The world keeps failing women, especially at key moments of their lives. Their healthcare needs deserve a much better response, says a report of the World Health Organisation.
Launching the report, entitled Women and health: today's evidence tomorrow's agenda
, WHO Director-General, Dr Margaret Chan called for urgent action both within the health sector and beyond to improve the health and lives of girls and women around the world, from birth to older age.
"If women are denied a chance to develop their full human potential, including their potential to lead healthier and at least somewhat happier lives, is society as a whole really healthy? What does this say about the state of social progress in the 21st century?" asked Dr Chan.
Worldwide, women provide the bulk of health care - whether in the home, the community or the health system, yet health care continues to fail to address the specific needs and challenges of women throughout their lives.
Up to 80% of all health care and 90% of care for HIV/AIDS-related illness is provided in the home - almost always by women. Yet more often than not, they go unsupported, unrecognized and unremunerated in this essential role.
When it comes to meeting women's health care needs, some services, such as care during pregnancy, are more likely to be in place than others such as mental health, sexual violence and screening and treatment for cervical cancer.
However, in many countries, sexual and reproductive health services tend to focus exclusively on married women and ignore the needs of unmarried women and adolescents. Few services cater for other marginalized groups of women such as sex workers, intravenous drug users, ethnic minorities and rural women.
"It's time to pay girls and women back, to make sure that they get the care and support they need to enjoy a fundamental human right at every moment of their lives, that is their right to health," said Dr Chan.
HIV, pregnancy-related conditions and tuberculosis continue to be major killers of women aged 15 to 45 globally. However, as women age, noncommunicable diseases become major causes of death and disability, particularly after the age of 45 years.
Globally, heart attacks and stroke, often thought to be "male" problems, are the two leading killers of women. Women often show different symptoms from men, which contributes to under diagnosis of heart disease in women. They also tend to develop heart disease later in life than men.
Because women tend to live on average six to eight years longer than men, they represent a growing proportion of all older people. Societies need to prepare now to deal with the health problems and costs associated with older age and anticipate the major social changes in the organization of work, family and social support.
Lack of access to education, decision-making positions and income may limit women's ability to protect their own health and that of their families. Though major differences exist in women's health across regions, countries and socio-economic class, women and girls face similar challenges, in particular discrimination, violence and poverty, which increase their risk of ill-health.
For example, in the case of HIV/AIDS the risk posed by a biological difference is compounded in cultures that limit women's knowledge about HIV and their ability to negotiate safer sex.
"We will not see significant progress as long as women are regarded as second-class citizens in so many parts of the world," Dr Chan said. "In so many societies, men exercise political, social and economic control. The health sector has to be concerned. These unequal power relations translate into unequal access to health care and unequal control over health resources," she added.
The report seeks to identify key areas for reform, both within and outside the health sector. These include identifying mechanisms to build strong leadership with the full participation of women's organizations, strengthening health systems to better meet women's needs throughout their lives, leveraging changes in public policy to address how social and economic determinants of health adversely impact women, and building a knowledge base that would allow a better tracking of progress.
Strategies to improve women's health must also take full account of gender inequality and address the specific socioeconomic and cultural barriers that prevent women from protecting and improving their health, the report points out.
The report can be accessed at http://www.who.int/gender/women_health_report/en/index.html