Public Health Issues of Women

By Shyam Prakash J

Introduction

Being a man or a woman has a significant impact on health, as a result of both biological and gender-related differences. The health of women and girls is of particular concern because, in many societies, they are disadvantaged by discrimination rooted in socio-cultural factors. For example, women and girls face increased vulnerability to HIV/AIDS.

Some of the socio-cultural factors that prevent women and girls to benefit from quality health services and attaining the best possible level of health include:

• unequal power relationships between men and women.• social norms that decrease education and paid employment

opportunities.• an exclusive focus on women’s reproductive roles.• potential or actual experience of physical, sexual and emotional

violence.• While poverty is an important barrier to positive health

outcomes for both men and women, poverty tends to yield a higher burden on women and girls’ health due to, for example, feeding practices (malnutrition) and use of unsafe cooking fuels (COPD).

• Public health is the science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases.

Maternal Mortality

Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.

The data are estimated with a regression model using information on the proportion of maternal deaths among Non-AIDS deaths in women ages 15-49, fertility, birth attendants, and GDP.

• 1990 -1991 :- Maternal Mortality Rate (MMR) of 437 per 100,000 live, India is required to reduce MMR to 109 per 100,000 live births by 2015.

• 1990 - 2006 :- There has been some improvement in the Maternal Mortality Rate (MMR) which has declined to 254 per 100,000 live births as compared to 327 in 1990. However, despite this progress, India is expected to fall short of the 2015 target by 26 points.

• Safe motherhood depends on the delivery by trained personnel, particularly through institutional facilities. However, delivery in institutional facilities has risen slowly from 26 percent in 1992-93 to 47 percent in 2007-08.

• Consequently, deliveries by skilled personnel have increased at the same pace, from 33 percent to 52 percent in the same period. By 2015, it is expected that India will be able to ensure only 62 percent of births in institutional facilities with trained personnel. Thus, universal coverage remains to be achieved.

Causes of Maternal Mortality

The leading causes of maternal death are classified as direct or indirect.

• Direct causes are those related to obstetric complications of pregnancy, labour and delivery, and the post-partum periods. Direct causes account for 80% of maternal death.

• Indirect causes are those relating to pre-existing medical conditions that may be aggravated by the physiologic demands of pregnancy.

Women and Mental Health

Women and Mental Health

• Mental illnesses affect women and men differently — some disorders are more common in women, and some express themselves with different symptoms. Scientists are only now beginning to tease apart the contributions of various biological and psychosocial factors to mental health and mental illness in both women and men. In addition, researchers are currently studying the special problems of treatment for serious mental illness during pregnancy and the postpartum period.

• The mental disorders affecting women include the following:

• Anxiety Disorders - including OCD, panic, PTSD, social phobia, and generalized anxiety disorders.

• Attention Deficit Hyperactivity Disorder (ADHD, ADD)• Bipolar Disorder• Borderline Personality Disorder• Depression• Postpartum depression• Eating Disorders• Schizophrenia

Obesity

Obesity negatively impacts the health of women in many ways:-

• Being overweight or obese increases the relative risk of diabetes and coronary artery disease in women.

• Women who are obese have a higher risk of low back pain and knee osteoarthritis.

• Obesity negatively affects both contraception and fertility as well.

• Maternal obesity is linked with higher rates of caesarean section as well as higher rates of high-risk obstetrical conditions such as diabetes and hypertension.

• Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breastfeeding, and decreased duration of breastfeeding. There seems to be an association between obesity and depression in women, though cultural factors may influence this association. Obese women are at higher risk for multiple cancers, including endometrial cancer, cervical cancer, breast cancer, and perhaps ovarian cancer.

The prevalence of obesity is rising

• The World Health Organization estimates that more than 1 billion people are overweight, with 300 million meeting the criteria for obesity.

• Twenty-six percent of non-pregnant women ages 20 to 39 are overweight and 29% are obese.

• This article will review the wide-ranging effects that obesity has on both reproductive health and chronic medical conditions in women.

Malnutrition

• Women are more likely to suffer from nutritional deficiencies than men are, for reasons including women's reproductive biology, low social status, poverty, and lack of education.

• Socio-cultural traditions and disparities in household work patterns can also increase women's chances of being malnourished.

• Globally, 50 percent of all pregnant women are anemic, and at least 120 million women in less developed countries are underweight.

• Research shows that being underweight hinders women's productivity and can lead to increased rates of illness and mortality.

• Adolescent girls are particularly vulnerable to malnutrition because they are growing faster than at any time after their first year of life. They need protein, iron, and other micronutrients to support the adolescent growth spurt and meet the body's increased demand for iron during menstruation.

• Adolescents who become pregnant are at greater risk of various complications since they may not yet have finished growing.

• Pregnant adolescents who are underweight or stunted are especially likely to experience obstructed labour and other obstetric complications.

Iron deficiency and Anaemia

• The body uses iron to produce haemoglobin, a protein that transports oxygen from the lungs to other tissues in the body via the blood stream.

• anemia is defined as having a hemoglobin level below a specific level (less than 12 grams of hemoglobin per deciliter of blood [g/dl] in nonpregnant women; less than 10 g/dl in pregnant women).

• Most women who develop anemia in less developed countries are not consuming enough iron-rich foods or are eating foods that inhibit the absorption of iron.

• malaria can also cause anemia and is responsible for much of the endemic anemia in some areas.

• Anemia affects about 43 percent of women of reproductive age in less developed countries.

• Severe anemia places women at higher risk of death during delivery and the period following childbirth.

Reference • http://www.cdcfoundation.org/content/what-public-

health

• http://www.who.int/topics/womens_health/en/

• http://data.worldbank.org/indicator/SH.STA.MMRT

• http://www.in.undp.org/content/india/en/home/mdgoverview/overview/mdg5.html

• http://healthandrights.ccnmtl.columbia.edu/reproductive_health/causes_maternal_mortality.html

• http://www.nimh.nih.gov/health/topics/women-and-mental-health/index.shtml

• http://www.jabfm.org/content/24/1/75.full