26/07/2025
NIGERIA PERSPECTIVES – REGIONAL COLLABORATION IN UTERINE HEALTHCARE
Remarks by the Special Guest,
Honourable Dr. Adaeze Chidinma Oreh, 27th Commissioner for Health, Rivers State, Nigeria at the Launching of the Uterine Health Fund (UHF): A New Era for Uterine & Reproductive Health in Africa in Freetown, Republic of Sierra Leone.
Your Excellency, The First Lady of the Republic of Sierra Leone, Dr. Fatima Maada Bio, Honourable Members of Parliament, Honourable Minister of Health, Deputy Minister, UN Resident Coordinator, Spiritual & Community Leaders, Executive Director White Ribbon Alliance, Youterus Health Team, Partners, Members of the press, Distinguished ladies and gentlemen.
It is with a great sense of honour and privilege that I join you today, standing in solidarity at a landmark initiative to transform the health of women and girls on the African continent – the unprecedented launch of the Uterine Health Fund (UHF), right here in Sweet Salone – the Republic of Sierra Leone
As a specialist family physician, something has always bothered me about the way reproductive care is framed – solely as maternal care. This has left many women and girls feeling lost, unseen and marginalised, because conditions such as heavy menstrual bleeding, abnormal bleeding, debilitatingly painful menstruation, fibroids, endometriosis, and even adenomyosis that affect millions of African women every year, the attention required to address these needs is lacking.
On our continent, the prevalence of uterine fibroids varies, with some studies reporting rates as high as 36.9% in Ghana and 45.1% in Nigeria. It is estimated that over their lifetime, 70–80% of black women will harbour fibroids. The greatest weight of this burden lies on our women, black women, African women, occurring at rates 3–4 times greater than in other races, sometimes even presenting right after the onset of menstruation.
Due to lack of knowledge, lack of access to care and late presentation, many women in Africa suffer greater morbidity and oftentimes-higher rates of mortality from fibroid disease. Many of these women end up at prayer houses or local herbalists who may have good intentions but are untrained in fibroid management. And so, many women die every single day due to complications associated with poor disease management.
Amongst most Sub-Saharan African women, delayed presentation before evaluation and management is frequent, if they even present at all. This delay is due to lack of knowledge; corrosive poverty; transportation limitations, procrastination and fear of finding out; misinformation from family and friends, as well as local herbalists and spiritual/prayer houses; wrongful deep-seated cultural beliefs, self-proclaimed spiritual prophets with promises for the cure to fibroids, and even fake news to mention a few.
It is a common occurrence to see African non-pregnant women presenting with huge fibroids almost appearing as though they are in advanced pregnancy. They note that their clothes do not fit anymore, and people ask them highly embarrassing questions such as, “When the pikin dey come?”
Some even cannot conceive due to fibroids and are labelled by family members, neighbours, and peers as infertile – even callously referred to as ‘men’. To hide their condition, many women will not seek medical attention in order not to impede their chances of marriage due to the attached stigma. Some women are driven away, ostracized, abandoned, and divorced due to their inability to conceive or carry a child to full-term.
Why today stands as a watershed moment for transforming the way we approach women’s health, is because we are committing to seeing women in their entirety and addressing their health issues in their wholeness. Whether or not a pregnancy and childbirth is involved. A woman’s worth must not be regarded as valuable only to the extent of her baby-carrying capacity.
In Rivers State, under the leadership of His Excellency Governor Siminalayi Fubara, we have been determined to address women’s health through a more holistic approach. With a person-centred and community-oriented view of health needs, and not a disease-focused approach. And these are a few ways we have begun to do this, sharing our experiences and positive outcomes nationally and regionally to inspire and provoke much-needed reform:
Increasing government investments in reproductive health commodities distributed to over 400 healthcare facilities.
Training community health providers on counselling for women’s health needs
Integrating such counselling and delivery services to post-natal wards, child wellness clinics, and community health outreaches (because women are often time-constrained, and we need to take these services to where they will be).
Introducing gynaecological and obstetric ultrasound scanning in all 350 primary healthcare centres in Rivers State
Introducing mental healthcare services in all 350 primary healthcare centres in Rivers State
Employing and training 2,000 frontline healthcare workers in the state, bringing the health workforce in Rivers State to 7,992.
Renovating and upgrading about 180 primary healthcare centres through state government investment and partnerships with World Bank, National Primary Healthcare Development Agency.
Strengthening referral services by upgrading cottage, general, and zonal hospitals to cater to the needs of clusters of primary healthcare centres that need to refer cases for surgical intervention and management of complications. Thus, building capacity in our local communities, and lightening the load on our state’s teaching hospitals and freeing them up to pursue advanced level research and innovation.
Revitalising Rivers State’s Emergency Medical Services
Collaborating with academia to design innovative approaches to providing school healthcare services for school children aged between 5 years and 17 years.
Partnering with the Ministry of Education to equip and staff sick-bays in our state secondary school for girls with 24-hour rotational nursing care from the Ministry of Health and linkage to primary care centres and community hospitals for state-funded healthcare services.
Digitalisation and strengthening of the state’s health management information systems for evidence-based learning, planning, and decision-making.
Though Sub-Saharan women bear the greatest brunt of uterine health conditions, Africa has not leveraged opportunities such as cross-country collaborations and the benefits of South-South learning.
I find myself deeply connected to Her Excellency, Dr Fatima Maada Bio, perhaps because in Rivers State, we too have a region called Kono, or maybe it is simply because of her fierce and unapologetic commitment to driving transformational change for our woman and girls. Your Excellency, your dedication to advancing the health and well-being on our continent is commendable, and your courage in bearing the torch and shedding light on a most ignored set of health conditions in women and girls is truly inspiring. It is therefore a great honour for me to be part of this launch of the Uterine Health Fund – a rousing call to action for all African nations.
As we gather here today, we do so with a shared commitment to confronting this challenge head-on, with the goal of alleviating the heavy burden that uterine health conditions place on our women, our girls, and on our communities. Let us all be reminded that we are not just here to discuss the problem, but to forge solutions, and march boldly forward.
This fund will have a profound impact on the lives of countless African women and girls. This launching is not just an event; it is a call to action. We therefore commit to Your Excellency and Youterus Health to collaborate in ways that will lead to meaningful change. Together, we can rise to the challenge before us. Together, we can build a healthier future for our women and our girls. In the words of Her Excellency at our introductory meeting, “This focus on uterine health is not a project, it is an ideology.”
Congratulations, Your Excellency.
Congratulations, the Republic of Sierra Leone and the African continent.
May the Almighty bless us all.
