Week 6 – Activity Post: Benin

Health does not exist in a vacuum; it is influenced by and operates within a network of social determinants that impact everything from life expectancies to lived daily experiences and overall personal well-being. The World Health Organization (WHO) is taking notice to the “…gross inequalities in health that we see within and between countries [and the] challenge [they present] to the world,” and launched a Commission on Social Determinants of health to analyze these factors and recommend policies to help address these issues (Marmot 2005). While WHO lists 10 social determinants (i.e. social gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food, and transport), other social determinants models include concepts like public safety and environmental conditions as well (Office of Disease Prevention and Health Promotion 2019). One of the most influential factors that effects health is education, and this social determinant is closely tied to the issue of maternal health and family planning in Benin.

Education in Benin is riddled with inequalities. Educational opportunities for women in Benin are extremely limited; as previously discussed, the stated enrolment ratios for females as a percentage of males for primary schooling is 87.5%, and it decreases to 60.2% for secondary schooling (UNESCO 2000). For many families who are from a lower socioeconomic background or who live in an area where public schools are not accessible, parents are forced to have their children miss school to help supplement family income. Others send their children away to be domestic workers in more affluent households in the south, and children work in exchange for food, clothing, and living quarters that are close to an area with access to public schooling. Most of these domestic workers are young girls, some of which suffer at the hands of abuse, sexual assault, and overworking from their employers. In this way, long work hours, gender-based violence, and financial/geographic restrictions serve as major obstacles for Beninese girls and women to receive institutionalized education. For those who do attend school, sex education is sparse and incomplete. While new programs to promote sex education in schools, such as the Comprehensive Sexuality Education report, are in the works, many of these programs are only being offered as pilot projects in select areas, or have not moved passed a theoretical stage of planning (UNFPA & Le Fonds Francais Muskoka 2019).

For adults, education about family planning and contraceptives also is lacking. While a majority of women in Benin report having heard family planning messages from the media or other information channels, only 14% report having discussed family planning with someone in 2012 (a decline from 18% in 2006) (Chae S 2015). This could be due to the lack of experience talking about the topic of reproductive health and contraception, encouraging a cultural taboo against discussing family planning. In addition, while all public health facilities are required to provide family planning services as part of their minimum package of services, these services are not always available (especially in rural areas); where they are available, there are stockouts of supplies and a major shortage of trained professionals who can instruct women about how to use contraceptive devices and inform them of what their family planning options are (Chae S 2015). These limited opportunities for education regarding reproductive health and family planning act as a barrier for Beninese women to access and appropriately use contraceptives, resulting in unwanted pregnancies, the transmission of STIs and HIV, and other adverse health effects.

References

Chae S, Woog V, Zinsou C, Wilson M. 2015. “Barriers to contraceptive use among women in Benin.” 1-22.

Marmot, Michael. 2005. “Social determinants of health inequalities.” Lancet 365: 1099-1104.

Office of Disease Prevention and Health Promotion. 2019. “Social Determinants of Health.” Healthy People.gov. Accessed August 10, 2019. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health.

UNESCO. 2000. “Education for All 2000.” Global Education Monitoring Report.

UNFPA & Le Fonds Francais Muskoka. 2019. “Comprehensive Sexuality Education.” Brochure.

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