By ABUJAH RACHEAL (NAN)

In Nigeria, where healthcare access is a challenge for many, the growing threat of Antimicrobial Resistance (AMR) is particularly worrisome.

Women, who are often the primary caregivers in their families and communities, bear the brunt of this crisis.

According to the World Health Organization (WHO), AMR occurs when bacteria, viruses or other microorganisms no longer respond to medications that were once effective in treating infections.

This phenomenon makes common illnesses harder to treat, increasing the risk of severe illness and death.

Whether managing their health or that of their children, women are frequently exposed to infections and rely heavily on antibiotics, making them more vulnerable to the consequences of AMR.

The implications are dire, as experts say that AMR not only jeopardises individual health but also poses significant threats to public health and socio-economic stability, especially in low-resource settings such as Nigeria.

In spite of being a global issue, the impact of AMR on women in Nigeria is often overlooked.

It affects not only maternal health but also their daily caregiving responsibilities.

The socio-economic implications are immense, particularly in rural communities where women lack access to quality healthcare and are often unaware of the dangers posed by antibiotic misuse.

This ignorance compounds the problem as women may rely on ineffective or outdated treatments, further exacerbating AMR.

When 32-year-old Mrs Hauwa Maigari fell ill with what she thought was a simple Urinary Tract Infection (UTI), she didn?t expect her journey to recovery to stretch into months of pain, frustration and fear.

Living in rural Bwari in the Federal Capital Territory (FCT), she relied on a local pharmacist for antibiotics. However, the medication didn?t work.

?I thought it was just a delay in recovery, but I kept feeling worse,? she recalled.

Her condition worsened because the bacteria causing the infection were resistant to the antibiotics available in her community.

As a mother of three and a farmer, her responsibilities didn?t allow her the luxury of prolonged illness, yet she found herself growing weaker each day.

?I had to borrow money to travel to the Federal Medical Hospital in Jabi, but by the time I got proper treatment, I was already very sick,? she recounted.

Maigari?s story is just one example of how AMR is threatening the health and well-being of Nigerian women.

From common infections such as UTIs to more serious complications during pregnancy and childbirth, women are on the frontlines of this global health crisis.

WHO warned that over 700,000 people die annually due to drug-resistant infections.

The number is projected to rise to 10 million by 2050 if there is no action.

In Nigeria, where healthcare infrastructure is weak and access to treatment is not easy, AMR poses a great challenge.

According to a 2022 Lancet publication, 4.95 million deaths globally in 2019 were associated with AMR, with the highest death rate in Western Africa, at 27.3 deaths per 100,000.

WHO has identified 15 priority antibiotic-resistant pathogens, four of which have been found in Nigeria. The rising incidence of these pathogens underscores the urgent need for effective surveillance and intervention.

The economic implications of AMR are staggering. By 2050, AMR could cost between 300 billion dollars and one trillion dollars annually worldwide due to increased healthcare costs, prolonged hospital stay and intensive treatments.

In Nigeria, where seven out of 10 people access antibiotics outside licensed facilities, over-prescription and misuse of these drugs heighten the crisis.

The situation is further aggravated by the misuse of antimicrobials in animals, particularly in food production, leading to residues in products such as milk and meat.

Experts say these residues pose health risks such as cancer and allergies to consumers, further complicating the landscape of public health.

Pregnant women are especially vulnerable to the consequences of AMR. Experts warn that infections during pregnancy can lead to serious complications, and without effective antibiotics, the risks increase significantly.

Conditions such as UTIs, which are common during pregnancy, can escalate into severe infections if not treated properly.

The rise in antibiotic resistance makes routine medical treatments more risky for both mother and child.

Many women in Nigeria face challenges in accessing timely medical care during pregnancy due to financial constraints, cultural barriers, or long distances to healthcare centres.

These delays, experts warn, can cause infections to worsen, requiring stronger and more expensive antibiotics that may no longer be effective.

According to the WHO, Nigeria has one of the highest maternal mortality rates globally, with an estimated 512 deaths per 100,000 live births.

AMR exacerbates this issue, as infections, once easily treated with antibiotics, are now harder to manage, placing additional strain on already overburdened healthcare services and threatening progress in maternal health.

