#SpeakerSpotlight: Sharon Kapambwe

Modern day healthcare is as advanced as it has ever been, with innovations in treatment and prevention promising a brighter future for many. But what about access to it? Today’s UGHE Women Leaders in Global Health #SpeakerSpotlight explores cultural and economic barriers to female health, and how we should be looking outside formal channels of communication to empower women to make their own decisions about health.

We have spoken a lot about how governments and policymakers should be tackling the inequities in health which, of course, they should. But to attribute this issue solely to the decision-makers is to ignore the delicate imbalances that exist at the community and individual level. Often driven by cultural norms, the power dynamics that exist within the home can be some of the most significant barriers to women seeking access to healthcare. A household ruled by patriarchal structure can strip a woman of her right to self-empowerment and consequently her right to make decisions about her body.

I spoke to Sharon Kapambwe, Director of Zambia’s Ministry of Health’ Non-Communicable Diseases Department, about whether she’d experienced this working in cancer prevention. ‘We find some women have a cancer we can treat, but because it is bordering on issues of reproductive health, women say they need to consult their husbands or partners…Women who are not empowered to make that decision, rarely come back, or if they do, it is when the disease is too far advanced.’ Whilst health systems might have all the tools in place to treat women, the cultural context shrouding sexual and reproductive health can prevent their very access to it. Sharon went on to explain that her advice to abstain from sex where necessary for treatment was often left unheeded when women were refused this by their husbands.

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It comes down to economic power too, or lack of it. Women dependent on their partners financially, can find themselves unable to autonomously seek treatment if their ‘provider’ disallows it. ‘Women who themselves not economically empowered…are sometimes not able to move to the next level of care’, explains Sharon. ‘They might have children to look after and they will say to us “who is going to look after them when I go to get treatment?”’.

Female health is just as much about the treatment as it is the access to it, which means forging clearer channels of communication and advocacy to empower women towards more self-seeking behavior. ‘We have for so long, for a good reason, really been more reactive, looking at curative treatments aspect of things.’ says Sharon, ‘You find that instead the actual promotion of health prevention usually takes a backseat.’ But promotion is much more than governments and health organizations broadcasting messages about men ‘leaning out’ and women ‘leaning in’, it is about prioritising channels of communication that women can trust and confide in.

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Whilst a doctor herself, Sharon advocates for other, less ‘professional’, advice sources; ‘They could be traditional marriage counsellors, they could be your auntie – these women have learnt how to package sexual reproductive health in a way that a woman in the village is going to understand so much better than a medical doctor like me.’ Going ‘direct to the ground’ as Sharon explains is one of the most valuable resources we have in healthcare, both in penetrating cultural barriers, and financially in using the resources we already have to communicate as opposed to creating new ones.

Sharon’s career working for over a decade in cancer prevention and now seconded to Zambia’s Ministry of Health has given her a wealth of practical advice to pass onto the next generation of aspiring female leaders. ‘You need to be able to look at the medical field much more broadly than the hospital wards’ she advises, ‘We should let them be free to make innovations to our field which we need in order to move forward’. The linear career path is not always simple, and nor is it necessary to become a leader in one’s respective field. It is about liaising with the very people you will treat, to be a ‘communicative person’ says Sharon, to understand what really needs to be done to move forward.

Laura Wotton