This paper discusses some of the health challenges encountered by women across their lives and provides a general idea of some of the fundamental determinants of wom¬en's health. It is apparent that women around the world encounter health challenges at every stage of their life, that is, at birth, adolescent throughout to old age regardless of their locality. Even as the world develops, women's health is deteriorating at every state of their life. This is a critical review of Women and health Agenda over the Last twenty years up to date.
Women and Health Agenda Over the Last 20 Years
This review is about women's health demands and their contribution in creating a healthy society. For many decades, World Health Organization (WHO) has had tremendous measures that concern women's health. Women's health remains a crucial priority by various healthcare agencies. This review explains why various healthcare institutions take a great initiative in ensuring that women's health remains an urgent priority in the society. In addition, this review takes a stock of our own understanding about women's health issues at all stages of their live. Highlighting major issues - some health issues are familiar, while others merit more focus on opportunities for developing the society.
Furthermore, the review also identifies areas that provide better information plus policy discussion at national, regional and international level. The work also shows the significance of the basic health care reforms established in The world health report 2008: primary health care -- now more than ever. Some of the reforms outlines focused on the significance of embracing strong political and institutional leaders, visionary and resources aimed at enhancing the future of women's health (Aiken LH et al. 288).
Historical overview
Improving the health of women is a life-course approach that requires critical understanding of government and societal intervention in improving the health of women in all their life stage. Women's health constitutes the relationship in biological and social requirements of women's health the role of gender discrimination in escalating exposure and susceptibility to risk, limited access to health care and informa-tion, and impact on health outcome. While this review focuses on health problems that affect only women -- such as cervical cancer and the health problems associated with pregnancy and childbirth (Katherine et al., 2010).
It also indicates that women's health requires institutions to focus on sexual and reproductive factors. In addition, the paper also discloses that over the last couple of years, institutions failed to address women's health issues for fear of risks associated to health high costs of conducting research. For instance, adolescent stage is very sensitive in and by then the society thought it was unwise to address sexually related issues (Neil & Virginia, 2010).
Parents and healthcare experts thought that addressing certain issues was against the set norms. The high cost in carrying out market research hindered addressing the health issue among females. In a world consisting of ageing populace, the institutions encounter the challenge of preventing and managing the health related issues. This prolongs the chronic health problems that may affect the future generation. Other than, depending on the society and health institutions to solve the underlying health problems, women should also take great initiative. The life-course approach comes in to disclose the significance of women is multiple involvements to soci-ety in their productive and reproductive functions, as well as consumers and health care providers. It is in respect of this fact that the review calls for reforms to ascertain that women become key agents in health-care provision. This is through participating in the design, management and provision of health services (Aiken LH et al. 288).
Several factors determine the lives of women of all ages and in all nations. These factors include; epidemiological, demographic, social, cultural, economic and environmental. These factors also affect the lives of males but some misfortunes influence girls and women in par-ticular. For instance, it is a natural biological incident that sex ratios during birth tend favors the boy child. This means that, in the last twenty years, for every 100 boys born, there are 94 girls born in USA and 98 in other continents. In some areas, societal prejudice against girl child and parental inclinations for boy child result in distorted sex ratios. In USA, for example, the 2001 market research found only 93 girls per 100 boys. This is a decline compared to 1961 when the number of girls was 98 (Cottingham, Garcia-Moreno & Reis 1555 -- 1562).
In other regions of America, the number of girls is less than 80 girls for every 100 boys. Low sex ratio is also a factor in other American regions, particularly, in North America, where according to survey conducted in 2002, there were 84 girls born for every 100 boys. This was a slight increase from 81 in 1991, but a decrease from 93 girls per 100 boys in the late 1980s. Generally, the life span of women is longer than that of men by six to eight years (Susan, David & Allison, 2009). The difference in lifespan is because of an inherent biological factor for the female. Newborn girls are likely to stay alive to their first birthday than newborn boys. This is an advantage throughout life; women records lower rates of mortality at all ages, probably because of combi-nation of both the genetic and behavioral factors (Aiken LH et al. 288).
Women's long life advantage becomes most evident in old age. The result may be because of lower lifetime risk behaviors, such as smoking and abuse of drugs. Today, life expectancy difference amid gender is reducing in some developed coun-tries. This may be because increased smoking among women and falling rates of cardio-vascular disease among men. The female advantage in life expectancy is a recent incident. Correct historical data are hard to find, but there are facts that in the last twenty years life expectancy of males was higher that of female. This explanation may partly lie in the low social position of women or the high rates of mortality that often linked with pregnancy and childbearing (Cottingham, Garcia-Moreno & Reis 1555 -- 1562).
