Women’s Health and Development

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Women’s Health and Development

Women’s Health and Development

M Farhad Hossain

The Constitution of the World Health Organization defines health as a state of complete physical, mental and social well being, are not merely the absence of disease of infirmity. This definition applies to every human being irrespective of gender, race, religion, color, socio-economic status, origin and other factors. It is recognized that ‘total health’ is a universal human right: having the highest possible standard of health and well being, is as important and necessary to women as to any other segment of the population. Universally women are considered as at the heart of development. The virtually manage most of the non – money economy, as for example, subsistence agriculture, bearing and raising children, domestic labor and they play a significant role in the money economy, for example, like trading, the informal sector, wage employment.  Every where on the globe, women do two jobs one at home and another outside it.

Women are often the critical focal point’ of health and development. They assume the crucial position between policy and practice in health as in many other domains. Paggy Antrobus’s observation about the third world women applies to women almost Universally. “Their central rule in human survival therefore places them at the centre of the balance between sustainable development and ecological disaster, between a more human world and one which denies a common humanity to the majority of the world’s population unless their values, views and vision serve as the central focus for our policy making we cannot achieve the ultimate goal of peace.”

The state of women’s health is over deteriorating. Because of poverty, lack of decision making over population, degrading environment, inequitable health services, illiteracy, social and family discrimination, women are often deprived of their basic health needs. To provide a glimpse of the noticeably miserable picture of the status of women’s health worldwide, we can quote these form the report presented to the 1985 Nairobi Conference on women that summarized the state of most of the world’s women thus: “Women in developing countries are often in poor health and overburdened with work, they are tried, most are anemic, many suffer from malnutrition and parasitism and chronic ill health from lack of personal attention and adequate health care, especially during pregnancy and childbirth. Early marriage, repeated child bearing, poverty and manual labor all have deleterious effects. Women’s special needs have often been ignored by health planners and women have efforts had to bear a disproper share of unmet health needs. If we consider the state of women’s health, life expectation reproductive health (absorption, facility, adolescents, older) nutrition should be task into account. Imbalances in Health risks exist in the form of the expectancy, reproductive health (abortion, fertility, adolescents, and older women), and nutrition should be taken into account. Imbalances in health risks exist in the form of life expectancy between men and women in countries like Bangladesh, Bhutan, Nepal, India, Iran and Pakistan where the average life expectancy was actually lower for women than for men. It is estimated that each year half a million women who include wives, daughters, sisters, mothers of families, pillars of the community die due to pregnancy and childbirth. But it is not worthy only a small portion (6,000) of those, 500,000 deaths occur in developed countries. It is a matter of great concern that over half of all maternal deaths take place in South Asia, mainly in Bangladesh, India and Pakistan. Early pregnancy is equally risky for both mother and child, at the same time, early mother hood reduces the young mother’s chances of education and employment.

Young women who give birth between 15 -19 years old as compared to women of 20-34 have a much higher risk of premature death. It is a fact that early marriage and early child bearing remain as an accepted way of life for vast numbers of women across the world. Dr Nafis Sadik, Executive Director, United Nations Population Fund, writes in her book, investing in women: the focus of the 90s, “In Africa 40% of teenage birth is to women aged 17 or under, compared with 39% in Latin America, 31% in Asia and 22% in Europe.” On the other hand, the health picture for older women is dissimilar from that of the younger women age groups. For example, women who become pregnant after the age of 35, especially those who have had more than three children, are again at greater risk than mothers in the 20-34 age groups.

Although the earth produces adequate food to feed everyone today, five hundred million people are affected by malnutrition. Inequitable distribution of food, poor storage systems, lack of knowledge of nutritional requirements, illnesses and parasites that get in the way of the body’s utilization of the food consumed are behind the wide spread malnutrition. The biggest problem is poverty; they cannot earn enough money to ensure a sufficient diet. Between 20 and 45 per cent of women of childbearing age in the developing world do not eat the WHO recommended 2,250 calories a day under normal circumstances, and they need an extra 285 per day when they are pregnant. This situation prevails because women feel the effect of poverty most keenly. Heavy workload, repeated pregnancies, low social status, discrimination in food distribution within the family, or food taboos and poverty in general undermine women’s nutritional status.