Health stakeholders have estimated that drug-resistant infections contribute to, at least, 20 per cent of maternal deaths, a worrisome figure considering the country?s already high maternal mortality rate.

?AMR is not just a medical issue but a social and gendered crisis,? says Dr Abiodun Egwuenu, AMR Programme Manager at the Nigeria Centre for Disease Control.

Egwuenu says Nigerian women are more vulnerable to AMR due to social, economic and cultural factors.

She adds that access to quality healthcare is limited, especially in rural areas, where women often bear the brunt of caregiving responsibilities.

?In many communities, misuse of antibiotics is common due to the scarcity of healthcare services, further increasing the risk of drug-resistant infections,? she says.

Dr Zainab Mohammed, a gynaecologist in Kano State, explains how AMR is dangerous for pregnant women.

?Infections during pregnancy, such as sepsis, can become deadly if antibiotics are ineffective.

?We have seen cases where both mother and baby suffer because the drugs no longer work,? Mohammed says.

The emotional toll on families is profound, as women including Mrs Chidinma Nwankwo, often endure prolonged periods of illness, causing anxiety and distress on their loved ones.

?Every day was a battle.

?I worried not just for my health but for my children. What if I couldn?t care for them? What if I didn?t make it,? Nwankwo narrates.

This fear is a common thread among women facing AMR, showing the urgent need for effective solutions.

Healthcare workers, many of whom are women, face additional risks from AMR.

Mrs Kadijat Aminu, a nurse from Bauchi State, expresses concerns about drug-resistant infections spreading in hospitals.

?Sometimes, we don?t have enough protective equipment. It is scary because we are exposed everyday,? Aminu says.

The emotional and physical effects on healthcare workers are much as they navigate the challenges of treating patients with infections that may not respond to available treatments.

Many Nigerian women, especially those in rural areas, face economic and cultural barriers to accessing healthcare.

Infections often go untreated or poorly managed due to limited access to vaccines, pre-natal care and medications.

Some women, including Mrs Chidinma Nwosu, a trader at Garki International Market, FCT, often resort to sharing antibiotics with friends or family members because they can?t afford proper medical treatment, exacerbating the AMR crisis.

Another factor is the overuse of antibiotics in livestock.

In many cases, these drugs are used to promote animal growth, leading to resistant bacteria that affect both animals and humans.

The cycle of misuse and resistance continues, as women in agricultural communities bear the burden of these practices.

Dr Abiodun Egwuenu argues that AMR is a gendered crisis that requires targeted solutions.

?Nigerian women need better access to healthcare and education on antibiotic misuse.

?Universal Health Coverage (UHC) is key to ensuring that women receive the care they need without facing financial hardship,? Egwuenu says.

She urges that policymakers should prioritise women?s health in their strategies to combat AMR, recognising that empowered women can drive positive change in their communities.

Ms Irene Adogboba, a public health specialist, emphasises the intersection of gender, AMR and UHC, urging that women should be at the centre of discussions on AMR.

?Women make up over 70 per cent of the global healthcare workforce but are often excluded from decision-making processes.

?Their voices must be amplified to ensure effective strategies are implemented,? Adogboba.

Dr Olayinka Umar-Farouk, Deputy Project Director of Risk Communication at Breakthrough ACTION Nigeria, notes that the 2024 UN High-Level Meeting on AMR provided an opportunity to prioritise gender in AMR strategies.

?We must address the unique challenges faced by women in the healthcare system and create pathways for their involvement in decision-making processes,? she urges.

Umar-Farouk believes that AMR is not just a medical issue but a social and gendered crisis that disproportionately affects women.

?If Nigeria is to combat AMR effectively, women must be empowered both as patients and as leaders within the healthcare system.

?With better access to healthcare, education on antibiotic misuse, and stronger support systems, Nigeria can start to turn the tide on this growing threat,? she says.

Analysts are convinced that the time to act is now, urging policymakers, healthcare providers and communities to collaborate to address AMR.

They believe that by prioritising women?s health and well-being, governments will protect lives and ensure a healthier future for generations to come.

Every life lost to infections that were once easily treatable is a stark reminder of the urgent need for action.

There is need to work together to combat AMR, safeguard public health and build a resilient healthcare system for all Nigerians.

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