Globally, women's life expectancy at birth has increased for the last 20 years since the early 1991. By then, life expectancy ranged between 60 and 65 years. In 2002, the life expectancy for women was 70 years as compared to 65 years for men. Today, female's life expectancy is more than 80 years in approximately 35 coun-tries, but this is an inconsistent picture. For instance, life expectancy at birth for women in the America was esti-mated at only 54 years in 1991 -- the lowest of any region. This low life expectancy resulted from chronic diseases and other fatal diseases, HIV / AIDS and maternal mortality, are factors that prevent efforts to improve life expectancy (Haidong, Wang & Samuel, 2009).
In addition, women's life expectancy equals to or shorter than men's because of the social disadvantages that women face (Cottingham, Garcia-Moreno & Reis 1555 -- 1562).
However, life expectancy narrates part of the story; the extra years in the life of women are not characterized by good health. In low-income nations, the difference between women and men is measured by their terms of healthy life expectancy. In some nations, the health life expectancy is marginal, and in other countries, women's health expectancy is lower than for men. It is very absurd that women are unable to access health services yet these health systems rely on women for growth and development. Women play a key role in providing care to the family and become the anchor to both formal and informal healthcare.
Women also dominate in healthcare provision in America and other nations. With approximately 59 million healthcare employees in the world, 30 million of these employees constitute women. Most women provide informal services within the healthcare set-up. They tend to focus in occupations considered to have lower status, for instance, nursing, midwifery, and community health services. Highly trained professionals associate these occupations to females, while males predominate as doctors and dentists among other high status professions (Cottingham, Garcia-Moreno & Reis 1555 -- 1562). There is a marked gender inequality between the percentage consisting of male doctors and female nurses. This is a rare research reported by few countries. For example, in America, there are over 70% of male doctors and over 70% of females taking nursing courses. This review found that, in numerous nations female health-service providers are significantly scarce in rural settings. Such a situation is unsafe for females in certain countries because women remain isolated in particular areas (Crapo et al., 1990).
In most cases, female employees are prevalent to various health related problems, for instance, hepatitis B and C. infections and HIV infections. This is because they are prone to injuries caused by needle sticks and other sharp objects. Women are also susceptible to musculoskeletal injuries that results from burnouts. They also get exposure to hazardous drugs that are either mutagenic or even carcinogenic, and other chemical hazards for instance disinfec-tants and sterilants. These may expose them to Asthmatic conditions if improperly handled. There is need for institutions to advocate for health transition within the healthcare system. These breaks down the gender disparity between male and female workers and either of them can work without any restrictions (Aiken LH et al. 288).
The health transition
Health transition is one of the most striking phenomenons in contemporary societies. It is also a shift in the underlying disease and mortality rates in the world. Health transition affects men, women and children in the entire world and commences from changes in three interconnected and mutually rein-forcing factors. These are demographic structures, patterns of disease and risk factors. Lower mortality rates among children below the age of five years and declining fertility rates characterizes the demographic transition. The outcome is an ageing populace. There is a decrease in the aver-age number of children borne by each woman in global perspective, from 4.3 during the early 1990s to 2.6 by 2002 -- 2010.
The reduced birth rate is the high usage of the contraception. The epidemiological transition indicates a shift in the major causes of death and diseases. This is in contrast to infectious diseases, such as diarrhea and pneumonia, towards non- communicable diseases for instance, cardiovascular disease, stroke and cancers. The risk transition is featured by a decline in risk factors for infectious diseases and a swell in risk factors for chronic diseases (for instance, obese and abuse of alcohol and tobacco). This health transition is happening at diverse rates in various countries. In most middle-income nations includ-ing much of Latin America, health transition is in progress (Vetter & Geller, 2007).
From the statistics conducted in 1991, communicable, nutritional and maternal factors causes about 13% of deaths compared to over 60% deaths in 2002. Even though the high death rate caused by non-communicable diseases may have decreased in America, these diseases result to an increas-ing proportion of total deaths, reaching 80% in 2010. Similar to other numerous nations, in America women were less prevalent to deaths caused by injuries than men. In 1991, injuries caused 23% of male deaths, but only 7% of women died from injuries Steward, Et al, 2007).
There is great advancement of health transition in America, where predominance of infectious diseases determines the mortality rate in girls and women. In the last couple of years, women and children encountered high rates of mortal-ity, often associated to nutritional deficiencies, unsafe water and sanitation, smoke emitted from traditional methods used for cooking and heating and pregnancy and childbearing among others. These traditional risks impose a direct toll on the health of women and children and causing a negative aspect in generational health. Women facing poor nutrition, infectious diseases and insufficient access to health care tend to have infants with low birth weight. These are challenges that compromise the health and survival of these infants. Public health interventions focus on controlling these problems through enhanced nutrition, cleaner household environments, and effective health care (Poole, 2008).