Malnutrition takes many forms.  Under nutrition and nutritional deficiencies is a problem for most of the malnourished people in developing countries. Anemia for women in the developing world. It is estimated that nearly two thirds of pregnant women and one half of all other women are suffering from Anemia. The consequences of anemia for women, their families and communities, are far reaching and seriously harmful. Anemia leads to fatigue and reduced productivity and lowers resistance to diseases. It means greater risk to the life and health of both mother and child during pregnancy and childbirth. Social factors responsible for the Vicious Circle of Malnutrition among women are poverty, low social status, discrimination against girls, and lack of education, lack of health care and early pregnancy.

Women have many key health issues to be resolved in global, national, social, family and personal perspectives. There are issues like reproductive health, safe motherhood along with lifestyle issues, including the use of tobacco, alcohol, drugs and medication, where education and action are required. Although there are many specific issues, the effective application and extension of primary health care (PHC) is a fundamental issue for women’s health. It is estimated that 500,000 women die from pregnancy related causes each year, 99% of them in developing countries. There are countries others who suffer prolonged or permanent ill health and disability, over and above the number of deaths. Moreover, for every woman who dies the risk of one more of her children dying also increases? Maternal mortality is a serious issue that needs to be addressed. The life time risk of a woman is a developing country dying in pregnancy related illness is 1 in 25 or 1 in 40. Some of the major cases of maternal mortality are the absence of prenatal care, having many children the problem of transportation, lack of Knowledge of dangers during pregnancy, lack of use of contraceptive, malnutrition at young age, handling by untrained traditional birth attendants. Lack of emergency care by hospital, and seeking illicit abortions.

There are other issues as well. Infertility, female circumcision and problems of reproductive health are widespread issues that have great psychosomatic impact on the women who are subject to them. Infertility is a great scourge in many parts of the developing world but it is found in all regions. A WHO estimate says that infertility affects between 35 and 70 million married couples worldwide. Being infertile brings with it social stigma, and great difficulty in finding a place in Society. A few decades age, neither woman not physicians was aware of the benefits of breast feeding. In 1939, a woman doctor, Dr Cicely Williams called attention to the dreadful fact that children were dying from being given formula in bottles instead of being breastfed. She called it murder. It took many years and much determined research and advocacy to discover the multiple benefits of breast feeding and the full dangers of bottle feeding. In the early 1970s, an international campaign began to stop the promotion of breast milk substitutes.

Some UN agencies especially UNICEF and WHO, joined this campaign along with NGOs in a worldwide effort to protect the health of women and children by protecting the practice of breast feeding.

Female circumcision remains as an issue or great health and psycho-social hazard in some 26 African countries and it is also found in Malaysia Indonesia, Yemen and in scattered parts of Brazil, Mexico and Peru. Immigrants form regions where it is practiced have also performed the operation in European countries. It is estimated that 80 million girls and women are living today with the results of genital mutation.

The serious consequences of female circumcision appear at different points of time in the lifetime of a woman. Immediate consequences are: pain retention of urine, infections and fever, and tetanus. Death is not uncommon, especially where the child or woman lives far from medical help. To resolve this painful and hazardous issue, over the years African women’s groups, NGOs governments and inter – governmental agencies have joined forces to raise the issue with national policy makers, key groups in the health care system, opinion leaders and the general public.

In the recent years, women’s reproductive role has been changed, as they are recognized human beings with reproductive rights among many other human rights. The reproductive rights include the right to state mother hood. The right to plan ones family, the right to assistance in preventing and overcoming infertility and the right to full and timely knowledge about all aspects of reproductive health and sexuality. Therefore, young women have the right to learn about and exercise their reproductive rights and safeguard their own reproductive health.

