Public Health issues of women

1. Public Health Issues of Women
By Shyam Prakash J

2. 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.

3. 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).

4. • 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.

5. Maternal Mortality

6. 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.

7. • 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.

8. • 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.

9. 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.

10. Women and Mental Health

11. 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.

12. • 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

13. Obesity

14. 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.

15. • 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.

16. 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.

17. Malnutrition

18. • 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.

19. • 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.

20. Iron deficiency and Anaemia

21. • 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).

22. • 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.

23. 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/mdgov
erview/overview/mdg5.html
• http://healthandrights.ccnmtl.columbia.edu/reproductiv
e_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