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Padmini Murthy MD,MPH,MS, CHES Asst Prof Dept of Health Policy and Management Asst Prof Dept Family and Community Medicine Global Health Program Director.

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Presentation on theme: "Padmini Murthy MD,MPH,MS, CHES Asst Prof Dept of Health Policy and Management Asst Prof Dept Family and Community Medicine Global Health Program Director."— Presentation transcript:

1 Padmini Murthy MD,MPH,MS, CHES Asst Prof Dept of Health Policy and Management Asst Prof Dept Family and Community Medicine Global Health Program Director NYMC Medical Women's International Association Representative to the United Nations HEALTHY WOMEN and GIRLS: GATEWAY TO A HEALTHY WORLD United Nations May 2009

2 Introduction Globalization has changed the fabric of society, while the health and human rights of women are remaining stagnant or growing worse in many parts of the world. Some of what the statistics document is so ugly as to seem incompatible with the word civilization. Women in this day and age are denied their fundamental right to enjoy a complete state of heath as defined by the World Health Organization.

3 A Portrait of Women Women in developing countries face a number of challenges to their health and well-being Over half a million women die each year from complications during pregnancy and childbirth, the vast majority of them in Africa and Asia. (1) This includes nearly 70,000 deaths from unsafe abortion

4 Portrait of Women in Developing Countries More women than ever before are being affected by AIDS. Globally, nearly 16 million women are living with HIV and constitute almost half (48%) of all HIV- positive adults (2) Fundamentally, these health problems are a reflection of the inequalities of power that exist between women and men in many societies around the world

5 Women’s Health and Human Rights Globally women’s health issues and human rights have been neglected by various stakeholders, and this has translated into an increased incidence of women’s mortality and morbidity

6 Impact of Violence Against women The direct and indirect impact of violence and gender discrimination against women and girls often cannot be measured; however, the resulting economic burden on the society is enormous

7 Staggering Statistics According to studies, between 10% and 69% of women report having been assaulted by an intimate male partner at some time in their lives.(3) A study conducted by Buvinic, Morrison, and Shifter found that in Latin America the proportion of women who were assaulted by their partners is between 10% and 35%, while in sub-Saharan Africa, it is between 13% and 45 %(3)

8 Classification of Violence Physical violence Sexual violence Psychological and emotional violence (including coercive tactics) Threats of physical or sexual violence

9 Examples of Gender Based Violence Prebirth—Sex-selective abortion Infancy—Female infanticide, physical abuse, neglect, poor nutrition, and lack of immunization and medical care Girlhood—Child marriage, female genital mutilation (FGM), trafficking, child prostitution, sexual abuse, poor nutrition, lack of immunizations and medical care, and minimal or lack of educational opportunities(3,4)

10 Examples of Gender Based Violence Adolescence—Forced marriages, date rape, FGM, limited or lack of social interaction, acid throwing, dowry deaths, sexual harassment at school and workplace, mass rape during war and civil unrest, lack of safe motherhood facilities, and forced prostitution and trafficking. Other types of violence include economic and social discrimination Young and middle aged women—Intimate partner abuse, marital rape, dowry abuse, psychological and sexual abuse of women at the workplace, rape, widow abuse, and lack of access to health care including access to safe motherhood facilities Elderly women—Physical and mental abuse of elderly woman and widows including rape and neglect (3,4)

11 Culturally Accepted Forms of Violence Female Genital mutilation Dowry Harassment Acid throwing Practice of Sati chimutsa mapfiwa or wife inheritance Widow cleansing

12 Culturally Accepted Forms of Violence Honor Killings Widow confinement Child marriages Forced marriages

13 Physical consequences of violence Injuries to the abdomen and thorax, which can result in damage to the tissues and vital organs such as the heart, lungs and spleen Bruises, welts, contusions, and fractures Bleeding or hemorrhage (internal and external) 1st-, 2nd-, or 3rd-degree burns Chronic pain and chronic fatigue syndromes Fibromyalgia (6,7)

14 Physical and Physiologocial consequences of violence Functional and organic gastrointestinal disorders Reduced physical movements and body functions Ocular damage(6,7)

15 Psychological impact of violence Depression and anxiety Eating and sleep disorders Feelings of shame and guilt Phobias and panic disorder Physical inactivity Poor self-esteem

16 Effects of Violence on Reproductive and infant health Unwanted or Unintended Pregnancies Unsafe and Forced Abortions Maternal complications : abruptio placenta Fetal complications: low birth weight, intrauterine death Sexually transmitted disease Chronic pelvic pain

17 Strategies to address gender based violence Male involvement and input when implementing programs to prevent violence against women has shown to be effective. Treatment programs for abusers Women Police Stations Stringent punishment for abusers

18 Universal Declaration of Human Rights and Women’s Health Universal Declaration of Human Rights, adopted by the United Nations (UN) in 1948, states that “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family,” and “Motherhood and childhood are entitled to special care and assistance (8)

19 Strategies to address gender based violence Educating boys from childhood that violence against women is an offence and a violation of human rights is an important step in designing preventive strategies. It is important to educate communities that women are not chattel or movable property but individuals who need to be valued and not abused

20 Strategies to address gender based violence Health care professionals should have the courage to refuse to accept laws that infringe on human rights of women Culturally sensitive programming is essential to a human rights-based approach –a necessary paradigm to holistically address both issues of women’s health and human rights, especially gender equality.

21 Strategies to address gender based violence When applied in a culturally sensitive manner, human rights principles are more effective in promoting dignity and social justice for clients and providers at the levels of clinical operations, facility management, service delivery, national and international policy

22 Strategies to address gender based violence Strategies to improve women’s health must be incorporated into the principles of human rights and gender equality and equity. Policy makers, politicians should be made aware of the devastating impact certain policies laws can have on women’s health and human rights ( ex: Global Gag R ule)

23 Peace Women and Human Rights Women constitute 50% of the global population, but their participation and full engagement in building sustainable peace at national, regional, and global levels still remains rather minimal. Though in nearly every country and region of the world, we can point to areas in which there has been some progress in achieving gender equality and women's empowerment, that progress has been uneven and the gains remain fragile. Virtually nowhere are women’s rights given the priority they deserve. “ ( Ambr A.K. Chowdhury)

24 Conclusion We have to mobilize global outrage - to challenge the violence, support those women who suffer and put pressure on those who can bring about change “( Unknown – Amnesty international



27 References 1.Singh S, Darroch JE, Vlassoff M, Nadeau J. Adding it up: the benefits of investing in sexual and reproductive health care. 2003. 2.UNAIDS. 2007 Report on the Global AIDS Epidemic 3. International Center for Research on Women. Violence against women must stop. 2005. 4. Interactive Population Centre. Violence against girls and women. 5. United Nations Children’s Emergency Fund. Domestic violence against women and girls. June 2000. 6. World Health Organization. World report on violence and health. 2002. 7.United Nations Children’s Emergency Fund. Child protection from violence, exploitation and abuse. 8.Universal Declaration of Human Rights, Article 25. 1948.

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