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Women’s Health Chapter 9. The Importance of Women’s Health. Being born female can be: dangerous to your health, especially in low- and middle-income countries, discriminatory, more likely to have unique health problems, and
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The Importance of Women’s Health Being born female can be: • dangerous to your health, especially in low- and middle-income countries, • discriminatory, • more likely to have unique health problems, and • related with having economic and social negative consequences as a result of morbidity, premature death and disability.
Table 9.2: Selected Definitions on Women’s Health Data from University of Kentucky HealthCare. Glossary Index. Available at: http://www.ukhealthcare.uky.edu/content/content.asp?pageid=P00527.Accessed April 15, 2007; University of New South Wales. UNSW Embryology Glossary Index
The Determinants of Women’s Health Biological Determinants • Iron-deficient anemia related to menstruation or inability to consume proper amounts of iron. • Complications of pregnancy: • Eclampsia /preeclampsia, uterine prolapse, fistula, PPH. • Increased susceptibility to some infections • Conditions, such as ovarian cancer, specific to women.
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 Fortunately, awareness is spreading. Video: Call to life, Pakistan and Maternal Health (5:01) http://www.youtube.com/watch?v=DfRDFSlQctU&list=PL2674ECE1194603EE&index=1
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 (Example: Punjab state, India). • Video: Female Infanticide- How can it be prevented? (3:43) https://www.youtube.com/watch?v=u9w_NFVa5uc • Video: The village where they kill their daughters (5:08) https://www.youtube.com/watch?v=QatckHHtx7c
The Burden of Health Conditions for Females Female Genital Cutting • Estimated 100-140 million worldwide have had some form of genital cutting performed on them. • Practice appears to be diminishing. • Can initially cause shock, infection or hemorrhaging. • Long-term problems include retention of urine, infertility, and obstructed labor. • Video: Female genital mutilation: (2:27) https://www.youtube.com/watch?v=3CR7Abg8UuE
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. • Inappropriately and late treatment of PID, chronic pain, ovarian abscess, ectopic pregnancies, infertility, chlamydia leads to significant maternal morbidity and infant mortality & morbidity.
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. • Other forms of violence against women.
The Burden of Health Conditions for Women Maternal Morbidity and Mortality • Estimates suggest that there are about 289,000 maternal deaths per year • 99% of maternal deaths occur in low- and middle-income countries. • 60% of all maternal deaths: India, Nigeria, Democratic Republic of the Congo, Ethiopia, Indonesia, Pakistan, Tanzania, Kenya, China, and Uganda. • 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 • Video: Birth in Nepal (23:40) http://www.youtube.com/watch?v=qZ76DB1NSfE
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. • 13% of total maternal deaths that occur annually worldwide are due to unsafe abortions. • Rates of unsafe abortion vary among regions: 60% occurs in Africa.
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. • One of the four major causes of maternal mortality and morbidity. • 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. Source: Women and Health Initiative, Harvard School Of Public Health
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 Female Genital Cutting • Efforts that promote change need to be specifically tailored to local practices and beliefs. • Promote female empowerment, education, and control over economic resources. • Since 1997,WHO has been trying to raise global concern to stop the practice. In 2008, they passed a resolution on the elimination of FGC. • Read the story of Sudan: Religious leader speaks out against female genital mutilation/cutting http://www.unicef.org/protection/sudan_29886.html
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. • Video: Bangladesh Ministry of Women and Children Affairs Communications Campaign on Violence Against Women (6:57) http://www.youtube.com/watch?v=eUe9W7sbpFY
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 • Reduce unsafe abortion and thereby reduce mortality http://www.youtube.com/watch?v=Os_NoidZVLs&list=PLAE0A046C4A21B639&index=5
Towards a better future… Video: Pakistan Maternal/Child Health music video (5:32) http://www.youtube.com/watch?v=9utrSI8C67k&list=PLA74963A60B05473D&index=50