Gynecology and obstetrics are crucial fields in women’s healthcare, addressing a wide range of medical concerns, with cervical cancer being one of the most noteworthy. According to the World Health Organization (WHO) in 2023, cervical cancer ranked as the fourth most common cancer among women worldwide, with approximately 660,000 new cases and 350,000 deaths reported in 2022.https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
Speaking with Savannah Hospital’s Obstetrician, Gynecologist Consultant, and Infertility Specialist, Dr. Wachira Murage, who brings 32 years of expertise to the field, he provides an in-depth analysis of the correlation between gynecology and obstetrics. Gynecology focuses on diagnosing and treating diseases of the female reproductive system, including conditions such as cervical cancer, uterine fibroids, endometriosis, and fertility issues. It plays a critical role in women’s health, addressing concerns that may impact their overall well-being and reproductive capabilities. On the other hand, Obstetrics is dedicated to comprehensive maternal care, covering prenatal health, childbirth, and postpartum recovery. This field ensures the health of both mother and baby throughout pregnancy and delivery, offering medical guidance and support to reduce complications and improve maternal outcomes.
“Walking through the pregnancy journey with expectant mothers and upto 6 weeks after delivery when a woman’s body begins to return to its pre-pregnancy state. Anything to do with pregnancy is what we call obstetrics.”
For a normal gynecological examination, the gynecologist must first understand the patient’s complaints and symptoms to provide an accurate diagnosis and appropriate care. One of the commonest complains in gynecology is vaginal discharge. The nature of the vaginal discharge in terms of itchiness, smell and irritation will depend on the approach of diagnosis. Dr. Wachira asserts that patient history taking is the first important step, where you need to listen to their stories, and it will lead to what tests to do and planning of the treatment they need.
“History taking will result in what examination a patient needs. A gynecological examination can involve abdomen and vaginal examination. Vaginal examination involves inspection through speculum examination where you want to see the inside of the outer female reproductive system. The next thing you want to do is palpation, where you use your hands to feel and assess the internal and external reproductive organs.”
The types of gynecological infections vary from bacterial, fungal, and viral. Candidiasis is the most common infection caused by a yeast called Candida. One of the viral infections is Human Papillomavirus (HPV), which is now considered the cause of cervical cancer. Notably, you find cases of uterine fibroids and ovarian cysts of all types. Endometriosis is a chronic gynecological condition that has been referred to as the ‘missed disease’ due to its unclear etiology and inconsistencies in its diagnosis and management. Initially, people used to treat pelvic inflammatory diseases, and forget to look into endometriosis.
Treatment and management of gynecological disorders vary depending on the type and stage of the infection. From recurrent infections like Candidiasis to uterine fibroids, where gynecologists treat symptomatic fibroids, which may include heavy or prolonged periods, bleeding between periods, pelvic pain, or abdominal discomfort. Once you have carried out a thorough systematic examination of the diagnosis, you can plan the pathway of management and counselling.
“ Endometriosis can affect can affect the bladder and the gut, then you need a GID surgeon. If it affects, say, the bladder, you need a bladder surgeon. Yeah, so it’s normally a multidisciplinary kind of approach in some of those conditions. Some of them, of course, like fibroids, we deal with it. But other conditions like malignancy or endometriosis, we need the inputs of other specialists.”
Some of the common misconceptions people have about gynecological health include;
- Many believe that gynecologists should only be consulted during pregnancy or when a health issue arises. However, Obstetrician and Gynecologist Consultant Dr. Dorel Ndayisaba, with 10 years of expertise, emphasizes the importance of regular gynecological check-ups for preventive care.
Routine visits can help detect conditions such as cervical cancer, sexually transmitted infections (STIs), and hormonal imbalances at an early stage, often before symptoms manifest. As with any aspect of health, prevention and early detection are essential in ensuring timely intervention and improved outcomes for women’s reproductive well-being.
- Painful periods are normal—you just have to deal with them.
While mild discomfort/cramps can be normal, severe period pain may be a sign of conditions like endometriosis, fibroids, or pelvic inflammation. Many women suffer in silence, thinking it’s something they have to endure, when in fact, it’s treatable.
Indicators often serve as warning signs of potential underlying health issues that may develop or worsen over time. Here are the signs women should never ignore when it comes to their health:
- Abnormal Vaginal Bleeding
This includes bleeding between periods, after sex, or after menopause. While it may sometimes be harmless, it can also signal serious conditions like uterine fibroids, hormonal imbalances, endometrial hyperplasia, or even cervical or uterine cancer. Early evaluation can be life-saving.