Our lifestyle mostly contribute to non – communicable diseases like heart disease, hypertension and stroke, obesity and diabetes, cancer and so on Many health problems, poor health’s, premature death may be caused by smoking, too much alcohol or too little exercise. To check this situation a growing number of countries regulate tobacco and alcohol promotion, Millions of women worldwide is becoming addicted to smoking. Cigarette advertising in developing countries has singled out two groups as targets: women and young people. And it is among young women that the proportion of smokers is rising most rapidly. Some of the facts on Smoking and reproductive health agreed at the conference on smoking and Reproductive Health International are: Women who smoke are three times more likely to be infertile than non – Smokers have more difficultly conceiving than non – smokers.

Smoking during pregnancy causes higher rates of spontaneous abortion. Smoking increases chances of in front death during the first month of the life. Children 6 -24 months old of parents who smoke tend to have more ear infections and respiratory problems (from passive smoke breathed at home) Women over 30 who smoke and use oral contraceptives have an increased risk of developing cardiovascular problems. Women who smoke more than double their risk of contracting cervical cancer.

Women and alcohol is another critical issue in many industrialized countries and in a growing number of developing countries.

Women pay a high price for addiction to alcohol. Physically, women who drink heavily are more likely than men to develop cirrhosis of the liver. Socially, women alcoholics tend to become totally isolated. Besides, due to addiction to alcohol by women, family life suffers, marriage break up. Cervical cancer, breast cancer, STDs AIDS/ HIV, occupational health hazard, women with disabilities, elderly women, refuge and migrant women,  women’s mental health (depression, suicide), women as consumers of health related products (product safety, research marketing practices and pricing) are some of the critical issues that cause far reaching damage.

Genetic or biological inheritance has a bearing on each human being, sometimes positively or sometimes positively. However, the environment in which everybody lives has an intense effect on what becomes of the biological influence. The accessibility to health information and health care, both preventive and curative, influences an individual’s health. It is evident that a person’s behavior or lifestyle plays a main role in determining the state of anyone’s health.

Many specific factors affect women’s health. Economic, demographic, political (policy decisions), and environmental factors affect women’s health and integrated socio economic development in a number of ways. Reliable statics say that more than one billion people, most of them women, live in acute poverty. Women are more prone to poverty than men and to be among the poorest of the poor. Households headed by women are typically more likely to be poorer than those headed by men. The influence that poverty has on women’s health is irreparable Poverty restricts women’s choice in so many areas that are basic to good health. The consequence of poverty at the individual or family level are: not having enough food or the right kinds of food; not having decent housing, sanitation and water supply: not being able to get health care when needed; not being able to send children to school or take advantage of adult education opportunities; not being able to think or plan beyond today’s crisis, today’s strategy for survival; and not being accorded his or her dignity as a human being. Extremely poor women spend more time and energy producing food or searching for food that they can afford. Due to their lack of skill and education, they are compelled to accept the most dangerous, backbreaking and least desirable work. The effects of these types of work are disastrous for their health and their families.

The status of women is another factor that operates more subtly on women. However, its consequences are not so readily measured or acknowledged. Though poverty has direct, dramatic and measurable impacts on women’s health, the status of women has an equally powerful and all pervasive impact.

Like men, women play certain roles in most societies.

The international Labor Organization (ILO) summed up status of women are half world’s population, receive one tenth of the world’s income,  account for two- thirds of the world’s working hours, and own only one – hundredth of the worlds property.

Demographic factors have serious consequences for women’s health at ‘macro’ and ‘micro’ levels, for example, for society as a whole, or at the level of an individual or family. Continuing growth in population puts pressure on the environment and makes it more difficult to keep up with the growing numbers of people needing food, Shelter, education, employment, water and sanitation, At the micro, level success or failure on to make decisions or failure on to make decisions about family size and spacing by couples can be major determinates of a women’s and her family’s life long chances of good health. At this level, she does not have any rights to buy anything. Similarly, nutrition is another demographic factor that has many implications for women health. Urbanizations are affecting women’s health, as squalor, malnutrition, lack of water and sanitation, malnutrition and overcrowding prevail.

