Global health Issue

Global Health 101 By Richard Skolnik

Chapter Nine Women’s Health

The Importance of Women’s Health

• Being born female is dangerous to your health, especially in low- and middle-income countries

The Determinants of Women’s Health

Biological Determinants • Iron deficiency anemia related to menstruation • Complications of pregnancy • Increased susceptibility to some infections • Conditions, such as ovarian cancer, specific to

women • https://www.ted.com/talks/mother_and_daughter_doc

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The Determinants of Women’s Health

Social Determinants Related to gender norms and roles • Female abortion or infanticide • Often fed less nutritious food than male children • Male dominance leads to physical and sexual

abuse • Cooking with poor ventilation contributes to

respiratory disease • Low social status limits access to health care

The Burden of Health Conditions for Females

Sex-Selective Abortion • Skewed ratios of males to females in some

countries, including China, India, Taiwan, Singapore, South Korea

• Rising incomes and levels of education have led to more sex-selective abortion in these countries

The Burden of Health Conditions for Females

Sexually Transmitted Infections • Biologically more susceptible • Risk factors for women are young age, sex

with high risk partners, and inability to use a condom

• 1.9% of total DALYs lost to women aged 15- 44 were due to STIs

The Burden of Health Conditions for Females

Violence and Sexual Abuse Against Women

• UNAIDS estimates 10-50% of women worldwide have been abused physically by a partner

• Can lead to injuries, unwanted pregnancy, STIs, depression, disability, and death

• Risk factors include low socioeconomic status, young age of the male partner, proximity to alcohol, and gender inequality

• https://www.ted.com/talks/jackson_katz_violence_against_wo men_it_s_a_men_s_issue

The Burden of Health Conditions for Women

Maternal Morbidity and Mortality • Estimates suggest that there are about 342,000

maternal deaths per year • 50% of all maternal deaths occur in six

countries- Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo

The Burden of Health Conditions for Women

• 20% of maternal deaths are from indirect causes, 80% are from direct causes

• Risk factors include general health and nutrition, level of education and income, ethnicity, location, age, and having a skilled birth attendant present

The Burden of Health Conditions for Women

Unsafe Abortion • A “safe” abortion is one performed by a

trained healthcare provider, with proper equipment, technique, and sanitary standards

• Estimates suggest that 70,000 women die from unsafe abortions every year

• Rates of unsafe abortion vary among regions

Figure 9.2: Unsafe abortion

The Burden of Health Conditions for Women

Obstetric Fistula • Condition in which a hole opens up between

bladder and vagina or rectum and vagina • 50,000 to 100,000 women each year will suffer a

fistula • Women with fistulas are often stigmatized or

abandoned • Risk factors are those associated with an

obstructed delivery

Differences Between the Health of Men and Women

• Greater focus has recently been put on the extent to which gender discrimination affects women’s health

• 19 conditions disproportionately affect women- some are specific to women, some are related to women’s higher life expectancy, some are a result of gender discrimination

• https://www.ted.com/talks/alyson_mcgregor_why_medicine_o ften_has_dangerous_side_effects_for_women

The Cost and Consequences of Women’s Health Problems

• Violence, STIs, and fistula tend to isolate women socially

• When a woman dies in childbirth, her family is typically left without a primary caregiver

• Substantial economic costs from women’s health issues

Addressing Future Challenges

Violence Against Women • Protecting women through legislation • Shelters for abused women • Ensuring police, judges, and healthcare

workers are trained to deal with violence against women in effective ways

Table 9.4: Selected Measures to Reduce Intimate Partner Violence

Addressing Future Challenges

Sexually Transmitted Infections • Surveillance of STIs • Program of health education • Appropriately trained health workers to

provide proper treatment

Addressing Future Challenges

Maternal Mortality • Provide hygienic and appropriate post-abortion

care at the lowest level of the health system possible

• Provide effective family planning methods • Births attended by a skilled healthcare provider • Enhance emergency obstetric care