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Published in final edited form as: Health Care Women Int. 2011 Oct;32(10):870–886. doi: 10.1080/07399332.2011.603872

The Health of Women and Girls Determines the Health and Well-Being of Our Modern World: A White Paper From the International Council on Women’s Health Issues

PATRICIA M DAVIDSON 1, SARAH J McGRATH 2, AFAF I MELEIS 3, PHYLLIS STERN 4, MICHELLE DiGIACOMO 5, TESSA DHARMENDRA 6, ROSALY CORREA-de-ARAUJO 7, JACQUELYN C CAMPBELL 8, MARGARETHE HOCHLEITNER 9, DeANNE K H MESSIAS 10, HAZEL BROWN 11, ANNE TEITELMAN 12, SIRIORN SINDHU 13, KAREN REESMAN 14, SOLINA RICHTER 15, MARILYN S SOMMERS 16, DORIS SCHAEFFER 17, MARILYN STRINGER 18, CAROLYN SAMPSELLE 19, DEBRA ANDERSON 20, JOSEFINA A TUAZON 21, YINGJUAN CAO 22, ELEANOR KRASSEN COVAN 23
PMCID: PMC3703826  NIHMSID: NIHMS485397  PMID: 21919625

Abstract

The International Council on Women’s Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women’s health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl’s health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally.

In 2011, women and girls remain victims of gender inequality (Read & Gorman, 2010). Despite progress in eliminating the social and health disparity between men and women during the last century, gender equality remains an elusive goal, particularly in the developing world. Although women work two-thirds of the world’s working hours, they earn only 10% of the world’s income. This represents less than 1% of the world’s property and illustrates the inequity experienced by women. In many countries, women and girls have less access to education, an important predictor of well-being (Bobbitt-Zeher, 2007). Impoverishment equates not only to hunger and sickness, but also to disempowerment and marginalization. As a result, many women and girls are subject to violence and other human rights abuses. When addressing women’s lives, it is crucial to examine the underlying social, cultural, environmental, epidemiological, and economic determinants of health (Marmot, Friel, Bell, Houweling, & Taylor, 2008).

Women and girls have specific health needs, and health systems around the world are failing them (World Health Organization [WHO], 2009). The WHO states that today women’s health has become an urgent priority, yet the data surrounding this issue are limited and often unreliable (WHO, 2009). It is ICOWHI’s aim to improve the health, health, care and well-being of women worldwide. The vision, mission, and strategic goals of ICOWHI are aligned with the WHO’s Millennium Development Goals (MDG; see Table 1). We believe it is important that these goals are not dealt with independently; many of them are closely interrelated, as development in one area will promote improvement in another. Depending on the global region and social, political, and economic climate, a range of activities and strategies are required to achieve optimal health outcomes. In all instances, strategic initiatives need to be undertaken within a framework of cultural competence and consideration of the health and well-being of women and girls across the life span.

TABLE 1.

Vision and Mission of the International Council on Women’s Health Issues

Vision
Through its commitment to improving the health and well-being of women worldwide,
ICOWHI is dedicated to:

  • Exploring the biological, socio-economic, cultural, political, and spiritual factors affecting the health and development of women and girls;

  • Promoting the education and empowerment of women and girls globally;

  • Examining the relationships between and among socio-cultural structures that influence the health and well-being of women and girls;

  • Identifying areas of need and facilitating, implementing, and evaluating solutions to potential and actual health problems of women and girls of all ages;

  • Encouraging a multi-disciplinary and multi-sector approach to promoting women and girl’s health and well-being;

  • Promoting and supporting women’s health research; and

  • Influencing policy related to women and girls health worldwide.

Mission
Improving the health, health care and well-being of women worldwide
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We are excited to support the United Nation’s (UN’s) women’s initiative launched on January 1, 2011. UN Women emerged from agreement by UN Member States, with strong support of women’s organizations that more needs to be done so that women can claim equal rights and opportunities (United Nations [UN] Entity for Gender Equality and the Empowerment of Women, 2011).

THE RIGHTS OF WOMEN AND GIRLS AS HUMAN RIGHTS

In most societies, women have lower social status than men, producing unequal power relations. For this reason, women and girls can be particularly vulnerable to human rights abuses and suffer poor health outcomes as a result. Arguably, women need special attention when framing an agenda for global health due to the fact that women are biologically different from men and therefore have different needs throughout their lifespan (Sankaran, 2010).

The Convention on the Elimination of all Forms of Discrimination against Women (CEDAW) is the principal international human rights treaty addressing the rights of women. In 1997 the United Nations Economic and Social Council (ECOSOC) adopted a resolution calling on all specialized agencies of the UN to mainstream a gender perspective into all their policies and programes. Numerous other conferences and declarations have resulted in the reaffirmation of women’s rights and needs in the health sector (Sankaran, 2010).