- Persistent Pelvic Pain
Ongoing or recurring pain in the lower abdomen or pelvis (especially if it interferes with daily life) should never be brushed off. It could be a sign of endometriosis, pelvic inflammatory disease (PID), ovarian cysts, or even early-stage cancer. Many women normalize pelvic pain, but it deserves proper medical attention.
In recent years, cases of women’s reproductive health issues have been increasingly prevalent in Africa. Dr. Dorel Ndayisaba outlines the biggest challenges affecting women’s health equity.
- Limited access to quality maternal and reproductive health services.
Despite efforts to expand universal health coverage, many women in Africa (especially in rural or underserved areas) still lack access to skilled birth attendants, family planning, emergency obstetric care, and safe abortion services. Health systems often face underfunding, workforce shortages, and supply chain disruptions, which directly affect maternal and newborn outcomes.
- High burden of preventable conditions like cervical cancer and unsafe abortions.
Cervical cancer remains a leading cause of cancer death among African women, largely due to low HPV vaccination and screening rates. Meanwhile, unsafe abortions continue to be a major contributor to maternal deaths, often due to legal, cultural, or logistical barriers to accessing safe services.
- Sociocultural barriers and misinformation.
Deep-rooted stigma, myths around contraception or menstruation, and gender-based violence limit women’s ability to make informed reproductive choices. Adolescents and unmarried women, in particular, often face discrimination or lack access to youth-friendly reproductive services.
There is a need to consider key health policy approaches that would significantly improve women’s health services in Africa and reduce the cases revolving around women’s reproductive health.
- Universal access to reproductive and maternal health services
Policies should ensure free or subsidized access to essential services like antenatal care, skilled birth attendance, emergency obstetric care, contraception, and safe abortion (where legal). Integrating these into national health insurance schemes or essential benefit packages would be crucial.
- Investment in women’s health workforce and infrastructure
There is a need to implement more policies geared towards incentivizing training, deployment, and retention of female health workers, especially midwives and OB-GYN specialists, in underserved areas. Investment in medical equipment (e.g., for MIS), telemedicine, and mobile outreach would be a boost in the world of gynecology and obstetrics.
- Youth-friendly sexual and reproductive health policies
Africa is composed of 60 % + of young people. Inadequately centered programs targeting the youth (both boys and girls) are a big gap that all governments should address. Creation and enforcement of policies that would provide appropriate reproductive health services to adolescents, including access to sexual and contraception education, and menstrual health education.
Advancements in obstetrics and gynecological medicine have seen significant progress in recent years. According to Dr. Dorel, the following developments have played a key role in improving diagnosis and treatment outcomes:
- Growth of Minimally Invasive Surgery (MIS)
There is a rising shift from open surgeries to laparoscopic and hysteroscopic procedures, particularly in urban referral centers. Minimally invasive techniques offer faster recovery, reduced hospital stays, and fewer complications; The benefits that are increasingly valued as surgical training improves and more hospitals invest in MIS equipment.
Minimally invasive surgery
2. Uptake of long-acting reversible contraceptives (LARCs)
There is growing demand for implants and IUDs due to their convenience, effectiveness, and support from international donor programs. Training efforts are underway to equip mid-level providers to insert and remove LARCs safely.
3. Renewed focus on endometriosis and menstrual health.
Traditionally, underdiagnosed and poorly understood, endometriosis and menstrual disorders are gaining attention thanks to advocacy, research, and clinician training. There has been a record of more women speaking out, and medical curricula are slowly incorporating these conditions more comprehensively.
4. HPV Vaccination & Cervical Cancer Screening Innovations.
Countries are expanding HPV vaccination programs for adolescent girls, while self-sampling for HPV testing is being piloted to improve access to screening, especially in low-resource settings. Additionally, there is a push to integrate cervical cancer prevention into existing maternal and HIV care platforms.
To better understand your gynecological symptoms or concerns, it is important to schedule an appointment with a qualified gynecologist. Dr. Wachira Murage advises that a medical professional should verify any information obtained online to ensure an accurate diagnosis and appropriate treatments. If necessary, seek a second professional opinion to avoid undergoing unnecessary medical procedures. Be part of your treatment and understand why a particular procedure needs to be done.
At Savannah Hospital, our board-certified specialists bring decades of clinical experience in the field of obstetrics and gynecology. We are committed to a patient-centered approach that emphasizes respect, confidentiality, and affordability. Our care packages are designed to promote preventive care and support early detection of potential health issues.
