Recommendations towards an integrated, life-course approach to women’s health in the post-2015 agenda

Abstract

Noncommunicable diseases (NCDs) -primarily cancer, cardiovascular disease, diabetes and chronic respiratory diseases -represent a major health, social, and economic burden that affects women globally, yet their impact on women in low-and middle-income countries (LMICs) has not been fully recognized.1 NCDs cause premature death and disability among women of all socioeconomic strata worldwide. This burden is expected to increase substantially in the coming decades, especially in LMICs, because of a combination of factors, primarily the "ageing" of the population, improvements in maternal health in LMICs and a projected increase in smoking, obesity and other risk factors for NCDs among women. 2Discussions surrounding the post-2015 development agenda provide an important and timely opportunity to realign policies and resources in trying to meet the complex and shifting health problems faced by women globally. The focus of the realignment should be on ensuring that health systems have the capacity to equitably provide health services to women throughout their lifecourse and on maximizing collective efforts to meet women's health needs in all settings, even the poorest. Achieving this will require strengthening the control of NCDs and integrating it into women's health frameworks and platforms, allocating resources optimally and promoting the development of health systems that serve the needs of women throughout all stages of life.3 NCDs, communicable diseases and maternal conditions are interrelated in complex ways. One can lead to the other. For example, hormonal changes during pregnancy can induce the appearance of diabetes and hypertension. A pregnant woman who has diabetes, hypertension or infection with the human immunodeficiency virus (HIV) as an underlying condition is at greater risk of suffering complications during pregnancy and delivery than a woman who has none of these conditions. 4 Because of these interrelations, the limited availability and accessibility of NCD prevention and control services makes it even harder to make headway in addressing established global health priorities.Opportunities to prevent and treat NCDs and reduce their financial and social burden on women abound, but most of the time they are missed. NCDs develop over years; it takes frequent contact with the health system to detect them at an early stage. In many settings, maternal and reproductive health services are the only potential points of contact for the secondary prevention of NCDs.Health systems are ill-equipped to keep pace with changing patterns of disease and the need for an expanded range of health services for women of all ages. Many women who have some type of NCD also have HIV infection or a pregnancy-related health problem. Integration of NCD prevention and control efforts within existing health services is becoming increasingly necessary to bolster future progress in women's health and socioeconomic well-being and to safeguard the progress made so far in attaining the goals and targets set in the area of women's he...

The gender gap and healthcare: associations between gender roles and factors affecting healthcare access in Central Malawi, June–August 2017

“…Male-dominated healthcare and economic decision-making are widely accepted as indicators of women’s disempowerment that obstruct a woman’s ability to advocate for her own health [ 44 – 46 ]. This was also an observation in our study as respondents who were married were less likely to have a female decision-maker for healthcare payments indicating gender inequity.…”

A framework for healthcare interventions to address maternal morbidity

“…The changing healthcare needs of women have profound implications for health systems, and services will need to be reorganized. Health systems are ill‐equipped to keep pace with the changing patterns of disease and the need for an expanded range of services for women . Integration of services and healthcare platforms across levels of care, medical specialties, and clinical and social care is needed.…”

“…Health systems are ill-equipped to keep pace with the changing patterns of disease and the need for an expanded range of services for women. 29 Integration of services and healthcare platforms across levels of care, 30 Another crucial area in need of training is intimate partner violence and other sensitive topics; interviewers (trained health workers) in the pilot study felt unprepared to engage in these discussions. While the skillset of the existing workforce is being improved, effort will be needed to ensure that the basic skills curricula for these personnel are updated to include new service components and skills.…”

Reaching substantive female representation among decision-makers: A qualitative research study of gender-related experiences from the health sector in Mozambique

“…We used an initial review of the literature [ 14 – 17 ] as a point of departure for identifying themes and adjusted as more and different ones emerged from the data through regular debriefing meetings. Transcripts were uploaded into Dedoose (version 7.6.6) and the study team developed a preliminary codebook by conducting a thematic analysis of the data developed from a priori and emerging themes [ 18 ]using 8 randomly selected transcripts (20% of total transcripts).…”