CONTRIBUTORS
Christopher Omumamu Maero
Senior Advocacy and Knowledge Management Officer
Winnie Achieng’ Opondo
Program Administrative Officer
As we reflect upon the year 2024, CPSE’s West Africa engagements in Sierra Leone, Liberia, and Burkina Faso have offered a unique lens into understanding the lived experiences of adolescents, young people, and women who often face considerable barriers to accessing and securing sexual and reproductive health and rights (SRHR) across the continent. These are the lessons, observations, and stories that resonated most deeply.
For too many, starting a family becomes a journey fraught with uncertainty. Unplanned pregnancies often leave women vulnerable—facing spousal neglect or intimate partner violence, societal stigma and marginalization, and insufficient healthcare access that could lead to increased maternal health risks due to delayed or missing prenatal care or unsafe abortions.
Teenage pregnancies amplify this vulnerability, pushing young girls into education disruptions, a cycle of stigma, exclusion, and hopelessness, including mental health challenges and sometimes poor child outcomes. Abortion, a deeply polarizing issue, becomes the only recourse for some—whether clandestinely performed by unqualified individuals or self-induced out of sheer desperation. The outcomes of unsafe abortion range from severe complications and lifelong consequences to death.
These grim realities underscore the urgent need for open, judgment-free conversations about reproductive health in Africa, a topic still shrouded in taboo.
A recurring theme emerged across the three West African countries: the absence or sluggish progression of robust policy and legal frameworks to address these pressing issues. In Burkina Faso, stakeholders raised concerns about the cultural sensitivity of sexual and reproductive health (SRH) advocacy. With various policy frameworks in place, though critical, they are ineffective for the sourcing and uptake of reproductive health services in the country.
In Liberia, the transition to a more progressive Public Health Bill that addresses these critical SRH needs remains sluggish, hindered by resource constraints and social, religious, and cultural barriers, including competing priorities by the government of the day. According to the Clinton Health Access Initiative (CHAI), the joint study on the incidence of abortion, magnitude of complications, and health system costs of unsafe abortions was cutting edge and timely. The first nationwide study on a taboo issue has influenced discussions and debates on the Public Health bill. It provided a “why and how” to those questioning and resisting these conversations, often due to ignorance rooted in culture and tradition.
Sierra Leone, grappling with its unique challenges, still tries to put up as a beacon of resilience, with community-driven innovations offering hope, coupled with the government’s commitment to advancing reproductive health rights through the Safe Motherhood and Reproductive Health Bill with tangible progress expected after a long time. Local organizations like Marie Stopes have been steadfast advocates of the bill, aligning with the Ministry of Health and Sanitation and joining various NGOs and civil society coalitions, notably the People Alliance for Reproductive Health Advocacy (PARHA). According to the Director of Reproductive Maternal, newborn, child and adolescent health (RMNCAH), Dr. Tom Sessay, the study on the incidence of abortion, magnitude of complications, and health system costs of unsafe abortions was used to create awareness on the bill and the source was often quoted to ensure the findings are accepted and credible.
When policies are absent or poorly enforced, it is the most vulnerable—children, women, and girls—who pay the price. Their needs are deprioritized, excluding them from the prosperity others enjoy.
Some norms often amplify exclusion. For instance, menstruation—an everyday reality for half the population—is cloaked in secrecy, leaving women to manage with inadequate resources and support. Conversations around reproductive health are similarly hushed, often relegated to whispers in the dark. Women still struggle to access basic menstrual health products coupled with poverty, even as they shoulder societal expectations. This silence perpetuates stigma, leaving issues unaddressed and unresolved.
Amid the challenges, there are pockets of hope. Some communities are harnessing indigenous knowledge to address health deficits. Sierra Leone is exploring innovative ways to improve SRH outcomes through cross-sector partnerships, youth involvement, and social media campaigns. Liberia is building alliances to amplify advocacy for health reforms. For instance, an inter-sector working group on SRHR is working with policymakers at the Liberian Senate to provide technical guidance on the draft Public Health Bill. Additionally, civil society organizations are working with public health providers, midwives, and nurses to advocate for accurate abortion-related services devoid of stigma.
These examples reaffirm that solutions exist when communities come together with a shared purpose. Synergistic engagements—where governments, civil society, and local actors work hand-in-hand—are crucial to overcoming exclusion and lifting those left behind.
The stakeholder engagements in West Africa have highlighted that social exclusion is not a destiny but a consequence of choices, priorities, and actions. As Africans, we must ask ourselves: What kind of future do we want to build? How do we develop sustainable local solutions? How do we ensure that no one is left behind?
The year 2024 has shown the depth of our challenges and the immense potential we hold as a continent. We need to turn insights into action, dismantling the structures of exclusion and building a more equitable Africa for all.
This is our story to tell and our time to act.