While in recent decades we’ve seen significant advances in women’s health and gender equity around the world, improvements have been unevenly spread across the globe and health disparities persist. Today, 215 million women have an unmet need for effective contraception and 356,000 women still die each year from pregnancy-related causes. Despite decreasing rates of HIV infection and major progress in treatment, HIV/AIDS is the leading cause of death among women of reproductive age globally. These are preventable conditions, yet much of the world’s female population – those in developing countries – lack access to adequate health care services and face other barriers to good health, in particular the lack of educational opportunities.
Attention and funding has helped, but there’s a long way to go. International awareness of women’s health issues got a boost when the United Nations’ Millennium Development Goals (MDG) established in 2000 included eliminating sex-based disparities in health care, reducing maternal mortality and combating HIV/AIDS. With a target to reach these goals by 2015, governments, NGOs and philanthropic organizations are in a passionate race. The UNFPA estimates that current global investment in family planning and pregnancy-related care is $11.8 billion and that this figure needs to double in order to significantly reduce maternal mortality, infant deaths and deaths from unsafe abortions. Preventing HIV infection in women and girls through education about safe sex and testing has been a priority for many global health crusaders as women are more susceptible to infection than men. The epidemic has seen impressive decreases in infection rates and increases in the numbers receiving treatment, but it is still one of the world's leading infectious killers. And in sub-Saharan Africa where HIV rates are the highest, the ratio of HIV-positive women to men is 3 to 2.
Cervical cancer, the most common cancer among women in developing countries, strongly illustrates health inequalities between low-resource and wealthy countries. Caused by the human papillomavirus (HPV), cervical cancer is preventable through regular Papanicolaou and HPV testing. While most women in developed nations have access to these tests, poverty and lack of infrastructure leave women in poor countries unable to benefit from these preventative methods. As a result, the WHO estimates that 80% of the half a million new cases each year are in developing nations, and half of these end in death. Alternative, low-technology methods for screening and treating cervical cancer as well as efforts to increase availability of the HPV vaccine in developing countries have shown great promise for addressing the disease, but the disparity remains great.
It is also much more than lack of health care infrastructure that cause these astounding figures. Cultural practices such as child marriage and female genital cutting, still prevalent in many parts of the world, bring health risks and consequences complicating a girl’s path toward a healthy adult life. Recent demographic data shows that in the poorest regions of the world, more than one-third of girls marry before age 18, ranging from 45 percent in South Central Asia, to nearly 40 percent in sub-Saharan Africa, to 25 percent in Latin America and the Caribbean. Teenage girls – these young brides – are twice as likely as women over 20 to die of complications from pregnancy and childbirth. The child bride is also more likely to leave school early and have fewer economic opportunities than her peers, which carries as much of a tool on society as it does on her.
It’s time to deepen our awareness – and financial investment in – the economic and environmental benefits of improving women’s health and education. The World Bank has recognized that there is no investment more effective for achieving development goals than educating girls. Demographers estimate that we will have 9 billion people on earth by 2043, but whether that number is 8 or 11 billion depends on the reproductive choices and conditions of the generation entering their childbearing years. We know an educated population grows slower and healthier. We also know educated, wealthier populations have disproportionately high consumption rates, so somewhere in the middle is a healthy balance we must continue to seek.
Anne Boyd Rabkin is a communications and advocacy consultant, writer, and editor supporting organizations building a healthy and sustainable future.
UN Photo by Martine Perret
This article was originally published in the Diplomatic Courier's March/April issue.