A Global Perspective on Women's Health

Shelby Pearson

There are a handful of categories, statistics, and traditions that separate the women of different countries all around the world today, but one global issue that needs to be more closely looked at is women’s health from a global perspective. Women’s health in all countries are influenced or affected by numerous factors. Some of those key factors are economic status, race and ethnicity, values placed on women, the country itself, and different employment opportunities. These significant factors play a vital role in the activities or choices that women are allowed to do or make such as have birth control or undergo abortions and these same important factors also allow for the traumatic action of rape or violence to be placed on certain women in different areas around the world. This paper will focus in on how lack of knowledge about health problems like pregnancies, family planning services and STDs only furthers the problem. The paper will also touch base on why women are more susceptible to these health hazards, and I also look inside the life of women inmates. The paper will comes to an end by discussing activism towards women’s health globally.

Women make up around 52% of the world’s population. Population growth is most significant in developing countries where 4.5 times as many individuals reside as opposed to already developed countries according to Laurel Spielberg an epidemiologist (Spielberg, 2011). This statistic allows readers to better understand women’s health globally because most of the world’s women are not living here in the United States where we are most familiar with but actually in developing countries such as Africa. A good estimation of a countries health as a whole is to take a look at their life expectancy rates. These life expectancies for women can range anywhere from 86.1 years in Japan to a trifling 39.4 years in Swaziland (Spielberg, 2011). These life expectancies often times are influenced greatly by disease and medicine available in the countries.

It seems as though that even at a very young age female children are more susceptible to an altered healthy life. According to the World Health Organization, looking at the world as a whole, girls under the age of five are at a greater risk of being overweight than the young boys which we all know can lead to diabetes, cardiovascular disease, and even certain types of cancers (World Health Organization, 2009). An even more troubling fact is that girls are far more likely than boys to be victims of different forms of sexual assault globally, 25.3% of girls have had some form of sexual abuse while 8.7% of boys have been victims (World Health Organization, 2009). It can also be estimated that in developing countries, 100 million young girls will get married before they turn 18, this increasing their chance of HIV/AIDS because at such a young age they lack the knowledge about safe sex (World Health Organization, 2011). Most of these girls who marry before age 18 live in several countries positioned in North Africa and also India (Seager, 2009).

An important issue under the topic of women’s health that needs to be discussed is that of maternal morality: the number of women and girls who die during labor or die from birth complications. Developing or underdeveloped countries compete against the odds of having good health care facilities or lack of medicine that is available. Given these rough odds it’s not surprising that many mothers pass away during birth because of the limited number of supplies and doctors around to help. It is said that 99% of maternal mortality could possibly be prevented by family planning opportunities, having an individual who is in the medical field present during the birth, and also the right precautions taken if a problem or issue should happen to arise during pregnancy (Spielberg, 2011). In these developing countries only 40% of births are actually inside a health care setting and within that 40% only 57% are under the supervision of a doctor or health care personnel (Spielberg, 2011). Needless to say, these underdeveloped countries strongly need the family planning service to prevent many of the health complications women face during pregnancy. One in four women who live in the sub-Saharan region of Africa, who decide to stop having children, do not practice any family planning method; therefore, a possible unwanted pregnancy could happen (World Health Organization, 2009). It would also be important to make sure the same types of contraceptives are available all throughout the world to cancel out the problem of pregnancy.
            An area of concern that prevents many underdeveloped countries with receiving the correct information on family planning is the Global Gag Rule. This policy bans “foreign organizations receiving U.S. family planning funds from using their own non-U.S. funds to provide information about abortion, to offer referrals or services for legal abortion, or to advocate for the legalization or decriminalization of abortion” (CHANGE, 2012). The Global Gag Rule does exclude occurrences of incest, rape, and events where the mother’s life would be taken but it does not exempt cases dealing with women’s physical or mental health. Recent records and research on the Global Gag Rule shows that this policy negatively affects the health of women by making it more challenging to receive information on family planning services, and it also has no direct link to reducing abortion statistics in the underdeveloped countries. On January 23, 2009, President Obama took matters into his own hands by canceling the provision with hopes of a new approach to family planning, one that doesn’t harm women’s health (CHANGE, 2012).