New or previously unidentified health chal-lenges continue to surface, for example, obesity, inadequate exercise, drug abuse, domestic violence and environmental risks. The effect of these rising risks differs at various levels of socioeconomic development. Urban air pollution, for instance, posses a greater risk to health in developing countries compared with developed countries. This is because the latter have made tremendous advancement in environmental and public health policies (Polacek, Ramos & Ferrier, 2007).
The risk transition accounts for the disparities in the trends of behavior of men and women. For instance, in various traditional settings, misuse of tobacco and alcohol was highly used by men compared to women.
Smoking levels among women is approaching that of men; the health effects, for instance, high rates of cardiovascular diseases and cancers, will surface in the coming years. In developing and developed countries, alcohol abuse is higher among men. However, in numerous developed nations, male and female trends of alcohol use are starting to converge (Moy & Dayton, 2007).
Socioeconomic inequalities adversely affect health
Socioeconomic status is a key factor of health for both males and females. Today, it is evident that women in developed nations have a high life span and are less prevalent to suffer from ill health. This is in contrast to women in developing nations. In industrialized nations, there are low death rates among children and younger women and most of these people die at the age of 60 years. There is a quite different picture in the developing nations. The population consists of young populace and the number of deaths reported for young people is high. In low-income nations, most of the deaths are happening among the girls, adolescents and younger adult women. In developed nations, non-communicable diseases, for instance, heart disease, stroke, demen-tias and cancers, are the leading causes of death. This accounts for about four causes in every 10 female deaths (Cottingham, Garcia-Moreno & Reis 1555 -- 1562).
By contrast, in developing nations, maternal and prenatal condi-tions and communicable diseases, for instance, reduced respiratory infections, diarrhea diseases and HIV / AIDS are alarming and resulting to more than 38% of total female deaths. Low living standards and low socioeconomic status leads to poor health outcomes. Research conducted from various low-income countries indicates that roughly 20% of households double those in the America. In both developing and developed nations, levels of maternal mortality are three times higher among underprivileged ethnic groups than among the women. There are comparable disparities in the way application of health-care services (Cottingham, Garcia-Moreno & Reis 1555 -- 1562).
Gender inequities affect women's health
Gender inequalities in women compound the adverse effect on health of low socioeconomic status. In numerous nations and settings, women and girls are perceived in terms of social inferiority. Behavioral and other social values, codes of conduct and laws effect the suppression of women and condone domestic violence. Imbalanced power relationships and gendered standards and values decipher into differential access to and regulate over health resources, within families and beyond (Morland & Everson, 2009).
Gender inequalities in the allotment of resources results in poor health and declined welfare. Across the various health problems, girls and women encounters differential exposures and susceptibilities often inadequately identified. Even though there is a growing intervention of women's participation in politics, men still exercise political dominance in most settings. They continue to dominate both the social and economic control. There is no consistent information available on the number of women living in low social economic status, but women are predominantly susceptible to income poverty because they are less likely in official employ-ment and much of their remuneration does not match that of men (Cottingham, Garcia-Moreno & Reis 1555 -- 1562).
In many low-income nations, a high number of agricultural employees are women and many are unpaid. They conduct voluntary work because this is part of their role within the family set-up. Women participation in non-agricultural employment increased since 1990s, and by 2002, about 40% of workers consisted of women. Nevertheless, employment ratios, for example, the number of employed persons in relation to the working age proportion, are signifi-cantly higher for males than for females. This creates a gender gap that varies from 15% in America to over 40% in the neighbouring regions. Even with formal employment, men still dominates in terms of income earned (Farris, 2007).
For this reason, they are unable to obtain formal labor market, encounters job security and the advantages of social protection, including provision to health care. In the formal employment, women encounter challenges associated to their low standards of living. They also face discrimi-nation and sexual harassment. For this reason, they must balance the requirements of remunerated work, and domestic work, resulting to work-based exhaustion, diseases, mental ill health and other challenges. Data collected from numerous national Demographic and Health Surveys indicate that a typical woman leads almost five households and most of these households are susceptible to poverty. The health of women is also at a risk because of traditional domestic chores (Cottingham, Garcia-Moreno & Reis 1555 -- 1562).
For example, women and girls use traditional cooking methods and this exposes them to air pollution. Inhaling the polluted air is responsible for over 641-000 of the 1.3 million deaths global because chronic obstruc-tive pulmonary disorder (COPD) among women annually. The challenge of COPD resulting from exposure to polluted air is more than 50% higher among women than among men. Women are unduly responsible for gathering household fuel and water. The amount of time used on collecting household fuel and water could or else be spend on income-generation, education, or provide care for family member. This is related to the women's health status and those of their families. In achieving equity in education -- primary level and above -- it is crucial for women to participate in developing both the society and the economy.
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