1. Chapter Nine
Women’s Health

2. The Importance of Women’s Health
Being born female is dangerous to your health, especially in low- and middle-income countries
Women’s health is linked closely with the MDGs

3. Table 9.2: Selected Definitions on Women’s Health
Data from University of Kentucky HealthCare. Glossary Index. Available at:
Accessed April 15, 2007; University of New South Wales. UNSW Embryology Glossary Index. Available at:
Index/index.htm. Accessed April 15, 2007; The White Ribbon Alliance. Glossary. Available at:
cfm?a0=Glossary. Accessed April 15, 2007; Wikipedia. Sepsis. Available at: Accessed April 15, 2007.

4. Table 9.2: Selected Definitions (cont.)

5. The Determinants of Women’s Health
Biological Determinants
Iron deficiency anemia related to menstruation
Complications of pregnancy
Increased susceptibility to some infections
Conditions, such as ovarian cancer, specific to women

6. The Determinants of Women’s Health
Social Determinants
Related to gender norms and roles
Female abortion or infanticide
Often fed less nutritious food than male children
Male dominance leads to physical and sexual abuse
Cooking with poor ventilation contributes to respiratory disease
Low social status limits access to health care

7. The Burden of Health Conditions for Females
Sex-Selective Abortion
Skewed ratios of males to females in some countries, including China, India, Taiwan, Singapore, South Korea
Rising incomes and levels of education have led to more sex-selective abortion in these countries

8. The Burden of Health Conditions for Females
Female Genital Cutting
Estimated million worldwide have had some form of genital cutting performed on them
Practice appears to be diminishing
Can initially cause shock, infection or hemorrhaging
Long-term problems include retention of urine, infertility, and obstructed labor

9. The Burden of Health Conditions for Females
Sexually Transmitted Infections
Biologically more susceptible
Risk factors for women are young age, sex with high risk partners, and inability to use a condom
1.9% of total DALYs lost to women aged were due to STIs

10. The Burden of Health Conditions for Females
Violence and Sexual Abuse Against Women
UNAIDS estimates 10-50% of women worldwide have been abused physically by a partner
Can lead to injuries, unwanted pregnancy, STIs, depression, disability, and death
Risk factors include low socioeconomic status, young age of the male partner, proximity to alcohol, and gender inequality

11. The Burden of Health Conditions for Women
Maternal Morbidity and Mortality
Estimates suggest that there are about 342,000 maternal deaths per year
50% of all maternal deaths occur in six countries- Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo

12. The Burden of Health Conditions for Women
20% of maternal deaths are from indirect causes, 80% are from direct causes
Risk factors include general health and nutrition, level of education and income, ethnicity, location, age, and having a skilled birth attendant present

13. The Burden of Health Conditions for Women
Unsafe Abortion
A “safe” abortion is one performed by a trained healthcare provider, with proper equipment, technique, and sanitary standards
Estimates suggest that 70,000 women die from unsafe abortions every year
Rates of unsafe abortion vary among regions

14. Figure 9.2: Unsafe abortion

15. The Burden of Health Conditions for Women
Obstetric Fistula
Condition in which a hole opens up between bladder and vagina or rectum and vagina
50,000 to 100,000 women each year will suffer a fistula
Women with fistulas are often stigmatized or abandoned
Risk factors are those associated with an obstructed delivery

16. Differences Between the Health of Men and Women
Greater focus has recently been put on the extent to which gender discrimination affects women’s health
19 conditions disproportionately affect women- some are specific to women, some are related to women’s higher life expectancy, some are a result of gender discrimination

17. The Cost and Consequences of Women’s Health Problems
Violence, STIs, and fistula tend to isolate women socially
When a woman dies in childbirth, her family is typically left without a primary caregiver
Substantial economic costs from women’s health issues

18. Addressing Future Challenges
Female Genital Cutting
Efforts that promote change need to be specifically tailored to local practices and beliefs
Promote female empowerment, education, and control over economic resources

19. Addressing Future Challenges
Violence Against Women
Protecting women through legislation
Shelters for abused women
Ensuring police, judges, and healthcare workers are trained to deal with violence against women in effective ways

20. Table 9.4: Selected Measures to Reduce Intimate Partner Violence

21. Addressing Future Challenges
Sexually Transmitted Infections
Surveillance of STIs
Program of health education
Appropriately trained health workers to provide proper treatment

22. Addressing Future Challenges
Maternal Mortality
Provide hygienic and appropriate post-abortion care at the lowest level of the health system possible
Provide effective family planning methods
Births attended by a skilled healthcare provider
Enhance emergency obstetric care