Gender and Women Health

Pinar Okyay, MD,PhDDepartment of Public Health, School of Medicine

Adnan Menderes University, Aydin Turkey

“Have a son and your name

continues!

“Last year only one girl child was born in our village. All other

families had sons”

Kristof, Nicholas D. 1993.

"Peasants of China discover new way to weed out girls."

The New York Times, 21 July, 1.

Today, the vast majority in Asia, Iin different populations,

60 million girls at least, otherwise expected to be alive,

are missing due to gender selective abortion, infanticide or

neglect .

Girl

Boy880

900

920

940

960

980

1000

19912001

945927

1000 1000

Sex distribution for 0-6 years of age in India

Girl

Boy

Oomman N, Ganatra BR., Sex selection: the systematic elimination of girls. Reprod Health Matters. 2002 May;10(19):184-

8.

117,4

116,7

90

95

100

105

110

115

120

Guangxi Zhejiang

Sex ratio at birth in China-1995

In CHINA:

•21 of 31 (%67.7) provinces have higher ratio than 108.0 (expected sex ration at birth)

•40 million single men by 2020

Gu B, Roy K. Sex ratio at birth in China, with reference to other areas in East Asia: what we know. Asia Pac Popul J.

1995 Sep;10(3):17-42.

Gender and Women Health

• In many societies, women systematically fail to achieve or fail to use some basic human rights according to men.

• Most of the time, women's health status and problems related to affect:

– morbidity– disability– mortality

DISCRIMINATION ALL THROUGH THE LIFE OF WOMEN

CHILDHOOD• Sex

selective abortion

• Female mutilation

• Nutrition problems

• Neglect• Cannot benefit

from the services

ADOLESENT/ADULT• Unwanted

pregnancies, STDs• Sexuel

harassment/abuse• Turnpike sex• Smoking and

substanve abuse

OLDERS• Increase in

morbidity /problems on quality of life

• Violence• Social pressure• Increase in

morbidity

Female Genital Mutilation (FGM)

• An estimated 100 to 140 million girls and women worldwide are currently living with the consequences of FGM.

• Each year 2 million girls at risk!

WHO, Female Genital MutilationThe prevention and the management

of the health complicationsPolicy guidelines for nurses and midwives, 2001.

 

FGM / Problems

•Obstetric

•Menstruel

•Phychological

•Urinary

• Other problems..

WHO, A systematic review of the health complications of female genital mutilation

including sequelae in childbirth, 2001.

Violence and Women

World scale: Today one of every

3 women are subjected to

different forms of violence.

(Heise, Ellsberg, Gottemoeller, 1999).

• "...any distinction, exclusion or restriction made on the basis of sex which has the

effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by

women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social,

cultural, civil or any other field." (UN, CEDAW-1994)

Discrimination against women

Violence Pandemiadepends on gender

• Researches from various countries between the years

1986-1997: women within the percentage of 16-41, were physically attacked by men with whom they had close relations.

• Violence exposed is the 10th cause of death in the 15-44 age group women.

• 7% of all women deaths in the world are associated with violence.

WHO,1998

Turkey• Domestic violence

Of women;– 84% slap– 70% being punched– 43% being beated hard– 55% threatened with death

• Home is the place violence most experienced.

• In the violence acts, the aggresive is mostly husband or the man with close emotional relationships.

CEDAW Report of Turkey-1993

Turkey

• Turkey Demographic and Health Survey 2003:– The percentage of justification of the thusband

in hitting or beating his wife is 39%.• Rural 57%• Lower education level 62%

– Reasons of the violence:Şiddet nedenleri:If she; • Burns the food• Argues with him• Refuses to have sex with him

Pablo Picasso/The Rape of the Sabin Women

In the World

• Completed rape at least once during the life of women completed rapeUSA 14-20%Canada: 40%

• 12-25 percent of all adult women have been specified that they were victims of rape or attempted rape.

Koss et al.,1997; Killpatrick et al.,1992; Randall and Haskell, 1995

A systematic weapon : Rape

• In South Africa every 83 second one woman is rapedA report by the U.N. (1996)

• Special Rapporteur on Rwanda estimated that at least 250 000 women were raped during the genocide.

• During the 1992-1995 conflict in Bosnia-Herzegovina between 20 000 and 50 000 women were raped

WHO, Sexuel violence in conflict setting and the risk of HIV, 2004.

Integrated Regional Information Networks (IRIN)

Sexually Transmitted Disease

•Young women know very little information on STDs and because of the fear of being branded as sexual active they hardly try to learn information.

• Woman equipping less power as a decision maker has resulted with late diagnosis and treatment.

Sex trade/tourism..

• 4 million people in sex abuse traffic is estimated in the world.

• The revenue / year of organized criminal organizations is 7 billion dollars

• 500,000 women and children for the sex trade is estimated to infiltrate into European Union countries in 1995.

Older Ages and Women

• The expected duration of life in our country, the birth (DIE-2000) -71.0 years for women -66.4 years for men

• At least 35 countries in the world in the birth of the expected life span for women has reached 80 years. Women live average 6-8 years more than men. (WHO)

Older Ages and Women

• A long way with diseases ..

Health care access problems

In our country, all illiterate population over 65 years is 24% and 74% are women.

Elderly women than elderly men are poor and lack social protection.

Blindness

Women36%

Men64%

Gender and Blindness

Abou-Garaeb, Lewallen, BassettCourtright. Gender and Blindness: a metaanalysis of population based

prevalence surveys.Ophthalmic epidemiology 2001; 8:39-56.

• The most important reason for blindness is cataracts, and according to the results of studies in five countries, 53-72% of all with cataracs are women. •Blindness connected to cataract may be reduced at a rate of 12.5% if only women and men have the same operation rates.

In Disaster• Women,

with lower rates of education and years of education, more work at home,

• at disaster their preparedness and education are less,

• they have little information about the preparation and risk approach.

• Target: Gender Equality

• Strategy: Gender mainstreaming

Equity in Health

• The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)-1979 / Turkey1985

• Madrid-2001

– Political and technical process – Health systems should be settled identfying of

men and women biological differences and gender

– Gender-related evaluation indicators should be identified and data shoul be collected

– Research on gender must be supported

What we know about gender on the women health

Key word: “gender”

Turkish MEDLINE: 14

Ulaknet National Medicine dizini: 3

Key words: “gender identity AND women”

PubMed: 1019

METHOD:

Gender Analysis

Atatürk, Founder of the Modern Turkey; Thank you..Atatürk, Founder of the Modern Turkey; Thank you..