Now, more than ever, it's time to address the neglect of female genital schistosomiasis

Female genital schistosomiasis (FGS) is a neglected sexual and reproductive health condition affecting women and girls across sub-Saharan Africa, where Schistosoma haematobium eggs trapped in the genital tract cause lesions often mistaken for STIs or cervical neoplasia, fuelling misdiagnosis and stigma.

This review takes stock of progress on FGS burden, diagnostics, treatment, integration and policy, and the threats to it. Surveys are improving burden data, and new diagnostics, portable colposcopy, digital imaging, molecular assays, are advancing detection despite resource constraints. Praziquantel remains standard treatment, but single doses clear parasites without reversing lesions; repeated dosing helps only partially, reinforcing the case for early, life-course preventive chemotherapy including paediatric access. Pilot programmes have produced training tools and service packages integrating FGS into SRH care, and policy momentum is building via WHO taskforces, though financing remains weak.

Aid cuts, climate change, emerging infections and gender inequity threaten this progress. The review sets out seven priority actions across health system building blocks, calling for coordinated, multisectoral efforts to embed FGS care within health systems.