Presentation on theme: "Panel 1. “Women, newborn and child health: Social protection in health and the Millennium Development Goals.” Social Protection in Health Forum Elsa Gómez."— Presentation transcript:
1 Panel 1. “Women, newborn and child health: Social protection in health and the Millennium Development Goals.”Social Protection in Health ForumElsa Gómez GómezTegucigalpa, November 8, 2006
2 Themes for reflectionGender as a structural determinant of health inequityMDG 3, “Gender equality and empowerment of women,” as an end in itself, from a rights and citizenship focusCentrality of MDG 3 for achieving the health objectives of women, mothers and childrenChallenges the health sector faces in contributing to progress in MDG 3, accelerating the achievement of the health goals
3 Cultural definitions of differential roles, rights and responsibilities for W(omen) and M(en) determine inequalities in:Health risks and problems for W and MAllocation of social resources for meeting the specific needs of each sexAccess for W and M to appropriate resources and servicesContributions of W and M to the financing of careDistribution by sex of the responsibilities, compensations and power in the social production of health
4 Gender and poverty: Poverty affects differently the survival opportunities of men and women Probability of dying (per 1,000) between 15 and 59 years of age, according to sex and poverty conditionNon-PoorPoorDom. Rep. Brazil MexicoBrazilMexicoBrazilMexicoDom. Rep.Dom. Rep.MenWomenSource: WHO - The World Health Report, 1999
5 Emphasis on W responds to the ethical imperative to rectify unjust inequalities that limit the exercise of the right to healthW have a greater need for services than Mtend to use services more than Mmust pay more than M to protect their healthhave lower economic capacityconstitute the majority of providers of formal care and the primary providers of family healthare more affected by reductions in public services, as users and caretakershave less power and representation
6 W and M get sick and die due to different causes Percentage distribution of years of life lost due to premature death and disabilities, by groups of causes. Latin America and the CaribbeanGroups of causesManWomanTransmissible, maternal, perinatal, nutritional3339Non-transmissible4552Accidents and violence2210Source: Hanson, Kara. Measuring Up: Gender, Burden Disease, and Priority Setting, 2002.
7 Percentages of total DALYS lost due reproductive ill health in women and men age years, 1990 in Amérca Latina and the Caribbean% of years lost due to premature death and disability due to illnesses of the reproductive system in the year old group, according to sex. Latin America and the Caribbean.Causes WomenMenSTIs, excluding HIV3.970.60HIV1.063.63Maternal Conditions9.64Cancers of the Repro. System2.140.02Total16.804.25Source: Abou Zahr, C. and P. Vaughan Assessing the burden & sexual reproductive ill-health.
9 Health care costs more for W W have greater needs for services, tend to use them with greater frequency and pay more for them In BRA, ECU, PER, PAR and the DOM REP, out-of-pocket spending on health was 15.45% higher for W than M.In the USA, out-of-pocket spending on health during the reproductive years was 68% higher for W than M.In Chile, private insurance premiums during the reproductive years are 3 times higher for W than M.
10 W have lower economic capacity 50% of W are outside of the remunerated labor marketUnremunerated domestic labor is not eligible for social servicesUnemployment is consistently higher for WW are the majority in occupations in the informal and part-time sectors, with lower social protectionThe remuneration of W is 30% lower than that of MLess W than M are entitled to rights:19% of W and 32% of M contribute to social security in LACW’s work history, since interrupted by family roles, limits access to and amount of social protection in old age.
11 Percentage of men and women in the urban labor force. 2000/2003 Source: PAHO/GE Gender, Health and Development in the Americas, Basic indicators
12 Urban unemployment rate (%) by sex. 2003 Women MenSource: PAHO/GE Gender, Health and Development in the Americas, Basic indicators
13 Average weekly hours worked by women and men in the urban labor market. Dominican Republic (2004)# hoursMenWomen
14 Percentage of women and men employed in low-productivity sectors Women, MenDominican Rep. (2004)WomenMen
15 Average female income as a percentage of average male income. 2000/2003 *Buenos Aires. **Asuncion. *** NationalSource: PAHO/GE Gender, Health and Development in the Americas, Basic indicators (CEPAL data)HRSA, Women’s Health USA 2002.
16 3. MDG 3 and MDGs for maternal and child health Education, reproductive autonomy, W’s access to resources, and a life free of violence are decisive factors for child and maternal health.1-3 years of maternal education reduce child mortality by 15%. 1-3 years of paternal education reduce it by 6% (BM, 2003)Control over their own fertility is critical for the health of women, mothers and children. Numerous, closely-spaced, very early or very late pregnancies put women’s and children’s lives at risk.Violence against women is the cause of physical and mental pathologies, is a risk for perinatal health and negatively affects self-care during pregnancy and, subsequently, childcare
17 Child mortality (per 1,000 live births), in the 10 years prior to the surveys, by maternal education level, selected countries of LA, 2000.No educationPrimarySecondarySuperior1 Demographic and Health SurveysSource: IADB: Los Objetivos de Desarrollo del Milenio en América Latina y el Caribe. Retos, acciones y compromisos
18 Child mortality (per 1,000 live births) according to duration of birth interval, LAC CMR< 2 years2-3 years>= 4 yearsIntervalSource: DHS. Taken from: The Alan Guttmacher Institute, 2002 Series, No.2
19 Maternal and child mortality rates in selected countries of the Americas, as multiples of the MM and CM rates in Chile.51015202530HaitiBoliviaNicaraguaHondurasEcuadorJamaicaGuatemalaPeruParaguayEl SalvadorVenezuelaPanamaDominican RepublicColombiaBrazilMexicoCosta RicaArgentinaCubaCMR/CMR ChileMMR/MMR ChilePAHO, Basic Indicators, 2005
20 Unmet need for contraception in 2 neglected groups: adolescent women and women without education Dominican Republic (2002)Dominican Republic (2002)15-19 yrsNo educationNatl. TotalSource: OCR Macro. DHS
21 Domestic Violence% of women years of age in union, that have ever experienced physical or sexual violence by their partner or companion. Around 2000444230292211Notavailable10176204050Colombia (2000)Peru (2000)Nicaragua (1997-98)Haiti (2000)Dominican Rep.(2002)PhysicalSexualData for the region indicates that approximately one in three women have experienced gender-based violenceSource: Measure ORC Macro, Demographic Health Surveys carried out in each country between 1997 and 2002.
22 4. Challenges for the sector in contributing to advances toward MDG 3, accelerating the achievement of the health MDGsProvide integral and integrated sexual and reproductive health services to W and M in the framework of strengthening PHC, emphasizing adolescents, and including care for domestic and sexual violence against WSeparate the labor situation from access to social protection in health, promoting universality and overcoming exclusion and segmentationPromote solidarity in financing in reproduction to ensure that its costs do not fall mainly on WStrengthen inclusion and citizen participation of W within the power structures of the local and national health systems