Not only would contraceptives help eliminate some of the complicated pregnancies, but they would also help rule out other health issues such as STDs which can later down the road go to cause other health impediments. Many women in underdeveloped countries contract HIV or AIDS because of lack of access to the correct information on health services available or types of contraceptives that are out there. They also have unequal power in sexual relations forcing them to have an unhealthy life and usually die within their reproductive years 15-44 (World Health Organization, 2009). Another common disease that is connected to HIV/AIDS is tuberculosis, which is the third highest cause of death to these women of low-income countries (World Health Organization, 2009). The human papillomavirus (HPV) is an additional major STD to be on the lookout for. According to an article found in the Journal of Women’s Health, HPV is the most common sexually transmitted disease in the United States, where it is said that 50% of the population who is sexually active will contract HPV at some point in their life time (Gelman, A., Nikolajski, C., Schwarz, E., & Borrero, S., 2011). The awareness of this disease is significantly low to the general public, but in a recent survey done black individuals were said to have an even more difficult time recognizing or identifying HPV (Gelman, A., Nikolajski, C., Schwarz, E., & Borrero, S., 2011). If left untreated, the human papillomavirus can become more severe and cause cervical cancer. In a study done in 2004, it was noted that women of the United States fell into the category of 10-19 (rates of 100,000 women) that had cervical cancer. The farther south one goes the rate becomes higher. Mexico fell into the 20-29 rate and several countries in Africa topped the list at around 50-100 rate (World Health Organization, 2010). Of all the cases of cervical cancer in the world today, it’s estimated that around 80% of those cases lead to death. That statistic is even higher in developing countries because of the limited availability to screening tools (World Health Organization, 2009).

            The issue of being a male versus a female plays a huge role in the level of health care that is received to that individual. Rendering a graph depicting the world’s gender gap index from 2005-2007, the countries that see their women as a higher rank or as an equal to men of the same country are the United States, Canada, Australia, and various countries located in northern Europe (Seager, 2009). Countries that view women on the opposite end of the spectrum include a number of countries in Africa and the Middle East (Seager, 2009). A number of sociocultural factors come into play that inhibits women and young girls to collect the quality of health care that they truly deserve. These factors include the following: “unequal power relationships between men and women, social norms that decrease education and paid employment opportunities, an exclusive focus on women’s reproductive roles, and potential or actual experience of physical, sexual, and emotional violence” (World Health Organization, 2009). Still in modern day, women of underdeveloped countries play the main role of caretaker within their households. Some of the more common tasks are to clean the house, watch after the children, and prepare meals. These women that are stricken with poverty, majority of African countries have at least 50% of their population at poverty level (Seager, 2009), pay an enormous price. They cook their food with unsafe solid fuels which puts them at a 50% greater risk of COPD than men, and if the woman is pregnant these toxic chemicals can cause the fetus to be born at a low birth weight and premature (World Health Organization, 2009).

            Unsafe cooking chemicals is not the only type of smoke inhalation that is putting women’s health at risk throughout the country; another main contributor is tobacco smoke. Even though smoking cigarettes is 10 times more likely in males, the recent aggressive tobacco industry has begun to market products aimed towards women causing an increase in the number of women and girls who smoke in developing countries. This poses a problem because women are said to have a more difficult time trying to quit smoking and tend to relapse more often than men. The advertising market is typically trying to catch girls at a younger age to have them become addicted sooner which goes to provide a poor diet and exercise in later life (World Health Organization, 2011).

            Cardiovascular disease (CVD) is a major killer of women throughout the world.  In countries where food is not scarce it is no surprise that heart disease kills thousands because of unhealthy diets and a lack of physical activity. But the idea of CVD contributing to 80% of deaths lower to middle income countries is what is hard to believe. A few of the reasons why this percentage is so high is because many individuals in underdeveloped countries have less exposure to prevention of CVD as compared with people from higher income countries. Of those with CVD in poorer countries, they have less effective health care to treat the disease. “Heart disease, stroke and diabetes are estimated to reduce GDP between 1 and 5% in low- and middle-income countries experiencing rapid economic growth, as many people die prematurely”(World Health Organization, 2011).

            One area that many would not think to consider when engaging in the topic of women’s health is the health of women in prison facilities. From a global perspective there are nearly 10 million individuals, both men and women combined, who are kept in prison facilities. Nearly half of the inmates are located within three major countries: the United States, China, and Russian Federation. Within recent years, the idea of women being in prison is becoming less unique. It is stated that somewhere around 500,000 women and girls are detained in some form of prison establishment either before or after sentencing worldwide (van den Bergh, Gatherer, Fraser, & Moller, 2011). According to an article located in the Bulletin of the World Health Organization, it is declared that in a few distinct countries like England and Wales, the increased population of women in prison facilities has jumped more than 200% within the past 10 years.

Many of the individuals who enter the prison system are from areas that are socioeconomically disadvantaged which contribute to their numerous health problems. Female prisoners in the United States are said to have reported being victims of sexual or physical abuse three times more often than American men, therefore; affecting their mental and physical health status. It can also be said that women who are in prison facilities generally suffer greater mental health problems such as post-traumatic stress, depression, as well as self-mutilation. Also because of these high rates of mental disorders, the disorder itself may cause the women to do harmful things to themselves while in jail like shoot up with an infected needle, running the chance of now catching HIV/AIDS which appears to be an important area of concern for areas located in the European Union Member States as well as in Norway. The current issue with women’s health in these types of facilities is that their health needs are not being met. There is a huge variation between the availability of treatment for men and women. For example, in women prison’s it is harder to provide care for drug addicts and also quite a handful of these places don’t have mental health programs for women. If a women goes in to prison pregnant, most of the time the prison’s food does not meet the nutritional value needed for a pregnant mother to have a healthy fetus and stay healthy herself (van den Bergh, Gatherer, Fraser, & Moller, 2011).

