Reproductive health in sub-Saharan Africa: Major challenges and opportunities

Thirteen years after Cairo, there has been progress in reproductive health globally, but the majority of African countries still exhibiting some of the worst reproductive health indicators. In part, progress has been hampered by the HIV epidemic, the scale of which makes it the worst epidemic that the human race has ever experienced to date. Programmes for reproductive health and those for HIV prevention and mitigation have adopted vertical approaches although the main causal factors and determinants of poor reproductive health and HIV infection are the same. The reduction in funding for family planning and reproductive health globally is beginning to show in some African Countries through reversal of the fertility decline experienced in the 1980s and worsening maternal health. A synergistic approach to tackling high fertility and maternal mortality, and HIV and AIDS is necessary in Africa, where these three interact so much to produce the worst morbidity and mortality rates for people of reproductive age. Broadening the reproductive health agenda to address gender equality and female education is major step to dealing with some of the root causes of poor reproductive health in sub-Saharan Africa.