Advocating for Women’s Health in Saudi Arabia

When Dr. Fatimah Alhamlan, a clinical scientist specializing in oncoviruses (viruses that can lead to

cancer), joined Saudi Arabia’s prestigious King Faisal Specialist Hospital and Research Centre in Riyadh, she started her research line on human papillomavirus (HPV) and related cancers.

“There are three key issues regarding HPV and cervical cancer in Saudi Arabia,” she explains. “First, half of the women diagnosed with cervical cancer in the country die from the disease. Although only about 358 cases are reported annually in Saudi Arabia compared to over 660,000 cases globally, the mortality rate is concerning. Every life matters and no woman should die from preventable diseases.”

The second issue she notes is “the lack of awareness and knowledge about HPV, both among the community and some healthcare providers” and the third is “the sensitivity surrounding this topic. There is stigma associated with discussing it, making it challenging to address. As a woman and a women’s health advocate, I felt the urge to act.”

Creating Rofaida

In 2016, she acted and — along with 24 co-founders — established the Rofaida Women’s Health Organization to provide Saudi women with essential information and education, and support policies concerning their health and wellbeing.

“We didn’t want Rofaida to be disease-oriented or cancer-focused. We aimed to take a holistic approach and focus on health and wellness. Our vision is to empower women with the knowledge, skills, and supportive policies that enable them to make informed health decisions.”

Inform, Educate, Advocate

Rofaida began with a core strategy to inform, educate, and advocate. Informing involved providing women with accurate health information in Arabic, “because this is what we were lacking.” Recognizing the significant challenges facing reproductive, maternal, sexual, and adolescent health in Saudi Arabia, Rofaida shifted its focus primarily to reproductive and sexual health.

“We started designing tailored programs for our community groups, including teens, women of reproductive age, and premenopausal and menopausal women.” Rofaida has established a website and a strong social media presence, launching several flagship projects, including a podcast called “Unfiltered Talk.” This platform facilitates honest and safe discussions between women and experts in reproductive and sexual health.

Education started with workshops, on-the-ground training, and health fairs. “To ensure accessibility for everyone in the community, we also offer online training for women who face transportation challenges, making it easier for all to participate.”

Critically, Rofaida began advocating for women’s health with policymakers by holding regular round-table discussions and an annual Women’s Health Advocacy Forum. “The forum brings together key decision-makers and experts to discuss necessary improvements in women’s health policies.” Since Rofaida’s inception in 2016, the organization prioritized advocacy for the HPV vaccine, providing supportive documents and global evidence.

HPV Immunization Program Begins

By March 2022, the Saudi Ministry of Health launched the National Immunization Program for schoolgirls. “Now, we are advocating for a cervical screening program, as the national immunization initiative only covers young girls, leaving a significant population of females aged 26 and older unprotected. Therefore, secondary prevention strategies, such as screening and appropriate treatment, remain essential in combating cervical cancer.”

“The Ministry of Health did amazingly well because they collaborated with the civil society organizations just to prepare community before release,” she recalls. “They also worked with the Ministry of Education and the community because it was a school -based program. It was highly accepted, and the uptake was about 70%.”

In fact, there was further demand in the community, so a secondary track was created to vaccinate women up to 26 years of age. Women in the Kingdom can consult with their physicians for the HPV vaccine up to age 45.

“Saudi Arabia’s HPV National Immunization Program set a commendable example for other countries,” she says. “The initiation of the vaccination program prompted swift adoption by other Gulf Cooperation Council and neighboring countries, showcasing Saudi Arabia’s influential role in the region and its global commitment to eradicate cervical cancer.”

The vaccine, she emphasizes, is just one step toward empowering women in the Kingdom to advocate for their health and engage knowledgeably with healthcare providers. “We educate women about various issues, including sexual health, reproductive health, and mental wellbeing,” she explains. “Women’s health is not only gynecological health; it is much more and requires holistic attention. The need for comprehensive research on women’s health is greater than ever, not only in Saudi Arabia but globally. It is undeniable that men and women experience different symptoms and responses to treatments. Therefore, personalized healthcare and evidence-based practices are fundamental rights for women.”

More Work Ahead

There’s still much work to be done regarding HPV and cervical cancer. Rofaida is advocating for improved access to screening and treatment, increased adolescent education, and gender-neutral vaccination. “The challenge in Saudi Arabia is the lack of national HPV prevalence data, which makes it difficult to advocate without supporting data.”

Joining the Global HPV Consortium helps, says Alhamlan. “Through this strategic partnership, we can leverage the expertise and the knowledge and the resources to really develop innovative programs based on the world’s experience. The Consortium provides us with all these resources.”

“Rofaida’s ultimate goal is to achieve co-production in healthcare, where women/patients and healthcare providers work together as partners to develop the best health services possible,” she says. “This cannot be achieved without a supportive health policies and infrastructures that allow for equitable access to healthcare.”