By RICHARD SKOLNIK
The good news is that the health of girls and women has improved in the last two decades. Young girls die at lower rates than earlier. They also die less often of pneumonia, diarrhea, measles and malaria. Women die less of pregnancy-related causes and malaria, among other things, and, until COVID, were living longer than ever before.
Yet, there remains a large unfinished agenda of needed improvements in the health of girls and women globally. Around 2.5 million under five girls still die every year, overwhelmingly of preventable causes, such as birth asphyxia, pneumonia, diarrhea, malaria, and whooping cough. Protein-energy malnutrition also remains one of the leading causes of under-five death for girls.
For 15- to 49-year-old women, the 10 leading causes of death not only include heart disease, stroke, breast cancer and road injuries, as we might expect, but also HIV/AIDS, maternal causes, self-harm, and TB. Women globally in this age group also bear important burdens of disability related to mental health disorders. Moreover, although rates are declining, female genital mutilation (FGM) is still common in some settings. Interpersonal violence against females is also pervasive in many places. Despite the fact that pregnancy can be a death sentence where maternal mortality ratios are high, many women still lack access to modern contraceptives.
Many societies also continue to severely constrain the opportunities for girls and women to “be all that they can be”. In such places, we find constraints on their independent movement, lower rates of schooling for girls, and reduced opportunities for women to engage in employment outside the home. In such places, women will rarely hold positions of social and political power, locally or nationally.
The evidence accumulated over considerable time suggests a number of measures that need to be taken as priorities if the health of girls and women is to be improved. Some of these include: ensure that all girls go to school, preferably until at least the end of secondary school; create an economy, that enables female participation; encourage the involvement of women in leadership at every level of society; implement the well-known packages for reducing young child death; and promote family planning.
In addition, we need to address the health of women holistically and need to go substantially beyond reproductive health in doing so. This will require attention to implementing well-known measures against the unfinished agenda of nutrition, maternal causes, TB, malaria, and HIV/AIDS. However, we also need to address the growing burden of noncommunicable diseases among women, by reducing overweight and obesity; promoting physical activity and healthy eating; and reducing consumption of alcohol and tobacco. Reducing environmental pollution would also lead to important gains in the health of females. Changing customs that are harmful to the health of girls and women, such as FGM and interpersonal violence, will not be easy. There is evidence, however, that community-led change efforts can make a difference, and sometimes even relatively quickly.
COVID has taxed many countries and their health systems. However, COVID has also provided opportunities for countries to “rebuild” in ways that are more fair, more efficient, and more effective. One way to do this would be to place an explicit emphasis on reducing gender inequality and trying to maximize opportunities for females to live long, healthy, and productive lives.
Editor’s note: This article is based, with the permission of Jones and Bartlett Learning, on Enhancing the Health of Girls and Women Globally, available at: https://blogs.jblearning.com/enhancing-the-health-of-girls-and-women-globally.