A gender-based approach is established on the recognition of the differences between men and women. Policies that support women’s empowerment serve to alleviate inequitable gender roles (Rosenfield, Min, & Bardfield, 2010). Despite much effort toward creating gender equality, women remain vulnerable, with many women still not able to experience enjoyment of their fundamental human rights. Recognition of the importance of women’s rights is central to any discussion of the MDGs, as innumerable studies have demonstrated that gender equality is a precondition for sustainable growth and poverty reduction.

MILLENNIUM DEVELOPMENT GOALS

For the MDGs to effectively redress the inequalities experienced by women and ensure a healthier future, a gender-based approach must be considered for each of these goals. A gendered approach means not only examining biological differences but also the socially constructed expectations that differentiate the roles and attributes of men and women (Correa-de-Araujo, 2006; Pinn, 2003). Increasingly, policymakers and nongovernment organizations have determined that the health and well-being of communities and societies is dependent on the welfare, education, and empowerment of women.

Goal 1: Eradicate Extreme Poverty and Hunger

In some regions, such as Asia and Oceania, the percentage of impoverished people in the region has more than halved since 1990, surpassing the WHO target for 2015 (UN, 2006). Unfortunately, those who still live in disadvantaged areas are more likely to report fair or poor health as compared with those from more affluent areas (Patel & Burke, 2009).

Across all ages of women, the highest mortality and disability rates are found in Africa (WHO, 2009). The improvement of women’s health and well-being hinges on a detailed understanding of the social determinants of health and their interaction. While socioeconomic status plays a large role in health and well-being, social networks and individual factors are also important.

It is ICOWHI’s aim to lobby for funding to strategically address poverty and hunger through supporting sustainable and culturally appropriate strategies, and to reduce the disparities between developed and developing countries. Applying a structured framework to define, address, and improve women’s health outcomes ensures implemented strategies remain both effectual and sustainable. In addition, increasing the profile of women’s health issues in public debate and discourse is critical to affect change and enable health policy that recognizes the discrete needs of women and children.

In order to address social determinants of health and achieve gender equality, the following factors need to be considered (Marmot, 2005):

  • Preventing people from falling into long-term disadvantage

  • Addressing the social and psychological environmental effects of health

  • Ensuring a good environment in early childhood

  • Addressing the impact of paid and unpaid work on health and well-being

  • Addressing the problems of unemployment and job insecurity

  • Promoting friendship, social relations, strong supportive networks, and social cohesion

  • Addressing the dangers of social exclusion

  • Addressing the effects of alcohol and other drugs

  • Ensuring access to supplies of healthy food

  • Ensuring access to healthier transport systems.

Goal 2: Achieve Universal Primary Education

Globally, despite a net increase in enrollments, a gender gap persists in education attainment. In many countries, educating girls is widely perceived as being of less value than educating boys (UN, 2010). It is estimated that one in every five primary school age girls are unenrolled, compared with one in every six boys (Lavin, 1992). Education directly benefits women and their children, and it is strongly associated with good health and is an important predictor of well-being (Grown, Gupta, & Pande, 2005; Lavin, 1992). In all countries with reliable data, child mortality rates are highest in households where the education of the mother is lowest (WHO, 2009). In addition, literacy plays a distinct role in determining a population’s level of disease and mortality by affecting accessibility to health-related literature and information (Wilson, 1992). In 1996 there were approximately 597 million illiterate women in the world, as compared with 352 million men.

The ICOWHI seeks to promote education initiatives because of the positive correlation between education and health outcomes. Education not only needs to be addressed at the primary level, but at secondary and tertiary levels as well. Raising education rates at a primary and secondary level will have positive flow on effects for women in terms of employment, health, and minimizing social disadvantage. Secondary education is associated with a higher age of marriage, low fertility and mortality, enhanced maternal care, and reduced risk of contracting HIV/AIDS (Grown et al., 2005). In addition, each additional year of secondary school education reduces the probability of public welfare dependency in adulthood by 35% (Lavin, 1992), exemplifying the correlation among education, social disadvantage, and health outcomes. The ICOWHI plans to support women in educational endeavors to promote empowerment and positively affect gender inequality in the educational sphere. We need to advocate for doctorally prepared graduates who can provide leadership and direction for research.

Strategies to ensure that these goals are met include the following; reducing the costs of education, providing scholarships, ensuring schools are girl friendly, educating men on the benefits of educated women, and reducing the physical barriers in accessing education such as issues surrounding transportation (Grown et al., 2005). Not only does accessibility need to be improved, but content and structure also need to be addressed. This can occur via teacher training and curriculum reform and by addressing institutionalized gender bias that exist within schools (Grown et al., 2005).

Through supporting higher-degree education and research in developing countries, ICOWHI is well placed to support initiatives to promote women’s health issues.

