Part of the Global Burden of Disease Study 2013, published in The Lancet this month (7 June), tracked the trends of 301 causes of disease and injury from 188 countries between 1990 and 2013. It found that women in developing countries still face unequal access to healthcare and often receive poor service.
Likewise, an article in the Lancet Commission published on 4 June, Women and health: the key for sustainable development, highlights that maternal health remains a big problem in many countries, despite improvements driven by a focus on women’s health in the Millennium Development Goals (MDGs).
“While, on average, maternal mortality has significantly declined in the last decade, it still is the most unequally distributed health condition,” says Ana Langer, a health researcher at Harvard University in the United States and lead author of the commission’s report. “The highly preventable deaths resulting from complications during pregnancy, delivery and the [post-natal] period are concentrated among the most vulnerable women living in the poorest countries or poorest sectors of the population in wealthier ones.”
“We still need to tackle long-standing health issues like iron-deficiency anaemia and maternal morbidity and mortality, and also important predictors of women’s health such as interpersonal violence.”
Anant Bhan, Yenepoya University in India
The report also points to misconceptions that affect how healthcare for women is delivered. It says that non-communicable diseases (NCDs) — such as heart problems and cancer — are generally thought of as mostly affecting men in wealthy countries. But the probability of death and disability from cancers, cardiovascular disease and respiratory disease is much higher in developing countries and among women, the commission found.
For example, women in Ethiopia are four times more likely to die of an NCD than in Australia, even if taking into account differences in life expectancy, the researchers found.
Respiratory problems caused by pollution from the burning of solid fuels were also found to be a major cause of long-term health problems for women, along with tobacco smoking, diet and physical inactivity.
Anant Bhan, a health researcher at Yenepoya University in India, says health systems around the world need to take more account of NCDs, particularly for women in developing countries.
“We still need to tackle long-standing health issues like iron-deficiency anaemia and maternal morbidity and mortality, and also important predictors of women’s health such as interpersonal violence,” Bhan says. But the Global Burden of Disease Study also revealed some good news about women’s health, says Colin Mathers, the World Health Organization’s coordinator for mortality and burden of disease. Research covered by the study indicates that global female life expectancy increased by six years to 71 between 1990 and 2013, while WHO figures show an overall life expectancy rise from 54 to 64 years for women in low-income countries over this period.
This reflects “substantial declines in infectious disease mortality, child and maternal mortality and also reductions in cardiovascular and other chronic disease risks”, Mathers says.
Two of the proposed Sustainable Development Goals that will replace the MDGs address women’s health: Goal 3 to ensure healthy lives for all and Goal 5 to achieve gender equality.