Political decisions, health and other related policies might help improve or hinder the state of women’s health and well being and recognize their role in socio economic development. Policies aside, other socio – economic factors like violence and exploitation, rape, prostration, armed conflicts affect the status of women and their health seriously when they are bound to become of victims as circumstances behind their control. It is observed that local customs in all parts of the world have a strong impact both positive and negative, on women’s lives and health. Traditional practices like female circumcision inflict inestimable harm on the health of women and girls.

We are profoundly concerned about ill health of the impoverished populations of the world, with special emphasis on the state of women’s health. We have observed with disappointment that the Alma-Ata-Declaration endorsed by the world’s nations.

Which outlined a revolutionary strategy called Primary Health Care (PHC).

With the goal of Health for All by the year 2000. Was not given a proper chance for implementation. Unfortunately, the vision of the Alma-Ata Declaration never materialized. The global health situation has been worsening in this declining situation worldwide, several international organizations, civil society movements. NGOs and women’s groups decided to work together towards the objective of putting the goals of Health for all in its rightful place on the development agenda. This group together with others committed to the principles of primary health care and people’s perspectives organized the ‘People’s Health Assembly’ which took place from 4 to 8 December 2000 at the premises of the Gonoshasthya Kendra (GK), Savar, Dhaka about 1500 participants from 92 countries came to the Assembly, which was the culmination of eighteen months preparatory action around the globe.

Having reviewed their problems and difficulties and shared their experiences, they have prepared and finally endorsed the Peoples Charter for Health’, a new global policy tool for promoting health for all on the earth.

The Charter says in its preamble. Health is a social, economic, and political issue and, above all, a fundamental human right.

It calls for action to combat the global health crisis at individual community, national, regional and global levels and in all sectors. Therefore, this Charter calls on people of the world to: support all attempts to implement the right health. Demand that governments and international organizations reformulate implement and enforce policies and practices which respect the right to health. Build broad based popular movements to pressure governments to incorporate health and human rights into national constitutions and legislation. Fight the exploitation of people’s health needs for purpose of profit.

It is an undeniable fact that improving women’s health and enhancing of their status are critical for a balanced and sustainable socio-economic development of our society. Definite and appropriate actions and measures are needed for the Socio economic advancement that is our principal aim. Opportunities for actions should be created at international, national and local levels. Government or inter government bodies, NGOs, structured associations and informal groups or networks can contribute through initiatives and collective action.

Attention to root causes, information or awareness rising, intersection approaches, participation, delegating responsibility or allocating resources are essential for enhancing women’s status and health. Unyielding advocacy action is extremely effective in raising awareness among the women and promoting policies, formulating laws and initiating programmes. Advocacy action programmes include a happy birth day; safe motherhood and the role of midwives; the right to stop tobacco promotion, training for self sufficiency maintaining effective communication; Women should be supported in their efforts to get training to achieve self sufficiency. They should be provided with health education programmes that focus on specific health problems with the objective of helping individual acquire the knowledge and motivation required in order to take action for their own or their families or communities health.

Formal or informal settings, classrooms, workplaces, living rooms and community meeting places can be used for this purpose. Communication may be person to person or through printed materials radio, video, telex vision, theatre, puppets, music and so forth. Health curricula need to be designed for children from preschool age through secondary school where it is absent.

Introduction of health education for women is a proven action to improve their health. Integrated approach to health along with different sectors is urgently needed.

Organization / networking introducing women in decision making positions and establishing women’s media networks can help promote the state of women’s health and status of women in families and communities. Women’s health issues should be on the public agenda. Women may use the media to change their lives. Families and communities, both the alternative and mainstream media could spread the word of health education far and wide.

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