Despite considerable progress in the past decades, societies continue to fail to meet the health care needs of women at key moments of their lives, particularly in their adolescent years and in older age. These are the key findings of this report. The World Health Organization (WHO) calls for urgent action both within the health sector and beyond to improve the health and lives of girls and women around the world, from birth to older age. The report provides the latest and most comprehensive evidence available to date on women's specific needs and health challenges over their entire life-course. It includes the latest global and regional figures on the health and leading causes of death in women from birth, through childhood, adolescence and adulthood, to older age.
Equity in Health
This report focuses on two key aspects of disaster risk reduction: early warning and early action. Advances in science and technology, in forecasting techniques and the dissemination of information are major contributors to reducing mortality. However, the development of a more people-centred approach is also essential. The report gives a more comprehensive explanation about the different interventions in disaster management and risk reduction such as: an introduction to early warning systems for different hazards and early action; emphasising the link between early warnings and early actions; taking a people-centred approach by finding out how individuals and communities can understand the threats to their own survival and well-being, share that awareness with others and take actions to avoid or reduce disaster; and, in terms of food insecurity, knowing what actions should follow the early warning. A system of data collection to monitor peoples' access to food, in order to provide timely notice when a food crisis threatens and thus to elicit an appropriate response should be developed in order to mitigate the occurrence of the disaster.
Africa will fail to achieve most UN Millennium Development Goals unless countries adopt effective family planning programmes and control rapid population growth, said Khama Rogo, World Bank senior adviser, speaking at a three-day international conference on family planning, organised by the Gates Foundation and Johns Hopkins and Makerere universities and held (from 16–18 November) in the Ugandan capital, Kampala. More than 1,000 policy-makers, researchers, academics and health professionals from 59 countries attended the event. Various speakers warned that the rate of Africa's population increase was too rapid, with women in some countries having on average seven children each. ‘Family planning improves maternal health, thereby increasing women's productivity and reducing dependency at both family and national levels,’ said Chisale Mhango, director of reproductive health at Malawi's Health Ministry. ‘Fewer children means manageable education targets; more children means that parents will mainly educate sons, which promotes gender inequality,’ he added. ‘The fewer the children the better the care, the more the food, the lower the child mortality and there will be savings for health provision.’
Concepts of fair distribution of health, such as equity of access to medical care, may not be sufficient to equalise health outcomes but, nevertheless, they may be more practical and effective in advancing health equity in developing countries. This study used a framework for relating health equity goals to development strategies allowing progressive redistribution of primary health care resources towards the more deprived communities is formulated. The framework is applied to the development of primary health care in post-independence Namibia. In Namibia health equity has been advanced through the progressive application of health equity goals of equal distribution of primary care resources per head, equality of access for equal met need and equality of utilisation for equal need. For practical and efficiency reasons it is unlikely that health equity would have been advanced further or more effectively by attempting to implement the goal of equality of health status. The goal of equality of health status may not be appropriate in many developing country situations; instead, a stepwise approach based on progressive redistribution of medical services and resources may be better.
This report presents a picture that is slightly at variance with many other reports on Africa’s progress towards the targets of the Millennium Development Goals (MDGs). It shows that progress is being made in a number of areas such as primary enrolment, gender parity in primary education, malaria deaths and representation of women in parliaments. There has also been a reinforcement of state capacity to deliver growth in many countries. If this rate of progress continues, the continent will be on course to meet a significant number of the MDGs by the target date (2015), but not all. A critical area for progress is the health-related MDGs, where progress is slowest. Interventions to accelerate progress on the health MDGs will yield significant dividend. In sum, the preconditions for accelerating progress to meet the targets of the MDGs are now largely in place, albeit constrained by inadequate resource flows and capacity in some critical areas like health capacity.
Entrenched poor health and health inequity are important public health problems. Conventionally, solutions to such problems originate from the health care sector, a conception reinforced by the dominant biomedical imagination of health. By contrast, attention to the social determinants of health has recently been given new force in the fight against health inequity. The health care sector is a vital determinant of health in itself and a key resource in improving health in an equitable manner. Actors in the health care sector must recognise and reverse the sector's propensity to generate health inequity. The sector must also strengthen its role in working with other sectors of government to act collectively on the deep-rooted causes of poor and inequitable health.
At least 100 people have died of cholera in parts of eastern Democratic Republic of Congo (DRC) since January. South Kivu Province is the worst affected, with at least 75 people dead and 6,392 infected. The South Kivu governor, Louis Leonce Muderwa, said the 10 worst-affected health zones in the province included Fizi in the region of Baraka, Nundu, Uvira, Kadutu, Ibanda, Bunyakiri, Katana, Minova, Nyantende and Kabare zones. Two deaths have been reported in Kadutu and one each in Ibanda and Katana. Muderwa declared a cholera epidemic there on 14 September. In neighbouring North Kivu Province, 48 deaths had been recorded and 4,609 people infected by 13 September. Other eastern regions have also recorded cases, with Katanga listing 199 new cases and two deaths. The North Kivu provincial medical inspector, Dominique Bahago, blamed the cholera outbreaks on poor hygiene. ‘The majority of the population's supply of cooking and drinking water is from Lake Kivu where all kinds of waste is dumped; cholera is endemic in that zone,’ said Bahago.
This study investigated the association between precipitation patterns and cholera outbreaks and the preventative roles of drainage networks against outbreaks in Lusaka, Zambia. Data was collected on 6,542 registered cholera patients in the 2003–2004 outbreak season and on 6,045 cholera patients in the 2005–2006 season. Correlations between monthly cholera incidences and amount of precipitation were examined. The distribution pattern of the disease was analysed by a kriging spatial analysis method. The association between drainage networks and cholera cases was analyzed with regression analysis. The study found that increased precipitation was associated with the occurrence of cholera outbreaks, and insufficient drainage networks were statistically associated with cholera incidences. Insufficient coverage of drainage networks elevated the risk of cholera outbreaks. Integrated development is required to upgrade high-risk areas with sufficient infrastructure for a long-term cholera prevention strategy.
Increasingly it is evident that women are affected by blindness and visual impairment to a much greater degree than men. In 1980 a systematic review of global population-based blindness surveys carried out showed that blindness is about 40% more common in women compared to men. This short article explores the gender dimensions of vision loss. The document considers the different risk factors faced by men and women including social and cultural differences and biological. Issues concerning the limited access women have to services are examined and the implications of women usually having a longer life expectancy. Cataract and trachoma are considered in addition to childhood blindness and briefly glaucoma and diabetic retinopathy. The authors emphasis the importance of understanding these problems at community, country, and global level. Reports should be provided which are disaggregated by sex.
This report gives an overview and analysis of the prevalence and impact of Alzheimer's disease, based on a systematic review identifying studies in 21 global burden of disease (GBD) world regions. The authors estimate 35.6 million people with dementia in 2010, with the numbers nearly doubling every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. In low- and middle-income countries, especially, there is a general lack of awareness of Alzheimer’s and other dementias as medical conditions. They are perceived as a normal part of ageing. This general lack of awareness has important consequences, such as a lack of training on dementia recognition and management at any level of the health service. The authors recommend that the World Health Organization (WHO) should declare dementia a world health priority. Low- and medium-income countries should create dementia strategies based first on enhancing primary healthcare and other community services. Collaborations should be created between governments, people with dementia, their carers and their Alzheimer associations, and other relevant non-governmental organisations and professional healthcare bodies.