World health report

Executive summary


Women

Women's health is inextricably linked to their status in society. It benefits from equality, and suffers from discrimination. Today, the status and well-being of countless millions of women worldwide remain tragically low. As a result, human well-being in general suffers, and the prospects for future generations are dimmer.

In many parts of the world, discrimination against women begins before they are born and stays with them until they die. Throughout history, female babies have been unwanted in some societies and are at a disadvantage from the moment of birth. Today, girls and women are still denied the same rights and privileges as their brothers, at home, at work, in the classroom or the clinic. They suffer more from poverty, low social status and the many hazards associated with their reproductive role. As a result, they bear an unfair burden of disadvantage and suffering, often throughout their lives.

Global population ageing is resulting in the evolution towards societies which are, for the most part, female. Yet while women generally live longer than men, for many of them greater life expectancy carries no real advantage in terms of additional years lived free of disability.

The status of women's health in old age is shaped throughout their lives by factors over which they have little if any control. If longer lives for women are to be years of quality, policies must be aimed at ensuring the best possible health for women as they age. These policies should be geared towards the problems that begin in infancy or childhood, and should cover the whole life span, through adolescence and adulthood into old age.

Infancy and childhood. The health of parents, particularly the mother before and during pregnancy, and the services available to her throughout her pregnancy, especially at delivery, are important determinants of the health status of their children. Infants whose health status is compromised at birth are more vulnerable to various health problems later in life. Girls who are inadequately fed in childhood may have impaired intellectual capacity, delayed puberty, possibly impaired fertility and stunted growth, leading to higher risks of complications during childbirth. Female genital mutilation, of which 2 million girls are at risk every year, or sexual abuse during childhood, increase the risk of poor physical and mental health in later years.

Adolescence. Most reproductive health and family planning programmes have not paid enough attention to the special needs of adolescents. Premature entry into sexual relationships, high-risk sexual behaviour and lack of education, basic health information and services all compromise the current and future well-being of girls in this age group.

These girls are at increased risk of sexually transmitted diseases, including HIV/AIDS, early pregnancy and motherhood, and unsafe abortion. Adolescent girls are not physically prepared for childbirth, and are much more at risk of maternal death than women in their twenties. Inadequate diet during adolescence can jeopardize girls' health and physical development, with permanent consequences. Iron-deficiency anaemia is particularly common among adolescent girls.

Adulthood. The consequences of poor health in childhood and adolescence, including malnutrition, become apparent in adulthood, particularly during the childbearing years. This time is a particularly dangerous phase in the lives of many women in developing countries, where health care services, especially reproductive health facilities, are often inadequate and where society puts pressure on couples to have many children. More than 50% of pregnant women in the developing world are anaemic.

About 585 000 women die each year of pregnancy-related causes. Where women have many pregnancies the risk of related death over the course of their lifetime is compounded. While the risk in Europe is one in 1400, in Asia it is one in 65, and in Africa, one in 16.

An estimated 50 million adult women in developing countries are classified as being severely underweight, and about 450 million suffer from goitre.

Older women. Many millions of women are made old before their time by the daily harshness and inequalities of their earlier lives, beginning in childhood. They experience poor nutrition, reproductive ill-health, dangerous working conditions, violence and lifestyle-related diseases, all of which exacerbate the likelihood of breast and cervical cancers, osteoporosis and other chronic conditions after menopause. In old age poverty, loneliness and alienation are common.

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