Introduction to Women’s Reproductive Health

Women’s health issues have received increased international visibility and renewed political commitment in recent decades. However, as targeted policies and programs enable some women to lead healthier lives, significant gender-based health disparities remain in many countries due to limited access to education or employment, high illiteracy rates, and increasing levels of poverty. A woman’s health can have serious and far-reaching consequences for the health of her children, family, and community. Women’s health is a cornerstone of the health of the entire family, and women play a critical role in maintaining the health and well-being of their communities. Women’s reproductive health issues are leading causes of death and disability among women. In 2015, the annual maternal mortality rate due to pregnancy and childbirth was 303,000— down from 532,000 in 1990—with 99 percent of those deaths occurring in developing countries (United Nations Children’s Fund [UNICEF], 2018). Every year, about 10 million women endure life-threatening complications during pregnancy and childbirth, sometimes leading to longterm disability. Globally, women compose half of the adults living with HIV/AIDS; in sub-Saharan Africa, the proportion rises to 61 percent. A woman affected by HIV/AIDS can be plunged into poverty, losing the ability to provide for herself and her children. Early and unwanted childbearing, pregnancy-related illnesses and deaths, and HIV and other sexually transmitted infections account for a significant proportion of the burden of illness experienced by women, especially in lowincome countries. Nearly all maternal deaths are preventable through timely prenatal and postnatal care, skilled birth attendance during delivery, and 

the availability of emergency care to deal with complication

 Family planning services that promote spacing of births and less frequent births provide health benefits for both mothers and children. A common perception is that women’s health is exclusively related to pregnancy and delivery issues. This idea is a misconception. Maternal health is only one aspect of women’s health. Further, it is relevant not only to women in their reproductive or fertile years (between the ages of 15 and 49 years), but also to the next generation’s health and development. Women’s health encompasses the entire life cycle of a woman, from being an infant girl to an elderly woman, and it includes a range of issues related to sexual and reproductive health. Key Health Issues for Women According to the World Health Organization (WHO), the following are currently the most important issues in women’s health (WHO, n.d.). Reproductive Health Sexual and reproductive health problems underlie one third of health issues for women between the ages of 15 and 44 years. Unsafe sex is a major risk factor—particularly among women and girls in developing countries. Getting family planning services to the 222 million women who are currently not getting the services they need is a critical goal. Maternal Health Many women are now benefitting from massive improvements in care during pregnancy and childbirth that have been introduced in the last century. But those benefits do not extend everywhere. In 2015, more than 300,000 women died from complications in pregnancy and childbirth. Most of these deaths could have been prevented if access to family planning and basic health services had been in place. Cancer Two of the most common cancers affecting women are breast and cervical cancer. Early detection for both of these cancers is key to keeping women who have them alive and healthy. The latest global figures show that around half a million women die from cervical cancer and half a million die from breast cancer each year. The vast majority of these deaths occur in low- and middleincome countries where screening, prevention, and treatment are almost nonexistent and where vaccination against human papilloma virus infection needs to take hold. HIV Three decades into the AIDS epidemic, it is young women who bear the largest burden of new HIV infections. Too many women still struggle to protect themselves against sexual transmission of HIV and to get the treatment they require. This also leaves them particularly vulnerable to tuberculosis—one of the leading causes of death in low-income countries of women 20 to 59 years old.

Sexually Transmitted Infections In addition to HIV and human papilloma virus, diseases like gonorrhea, chlamydia, and syphilis require better prevention and treatment. Each year, untreated syphilis causes more than 200,000 stillbirths and early fetal deaths and the deaths of over 90,000 newborns. Violence Against Women Women experience a range of different forms of violence, but physical and sexual violence—by a partner or someone else—is particularly prevalent. Today, one in every three women under age 50 has experienced physical and/or sexual violence by a partner or non-partner. Sexual violence affects women’s physical and mental health in both the short and long term. Health workers must be alert to violence so they can help prevent it and provide support to people who experience it. Mental Health Evidence suggests that women are more prone than men to experience anxiety, depression, and somatic complaints—physical symptoms that cannot be explained medically. Depression is the most common mental health problem for women, and suicide is a leading cause of death for women under 60 in middle- and high-income countries. Helping sensitize women to mental health issues and giving them the confidence to seek assistance is vital. Noncommunicable Diseases In 2012, some 4.7 million women died from noncommunicable diseases before they reached the age of 70—most of them in low- and middle-income countries. They died as a result of road traffic accidents; harmful use of tobacco; abuse of alcohol, drugs, and substances; and obesity. Helping girls and women adopt healthy lifestyles early on is key to a long and healthy life. Age Adolescent girls can face a number of sexual and reproductive health challenges such as sexually transmitted infections (STIs), HIV, and pregnancy. About 13 million adolescent girls (under 20) give birth every year. Pregnancy and childbirth complications are a leading cause of death for these young mothers. Many adolescents also experience adverse consequences of unsafe abortion. Older women, who often did not work outside the home, may have fewer pensions and benefits and less access to health care and social services than their male counterparts. This greater risk of poverty coupled with age-related physical limitations results in a high risk of abuse and generally poor health for older women.s.