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IMPROVING WOMENS HEALTH POLICY & INTERVENTIONS DR CHITRA RAGHUNANDAN DIR. PROFESSOR OBS & GYNE DEPT, L.H.M.C & S.S.K.H, NEW DELHI DR SHILPA DHINGRA ASST.

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Presentation on theme: "IMPROVING WOMENS HEALTH POLICY & INTERVENTIONS DR CHITRA RAGHUNANDAN DIR. PROFESSOR OBS & GYNE DEPT, L.H.M.C & S.S.K.H, NEW DELHI DR SHILPA DHINGRA ASST."— Presentation transcript:

1 IMPROVING WOMENS HEALTH POLICY & INTERVENTIONS DR CHITRA RAGHUNANDAN DIR. PROFESSOR OBS & GYNE DEPT, L.H.M.C & S.S.K.H, NEW DELHI DR SHILPA DHINGRA ASST. PROFESSOR

2 Womens health a major development task for us An unfinished agenda An unfinished agenda Challenges include reducing Challenges include reducing Maternal mortality Maternal mortality Unwanted fertility Unwanted fertility Sexually transmitted infection ( HIV, AIDS) Sexually transmitted infection ( HIV, AIDS) Female feticide & Violence against women. Female feticide & Violence against women.

3 LIFE CYCLE OF WOMEN & HEALTH ISSUES INFANCY AND CHILDHOOD(0-9 YEARS) Sex selection Sex selection Genital mutilation Genital mutilation Discriminating nutrition Discriminating nutrition Discriminating Health care Discriminating Health care

4 ADOLESCENCE ( YEARS) Early child bearing and abortion Early child bearing and abortion STD & HIV Infection STD & HIV Infection Undernutrition and Anemia Undernutrition and Anemia Increase substance abuse Increase substance abuse

5 REPRODUCTIVE AGE(20-44 YEARS) Unwanted / Unplanned pregnancies Unwanted / Unplanned pregnancies Abortions Abortions STI & AIDS STI & AIDS Pregnancy Complications Pregnancy Complications Anemia Anemia

6 POST REPRODUCTIVE (45 YEARS & ABOVE) Gynecological Malignancies Gynecological Malignancies Cardiovascular diseases Cardiovascular diseases Osteoporosis Osteoporosis Osteoarthritis Osteoarthritis Diabetes Mellitus Diabetes Mellitus LIFE TIME Gender Violence Gender Violence Enviornmental and occupational hazards Enviornmental and occupational hazards Depression Depression

7 HARD FACTS MATERNAL MORTALITY India accounts for 20% of maternal deaths. India accounts for 20% of maternal deaths. Every minute one women dies of pregnancy and childbirth. Every minute one women dies of pregnancy and childbirth. MMR is 330/ 100,000 live births. MMR is 330/ 100,000 live births. Greater than Bangladesh & Pakistan Greater than Bangladesh & Pakistan

8 HARD FACTS POPULATION PARABLES Indian population is 1.2 billion. Indian population is 1.2 billion. India occupies 2.4% of world land. India occupies 2.4% of world land. 17.5% of world population. 17.5% of world population. One out of 6 people in world live in India. One out of 6 people in world live in India. 35% population below the poverty line. 35% population below the poverty line.

9 HARD FACTS The total number of HIV Rose from 8 million in 1990 to 34 million in 2010 The total number of HIV Rose from 8 million in 1990 to 34 million in 2010 Prevalence of HIV in children- 3.4 million Prevalence of HIV in children- 3.4 million People newly infected in million People newly infected in million India has population of 1 Billion out of which half in sexually active group India has population of 1 Billion out of which half in sexually active group Total number of people with HIV in India is 23.9 lakhs in 2009 with children accounting for 3.5% Total number of people with HIV in India is 23.9 lakhs in 2009 with children accounting for 3.5% Parent to child transmission: 5.4% of all routes Parent to child transmission: 5.4% of all routes

10 HARD FACTS FEMALE FETICIDE / GENDER ISSUE Sex Ratio 940/ Sex Ratio 940/ Deficit of 3 crore women. Deficit of 3 crore women. 60 million girls missing. 60 million girls missing girls aborted everyday in India girls aborted everyday in India. A girl child is killed and disowned every hour. A girl child is killed and disowned every hour. 35% of girls sexually abused between 12 to 16 years. 35% of girls sexually abused between 12 to 16 years.

11 KEY ISSUES, POLICY & INTERVENTIONS Complication of pregnancy and childbirth are major cause of death and disability among women of reproductive age leading to high maternal mortality in India. PREVENTION Improving diet supplimentation of pregnant and lactating women. Improving diet supplimentation of pregnant and lactating women. Health care providers and skilled midwife. Health care providers and skilled midwife. Strengthening referral system for effective management of complications. Strengthening referral system for effective management of complications. Tertiary level centers fully equipped. Tertiary level centers fully equipped.

