The mental health of mothers cannot be studied in isolation, as just a psychological snapshot in time. Their complex lives both past and present must be taken into consideration. When I was researching marriage, motherhood, and social support in Korogocho, an informal settlement in Nairobi, stories I heard underscored how a range of life experiences conspire to affect a woman’s mental health. I heard life histories like this:

When Ann was 17, she met Fredrick, got pregnant and moved in with him when she was 18. Two years later, Fredrick got arrested and was gone for two years. When he came back, she got pregnant with child No. 2 within a month but then left the relationship seven months later because of ongoing conflict. When she was about 23 with a 2-month-old and 5-year-old, Frederick shot her. Two months later, he himself was killed. Four months later, she met the man who would become her second husband. After living together for three years, he took her back to his home to meet his family. She then had her third baby.

When childbirth takes place without skilled birth attendants or adequate emergency obstetric care, a woman may suffer from obstetric fistula. Women with fistula live with uncontrollable urinary and/or fecal incontinence, because a hole has formed between the birth canal and bladder or rectum. They have usually survived prolonged/obstructed labor, often lost their child to stillbirth, and frequently face severe social isolation and stigma. There are also now more and more women suffering from iatrogenic fistula caused by injuries during pelvic surgery, especially obstetric or gynecological surgery. Between 1 million and 2 million women currently need fistula repair, with thousands of new cases each year. However, most fistulas can be treated, enabling women to resume healthy, productive lives in their communities. Recognizing this, the United Nations has issued a call to end fistula by 2030.

For some time, it has been clear that a global population imbalance is emerging. High income countries, including nearly all of the Americas, Europe, and most of East and parts of South and Southeast Asia, have seen a dramatic, sustained fall in fertility. Already, this is resulting in shrinking labor forces and the oldest mean age populations seen in history. At the same time, the low income countries and even some lower middle-income countries—mainly in Africa but also in Central America, the Middle East, and parts of South and Southeast Asia—continue to have relatively high fertility. This is now, and even more in the coming decades, producing fast-growing labor forces and relatively young populations.

To address the security challenges facing Sub-Saharan Africa we need to shift the focus from a concept of state security to one of citizen security, says Ambassador Phillip Carter III (ret.), former Ambassador to the Ivory Coast and the Republic of Guinea, in this week’s Friday Podcast. “Our current strategy of a military response to terrorist organizations or criminal networks is inadequate at best, and probably unsustainable at worst,” says Carter. “To me, the greatest security threat in Africa is poor or bad governance.”