HEALTH MATTERS: Women’s Health – Vulnerabilities, Disparities and Gaps

healthDespite several measures taken by the government under the National health mission, to improve healthcare for women and reduce maternal mortality, several gaps remain, especially in rural areas and urban settings as well. According to health mission survey, every year, 2500 young women die due to unmet needs. Besides, a majority of women suffer from multiple ailments like Malaria, Hepatitis and Diarrhea. The commonest causes of death in women were found to be heart attacks, stroke, chronic respiratory diseases and diabetes.

But the biggest killer that has emerged is non-communicable disease (NCD), which is responsible for about 60% of all deaths among women according to date from George Institute of Global health and Oxford Martin School, UK. Other independent studies done in different parts of India found that NCDs, like heart disease, back and neck pain, depressive disorders and respiratory diseases cause major disability amongst women in India.

Dr. R C Sharma, from ICMR, says there are many elements which play a major role in the health status of women. Apart from infectious diseases, social and cultural roles such as gender inequality have a significant impact on women’s health.

At least 50 to 90 percent of pregnant women are anaemic because of poor food intake and non-availability or poor uptake of iron tablets. As a result, about 20% of maternal deaths are due to anaemia because when they go into labor, severe hemorrhage leads to death.

However, none of these issues have been addressed to prevent maternal deaths or morbidity. In many regions,
access to health care facilities in rural areas continues to remain poor, therefore many deliveries are still done at home which makes women vulnerable. Any complications during childbirth not only put the mother but also the child at risk.

Endometriosis – An emerging health challenge for Women

The other unaddressed women’s health issue has been found to be Endometriosis, which is a complex disease, which affects thousands of women but remains neglected.

Currently, the relationship between endometriosis and other reproductive infections is not clear. There is limited information about the causality. Endometriosis causes chronic inflammatory infections which leads of incredible pelvic pain but since it is undiagnosed, the linkage is not established. Those affected are unable to sleep due to chronic pain. A researcher from Australia says that in India, endometriosis is seen as a mystery disease. However, it does have a significant impact on reproductive organs, especially ovarian tissue and oocytes which causes infertility since the condition puts pressure on the reproductive tissues, especially outside the uterus and the uterine cavity causing ectopic lesions.

The factors responsible for the pain

To understand the extent of endometriosis in India, it is imperative to know the burden of cases. However, since no studies have been done, there is an urgent need to identify the causality of this condition, both in rural and urban settings to understand what causes endometriosis and why do women get affected by it so that early diagnosis can be done and appropriate treatment can be provided.

At the district level, in states like Jharkhand, many women were found to have similar symptoms but the health provider was unable to diagnose the condition since the process of identifying endometriosis is done through biopsy, using a microscope which is not available in these health facilities. Other infections like coronary artery disease, polycystic ovarian syndrome or genital cancer is also not addressed.

Way Forward

Clearly, the immediate need is for the governments, both at the Centre and State level, to broaden their focus on health issues, especially the quality of health care services being provided to people, its implementation and regulation at all levels.

These multiple risk factors that women face related to reproductive health along with respiratory and lung diseases need to be addressed by the health departments. Apart from creating social awareness among people through interactions at the community, district level and urban centres as well to make the public aware about the disease burden and the methods to prevent and ensure early treatments, the government also needs to provide adequate support in terms of funding research, to identify undetected disease burden and the existing gaps, as well as to ensure provision of proper staff, equipment and overall medical needs at the hospitals, Primary Health Centres, Sub Centres and health workers at the community level. Special focus should also be on the disadvantaged and almost invisible communities so that they are able to access health care treatment on time and get quality care.

Only then will health care improve for the communities, primarily for women across all states, especially in low performing ones, and it will also help reduce the ongoing disparities that women and others face and will prevent high mortality and morbidity in these groups.