By Ana Langer and Annie Kearns. Women and Health Initiatve, Harvard T.H Chan School of Public Health
A groundbreaking report, “Women and Health: The key to sustainable development,” was released in June 5, The Lancet’s Commission on Women and Health. The report explores the multifaceted ways in which women and health interact, moving beyond a narrow focus on women’s health to build dialog around the roles of women as both users and providers of health care. The fundamental message is that sustainable development needs women’s social, economic, and environmental contributions. Only when women are healthy, valued, enabled and empowered will they reach their full potential in all aspects of their lives, including in their roles as providers of health care, and sustainable development will be possible. Supporting women will also benefit them in their roles as mothers, since newborns are more likely to survive and thrive if their mothers are healthy, valued, enabled and empowered.
Many of the report’s key recommendations directed towards women also have implications for newborns. The report reinforces the connections between newborn health and women’s status as health care providers and consumers. For example we know that better access to quality health care for women before and during pregnancy, as well as during labor and delivery, will lead to healthier mothers and newborns and reduce the risk of adverse pregnancy outcomes, such as stillbirths, prematurity and low birthweight. Yet the Commission report repeatedly points out that poor women often receive care from the most disenfranchised members of the health system, perpetuating the cycle of inequity and poor health. Health system reforms in Brazil, China, Thailand, and Mexico that moved toward providing universal health care (UHC) are cited for improving access to high-quality care and reducing inequalities, particularly benefitting poor women and their children. While the effects of UHC policies on women’s health are at the forefront of the report, such policies also protect the health and wellbeing of newborns and older children and improve pregnancy outcomes. Integrated UHC policies make health systems more efficient and provide the right platform for health care providers such as midwives, who aim to protect the lives of both the mother and the foetus/newborn during pregnancy and childbirth.
Original research done for the report found that roughly half of women’s contribution to global health care—valued at 2.35 percent of global GDP, or almost $1.5 trillion—is uncompensated. Properly valuing and compensating women’s contributions to the health care sector would raise household income and increase the resources available for health care, education and other investments that are critical for the health and wellbeing of women and children. Further, compensating women for their health-related work benefits society: when women conduct such work to improve the health of their own and others newborns they gain standing.
The report also recommends increasing focus on gathering sex-disaggregated data, particularly pertaining to health. Such data, especially in the neonatal period, could be used to improve identification of trends in the health of female and male newborns and the impact of biomedical, social, and other factors on their chances of surviving and thriving. For example, the Born Too Soon report disaggregated data for preterm birth, showing that it is both more common in boys, with around 55% of all preterm births occurring in males, and is associated with a higher risk of dying when compared to girls born at a similar gestational age. Also the documented evidence of female infanticide in parts of Asia shows us that more needs to be done to eliminate this practice.
Newborn health is inextricably linked to women’s health and to women’s roles as providers of health care. Support for the concepts and recommendations outlined in this report from the Commission on Women and Health could contribute to the improved health and wellbeing of newborns worldwide.
Table 1: Recommendations from the Commission on Women and Health
- Ensure women’s universal access to health care that is responsive to gender and the life course; states should use the maximum available resources to ensure availability, accessibility, and quality of health services to address women’s comprehensive needs
- Recognise women’s paid and unpaid contributions as health-care providers
- Develop, implement, and enforce gender-responsive policies to support women in their diverse roles and enable them to integrate their social, biological, and occupational contributions
- Estimate the value of women’s paid and unpaid contributions to health care and recompense their
- invisible subsidy to health systems and societies
- Ensure that men and women receive equal compensation for equal work in health and other sectors
- Ensure that women are accounted for in quantification of the health workforce
- Guarantee that sex-disaggregated civil, vital, and health statistics and survey data are obtained through national systems
- Mandate that research studies enroll women and publish findings disaggregated by sex
Be accountable to women
- Develop and implement an accountability framework and indicators for women and health
- Establish independent mechanisms at global and country levels to support, catalyse, and ensure
- accountability for global, regional, and national action for women and health