Mother’s Day in the United States is Sunday, May 9. It is another reminder of the importance of women’s well-being to all of us. In this light, I offer some comments below on the health of girls and women globally.
A seminal 2003 article on the health of females is called: “Being born female is dangerous to your health”. Elaine Murphy, the author, used this title to highlight the critical health risks that females face and the important extent to which these risks relate to the social position of girls and women in different societies.
The good news is that the health of girls and women has improved in the last two decades. Young girls die at lower rates than earlier. They also die less often of pneumonia, diarrhea, measles, and malaria. Women die less of pregnancy-related causes and malaria, among other things, and, until COVID, were living longer than ever before.
Yet, there remains a large unfinished agenda of needed improvements in the health of girls and women globally. Around 2.5 million under-five girls still die every year, overwhelmingly of preventable causes, such as birth asphyxia, pneumonia, diarrhea, malaria, and whooping cough. Protein-energy malnutrition also remains one of the leading causes of under-five death for girls.
For 15- to 49-year old women, the ten leading causes of death not only include heart disease, stroke, breast cancer, and road injuries, as we might expect, but also HIV/AIDS, maternal causes, self-harm, and TB. Women globally in this age group also bear important burdens of disability related to mental health disorders. Moreover, although rates are declining, female genital mutilation (FGM) is still common in some settings. Interpersonal violence against females is also pervasive in many places. Despite the fact that pregnancy can be a death sentence where maternal mortality ratios are high, many women still lack access to modern contraceptives.
Many societies also continue to severely constrain the opportunities for girls and women to “be all that they can be.” In such places, we find constraints on their independent movement, lower rates of schooling for girls, and reduced opportunities for women to engage in employment outside the home. In such places, women will rarely hold positions of social and political power, locally or nationally. In addition, girls and women may be less well-nourished than boys and men and may have difficulty accessing health services.
The evidence accumulated over considerable time suggests a number of measures that need to be taken as priorities if the health of girls and women is to be improved. Some of these include:
- Ensure that all girls go to schools of good quality, preferably until at least the end of secondary school;
- Create an enabling environment for the economy, so that it will grow and the demand for female involvement in the economy will also grow;
- Encourage the involvement of women in leadership at every level of society;
- Implement the well-known packages for reducing young child death, including breastfeeding, vaccines, early treatment of pneumonia and malaria, oral rehydration, vitamin A and supplementary nutrition; and
- Promote family planning.
In addition, we need to address the health of women holistically and need to go substantially beyond reproductive health in doing so. This will require attention to implementing well-known measures against the unfinished agenda of nutrition, maternal causes, TB, malaria, and HIV/AIDS. However, we also need to address the growing burden of noncommunicable diseases among women by reducing overweight and obesity, promoting physical activity and healthy eating and reducing alcohol and tobacco consumption. Reducing environmental pollution would also lead to important gains in the health of females. Changing customs that are harmful to the health of girls and women, such as FGM and interpersonal violence, will not be easy. There is evidence, however, that community-led change efforts can make a difference, and sometimes even relatively quickly.
COVID has taxed many countries and their health systems. However, COVID has also provided opportunities for countries to “rebuild” in fairer, more efficient, and more effective ways. One way to do this would be to emphasize reducing gender inequality and maximizing opportunities for females to live long, healthy, and productive lives.
About the Author
Richard Skolnik, MPA - Author of Global Health 101, Fourth Edition. Yale, School of Public Health, New Haven, Connecticut.
Richard Skolnik has spent more than 40 years working on international development and global health and was formerly a lecturer in the Yale School of Public Health, the Yale School of Management, and the George Washington University School of Public Health.