12 Uncontrolled fertility / Sexually transmitted infection Uncontrolled fertility / Sexually transmitted infection Unequal power between men and women in sexual relationship exposes women to involuntary exposure to sex, sexually transmitted infections and unwanted pregnancy. Unequal power between men and women in sexual relationship exposes women to involuntary exposure to sex, sexually transmitted infections and unwanted pregnancy.

13 PREVENTION Empowering women with education and employment. Empowering women with education and employment. Family planning and sexual counselling. Family planning and sexual counselling. Sex education of young adolescents. Sex education of young adolescents. Promotion of mutual consent and condom uses. Promotion of mutual consent and condom uses.

14 Female feticide, Domestic violence, rape and sexual abuse occur in all regions, class and age. Female feticide, Domestic violence, rape and sexual abuse occur in all regions, class and age. Affects 30% women worldwide. Affects 30% women worldwide.

15 PREVENTION Law Law Counselling Counselling Support services Support services Medicare Medicare Raise awareness Raise awareness Mobilize support Mobilize support

16 STAKE HOLDERS Family Family Society Society Health Professionals Health Professionals Strong & Sustained government agencies Strong & Sustained government agencies Well endowed resourses. Well endowed resourses.

17 INTERVENTIONS Strengthen the performance of overall health system specially district level. Strengthen the performance of overall health system specially district level. Effective programs to promote increased utilization of maternal health services / EOC. Effective programs to promote increased utilization of maternal health services / EOC. Women access to basic and comprehensive emergency obstetric care. Women access to basic and comprehensive emergency obstetric care. Availability of skilled birth attendant. Availability of skilled birth attendant. Information on maternal morbidity Information on maternal morbidity Maternal death audits. Maternal death audits.

18 Quality of care where health services are available and affordable NEEDS Skilled staff / Professionals. Skilled staff / Professionals. Effective client provider interaction. Effective client provider interaction. Adequate supply of drugs. Adequate supply of drugs. Communication programmes. Communication programmes. Information to poor women and family Information to poor women and family On health problems and importance of seeking care. On health problems and importance of seeking care.

19 Focused Interventions Ante- natal services Ante- natal services Basic Ante-natal care Basic Ante-natal care Prompt detection/Management and referal of ante-natal complications Prompt detection/Management and referal of ante-natal complications TT Injection TT Injection Iron and folic acid supplementation Iron and folic acid supplementation Treatment of other associated infection Treatment of other associated infection

20 Safe Delivery Skilled birth attendant Skilled birth attendant Timely detection and referral of intra-natal complications Timely detection and referral of intra-natal complications Tertiary level Obstretics care Tertiary level Obstretics care Post-Partum Care Family planning services Family planning services Monitoring for post-partum sepsis Monitoring for post-partum sepsis

21 Preventing unwanted pregnancy Emergency contraception Emergency contraception Medical termination of pregnancy Medical termination of pregnancy Management of unsafe abortion complications Management of unsafe abortion complications Post- abortal contraception Post- abortal contraception

22 Prevention of RTI & STI Promotion of barrier contraception and distribution Promotion of barrier contraception and distribution Symptomatic management of RTI Symptomatic management of RTI Screening and treatment of sex-workers Screening and treatment of sex-workers Screening for cervical cancer Screening for cervical cancer

23 Positive Health promotions Public education program for Public education program for –adequate nutrition –Decision on family size –Safer sex –Male participation –Education and employment School Health Program School Health Program –On reproductive health, dangers of substance abuse

24 Eradication of social problems Law, public education and services to eradicate Law, public education and services to eradicate –Domestic violence –Sexual assault –Forced prostitution –Early childhood marriages Strict regulation of use and abuse of medical technology Strict regulation of use and abuse of medical technology

25 INTERVENTIONS STI treatment education. STI treatment education. Social marketing of condoms. Social marketing of condoms. Voluntary testing of HIV and counselling. Voluntary testing of HIV and counselling. Women controllerd barrier methods for preventing STI / pregnancy. Women controllerd barrier methods for preventing STI / pregnancy.

26 To summarise…… Women Health requires Favourable health policies. Favourable health policies. Strengthening and expanding health services. Strengthening and expanding health services. Positive attitude and approach. Positive attitude and approach. Long term basis … improvement in nutrition, education and employment opportunities for women for positive impact on health. Long term basis … improvement in nutrition, education and employment opportunities for women for positive impact on health.

27 Thank you Thank you


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