Activism directed towards the health of women located in jail has stepped up also in recent years. The WHO Regional Office for Europe and UNODC has put together a set of guidelines or rules that they are going to be focusing on within their Declaration on Women’s Health in Prison. These guidelines will be directed toward the ministers and policy makers, prison management, and prison health staff.  Another group worth mentioning is a Thai project; Enhancing Lives of Female Inmates (ELFI). In 2008 this group had ambitions to promote awareness and to sponsor better care for women in prison globally (van den Bergh, Gatherer, Fraser, & Moller, 2011). All of these examples show activism and involvement of feminists to help the issue of women’s health in a positive and constructive way.

            There are numerous feminist throughout the decades and in recent years that has helped change or passes certain laws helping countries all over the world in the women’s health department presenting great amounts of activism. In the country of Chad located in Central Africa in 2002, Parliament passed a law that allowed women the right to reproductive rights. This entails that the government must provide the proper education on reproductive planning, pre-natal and post-delivery care, as well as any infections or STD attention that may be needed. Discrimination is not tolerated under this law nor is abortion looked at as a correct family planning route (United Nations Population Fund, 2003).This law also ensures no violence can occur against the women of Chad, which includes any type of sexual violence, genital cutting, and forced marriage. The country of Chad furthermore promises the right to health care for any individual who has HIV/AIDS and makes family planning services available (Seager, 2009).

An even more recent event of activism happened in Thailand in 2007 when a law was passed that makes spousal rape a crime (Seager, 2009). This new law not only protects women but also defends against male, homosexual, and even transgendered individuals that may be victims of spousal rape. Any witnesses to any form of abuse now have the duty to report it to federal officials. In addition to the new law, 104 One Stop Crisis Centers were established inside Thailand by the Ministry of Public Health to provide victims of abuse a place to turn to (Immigration and Refugee Board of Canada, 2007).

            It is important for not only women across the world, but men as well to really look into the health issues facing women today that are located within the country they belong to. Women should not be looked upon or treated as a second class group in any country; women deserve the same amount of quality and care as men receive when it comes to our health. If girls are taught at a young age about these health hazards that they are susceptible to obtaining it would raise awareness throughout the world. If these efforts could save or prevent even one innocent woman or young female from some of the disturbing health topics talked about in this paper, it would be well worth it.

References

CHANGE. (2012). Family planning policy restrictions and hiv. Retrieved from http://www.genderhealth.org/the_issues/us_foreign_policy/family_planning

CHANGE. (2012). Global gag rule. Retrieved from http://www.genderhealth.org/the_issues/us_foreign_policy/global_gag_rule/

Gelman, A., Nikolajski, C., Schwarz, E., & Borrero, S. (2011). Racial Disparities in Awareness of the Human Papillomavirus. Journal Of Women's Health (15409996), 20(8), 1165-1173. doi:10.1089/jwh.2010.2617

Immigration and Refugee Board of Canada. (2007, December 20). Thailand: Domestic violence; state protection and resources available to victims of domestic abuse. Retrieved from http://www.unhcr.org/refworld/topic,45a5fb512,45a5fb6e2,47d6547b23,0,,,THA.html

Seager, J. (2009). The penguin atlas of women in the world. (4th ed.). Brighton, UK: Penguin Group.

Spielberg, L. (Performer) (2011, January). A global perspective on women's health. Global Health Education Consortium. [Video podcast]. Retrieved from http://www.kaiseredu.org/Tutorials-and-Presentations/Global-Womens-Health.aspx

United Nations Population Fund. (2003, August 19). Laws and polices in the African Union, Chad and Mexico UNFPA Newsletters, (7), Retrieved from http://www.unfpa.org/public/cache/bypass/parliamentarians/pid/3615?newsLId=7290

World Health Organization. (2011, March). 10 facts about women's health. Retrieved from http://www.who.int/features/factfiles/women/en/index.html

World Health Organization. (2011, September). Cardiovascular diseases (cvds). Retrieved from http://www.who.int/mediacentre/factsheets/fs317/en/

World Health Organization. (2010, May 7). Global health observatory . Retrieved from http://gamapserver.who.int/mapLibrary/app/searchResults.aspx

World Health Organization. (2009, November). Women's health. Retrieved from http://www.who.int/mediacentre/factsheets/fs334/en/index.html

van den Bergh, B. J., Gatherer, A., Fraser, A., & Moller, L. (2011). Imprisonment and women's health: concerns about gender sensitivity, human rights and public health. Bulletin Of The World Health Organization, 89(9), 689-694. doi:10.2471/BLT.10.082842