Brazzaville – Women account for a slightly smaller proportion of COVID-19 infections and deaths compared with men, a preliminary analysis by the World Health Organization (WHO) in 28 African countries shows.

The analysis based on COVID-19 gender specific epidemiological data provided by countries found that although women account for around 41% of COVID-19 cases, this ranges from 31% in Niger to over 57% in South Africa.

In most countries, women are somewhat less likely to die from COVID-19 than men. For instance, in Cote d’Ivoire the case fatality ratio stands at 0.4% for women compared with 0.5% in men, while in the Democratic Republic of the Congo it is 2.2% versus 2.7% and 0.1% versus 0.5% in Seychelles.

This comes despite women accounting for a large part of the health workforce which puts them at higher risk of infection. In Africa, more than 95 000 health workers have been infected with COVID-19. In Seychelles, women account for 71% of health worker infections, 64% in Eswatini, 55% in Cote d’Ivoire and 54% in Senegal.

Further analyses are required to determine the factors behind the disparity in infections between men and women. However, some studies have suggested that biological, behavioural or social factors could be responsible. Other studies report that men are significantly more likely to suffer severe effects of COVID-19 and more likely to have pre-existing conditions, explaining the slightly lower fatality rate seen in women.

However, the pandemic and the initial strict containment measures such as lockdowns, movement restriction and school closures accentuated existing vulnerabilities faced by women and girls.

“The aftershocks of the COVID-19 pandemic on women and girls have been profound, leaving many grappling with heightened risks to their health and safety,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa. “Our response must go beyond the clinical aspects of the pandemic and address the hidden crises that risk causing long-term effects to lives and livelihoods.”

With the pandemic accentuating challenges to accessing essential health services, a WHO preliminary analysis in 22 countries found 10 reported a rise in maternal deaths, with the highest increases reported in Comoros, Mali, Senegal and South Africa between February and July 2020, compared with the same period in 2019. Nine of the 22 countries reported a decline in births in health facilities and an increase in complications due to abortions.

Studies have also found that violence against women, and particularly domestic violence, increased in several countries as security, health, and financial worries created tensions and strains which were worsened by the confined living conditions of lockdown.

The economic fallout due to COVID-19 has greatly affected women. Informal workers, most of whom are women, account for more than 90% of the labour force in sub-Saharan Africa, according to the World Bank. Informal sector jobs have been particularly hit by the pandemic.

WHO is working with countries to mitigate the impact of the pandemic on women’s health. Several countries have implemented initiatives to ensure services for sexual, reproductive, maternal, newborn, adolescent and older people’s health are maintained.

The projects include reorganizing antenatal care services and providing personal protective equipment to minimize COVID infection, mobile-based family planning services, self-care options for oral and injectable contraceptives as well as public private partnerships to deliver contraceptives and other family planning commodities.

Dr Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Oulimata Sarr, Regional Director, UN Women, Central and West Africa, and Yvonne Chaka Chaka, internationally renowned South African singer and humanitarian. Also on hand to answer questions were Dr Richard Mihigo, Immunization and Vaccine Development Programme Coordinator, WHO Regional Office for Africa, and Dr Nsenga Ngoy, Emergency Response Programme Manager, WHO Regional Office for Africa.