived cultural habits and ideas often preclude women from even considering reaching out to existing government facilities. As a result, preventable diseases spread easily and treatable illnesses often become endemic, particularly among women and children.