Women Still Face Big Gaps in Access to Health Care

Posted on Mar 8, 2013

Women Still Face Big Gaps in Access to Health Care
February 1, 2013, Neno, Malawi. With the assistance of Nurse Pilirani Eddie Dickson, a young woman delivers her baby at Neno District Hospital. Photo: Rebecca E. Rollins/Partners In Health

March 8 is International Women’s Day, a global day to celebrate the social, economic, and political achievements of women while advocating for women’s rights. Founded in 1910 by German women’s rights leader Clara Zetkin, International Women’s Day is honored across the world and is an official holiday in nearly 30 countries, including Kazakhstan, Nepal, and Russia—three countries with deep ties to Partners In Health. 

Even as we celebrate progress in women’s rights globally—for example, in Rwanda women hold 56 percent of seats in Parliament—women continue to face significant inequities in health care. In the developing world, women without access to modern contraception accounted for an estimated 63.2 million unintended pregnancies in 2012. A recent study in The Lancet estimated that more than 100,000 women could be saved from maternal deaths each year if they simply had access to effective contraceptive methods. And data from the World Health Organization show that 99 percent of the more than half a million maternal deaths each year happen in developing countries.

Women face health inequities because of their specific needs around sexual and reproductive health care, and because they often lack adequate resources to pay for care. All the factors of gender inequity—including limited access to education, legal systems that fail to protect women, and gender-based violence—are exacerbated by poverty. For these reasons, HIV disproportionately affects women and girls: More than 50 percent of people now living with HIV/AIDS globally are women.

So how does Partners In Health address the particular challenges poor women face? First, by taking a rights-based approach to health. We believe health is a human right for all people—women and men—and that our work must be done in a human rights framework that values participation, empowerment, and equality. This is most evident in our community health worker programs, largely staffed by women, who are tasked with the critical role of educating and accompanying community members. By paying community health workers, PIH engenders economic opportunity and independence that allows women to help feed their families and keep their children in school.

Second, PIH develops programs and health services that address the unique health care needs of women. These include prioritizing broad access to modern family planning methods that meet the specific health and cultural requirements of the population, as well as actively reaching out to women for care before, during, and after pregnancy.

For example, PIH/Lesotho has made tangible progress toward Millennium Development Goal 5, which aims to reduce maternal mortality around the world. Through its Maternal Mortality Reduction Program, PIH employs community health workers specially trained in accompanying women through pregnancy and birth, thus ensuring that pregnant women have access to skilled care at a health clinic in the remote, mountainous terrain of Lesotho. This effort has paid off already: In a country where one in 32 women will die of pregnancy- and childbirth-related conditions, there have been few maternal deaths reported at the government clinics supported by PIH/Lesotho.

Third, by targeting poverty as the root cause of disease, PIH seeks to change systems that perpetuate inequality. Removing financial barriers to health care, whether by eliminating user fees or providing transport stipends, makes it easier and safer for women to get care. By working with governments and the public sector to build health systems that meet the needs of their citizens, we’re disrupting the cycle of poverty and disease.

As PIH celebrates the achievements of women, we remember there is still much to do. Preventing the “stupid deaths” of women—whether due to maternal causes, HIV, or gender-based violence—requires that we all commit to realizing the political, economic, and social rights of women in every country.

Thank you for standing shoulder-to-shoulder with our patients, community health workers, and staff around the world as we break down the barriers that drive inequality.

Erin George is a nurse-midwife and a 2012-2013 Yale Law School Gruber Fellow in Global Justice and Women's Rights. Through this fellowship, she is serving as the nursing and midwifery advocacy coordinator for PIH in Boston and Haiti. Jennie Riley is the project coordinator for PIH/Lesotho, providing programmatic management and support for all aspects of PIH’s work in Lesotho. Together they lead the PIH Women's Health Working Group.

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