Goal 3: Promote Gender Equality and Empower Women

Gender inequality also pervades labor markets and the political landscape. It is deeply rooted in entrenched attitudes, societal institutions, market forces, political values, and ideas (Kettel, 1996). Since 1990, there has been a steady global increase of women in nonagricultural wage employment. The WHO estimates that women remain at a disadvantage in securing paid jobs, however, due to pervading sociocultural attitudes, minimal options for balancing work and family responsibilities, and challenges in birth control (UN, 2006).

In the health profession, women make up the majority of health workers in most settings but are often excluded from positions of responsibility and authority. The WHO describes the current situation as a paradox, as women are the backbone of formal and informal health care: however, they are often excluded from these services or have limited access (WHO, 2009). Similarly, these factors contribute to the underrepresentation of women in politics and business (Terjesen, Sealy, & Singh, 2009). While the percentage of parliamentary seats held by women has increased from 12% to 19% since 1990, progress is slow and there is still much advancement to be made (UN, 2010). Some countries have implemented mandatory or voluntary measures to increase the number of women in politics, which partially may account for such increases.

It is the ICOWHI’s aim to support such legal, political, and business changes, which positively assert gender equality and promote fair and equitable workplace policies. The ICOWHI intends to facilitate increased female participation in decision-making positions not only in the governance of health but other policy area as well.

Goal 4: Reduce Child Mortality

Mortality rates for children under the age of 5 have decreased globally, with the rate dropping 28% (UN, 2010). Unfortunately, the number of children who die every year from preventable disease significantly exceeds the goal set for 2015 and remains at 87 deaths per 1,000 live births. Pneumonia, diarrhea, malaria, and AIDS account for 43% of all deaths in children under 5 worldwide in 2008 (UN, 2010). The leading risk factors for child mortality include malnutrition (under nutrition), unsafe water, poor sanitation and hygiene, suboptimal breastfeeding, and indoor smoke from solid fuels (WHO, 2009). The under-5 mortality rate is highest in developing areas with low household wealth and poor maternal education rates. Similarly, a link between maternal education level and child vaccination has been identified. This further exemplifies the critical link between poor levels of education, social disadvantage, and adverse health outcomes.

Every year around nine million children under 5 years, including 4.3 million girls, die from conditions that largely are preventable and treatable (WHO, 2009). It is therefore crucial to promote the provision of early childhood education to all mothers, including programs regarding breastfeeding, nutrition, and child vaccination and targeting women in low socioeconomic and impoverished areas. As a result of the positive correlation between education and health outcomes, it is ICOWHI’s goal to target women for education initiatives. Improved and wider access to education paired with the provision of basic health services and vaccination will likely have a cost-effective and dramatic effect in reducing child mortality.

Improving child mortality is closely linked to advancing maternal health, as it will reduce those who die at birth and ensure health development in the early stages of the child’s life (Shaw, 2006). It is therefore vital that these goals are addressed codependently, rather than separately.

Goal 5: Improve Maternal Health

When a mother dies, it impacts negatively on the health, education, nutrition, and economic status of her orphaned children and the community, and it also leads to a welfare loss that may take generations to overcome (Alban & Andersen, 2007). More than half a million women continue to die every year in pregnancy and childbirth due to entirely preventable reasons, 99% of whom live in the developing world (Grown et al., 2005). In developed countries, there are, on average, nine maternal deaths per 100,000 live births; however, for disadvantaged developing countries this figure is 1,000 or more per 100,000 live births (WHO, 2009). Maternal mortality remains highest in sub-Saharan Africa and Southern Asia. Despite a global increase in the number of births attended by skilled health care personnel, ratios of maternal mortality in these areas have changed very little since 1990. Significantly, wealthy and urban mothers are three to six times more likely than rural and poor mothers to deliver with health personnel present. In sub-Saharan Africa, where approximately half of the world’s maternal death occurs, only 46% of births occur with the assistance of a skilled health professional, an increase of merely 4% since 1990 (UN, 2006).

Regular use of antenatal services prior to delivery also has been shown to improve maternal and neonatal health outcomes. Lack of access to antenatal and postnatal care services is commonly associated with social isolation, a lack of recognition of the importance of gestational care, or lack of resources such as transport (Womens Health Outcomes Framework, 2002). Given that the two main causes of maternal mortality in developing regions are hemorrhage and hypertension (UN, 2010), providing skilled health care prior to and at delivery is pivotal to minimizing maternal mortality. In some areas of Asia and Africa, less than half the women giving birth are attended to by skilled health personnel (UN, 2010). The ICOWHI seeks to support universal education and health strategies that aim to increase the proportion of births attended by skilled health personnel, particularly for women in remote and rural areas. In addition to providing care at delivery, it is important to make available adequate reproductive health services, postpartum care, and family planning. While no single answer can address the multiple causes of maternal deaths, the ICOWHI intends to lobby for increased funding for health care interventions that reduce maternal death rates. The ICOWHI also intends to make these interventions more widely available, particularly in rural and impoverished areas.

Goal 6: Combat HIV/AIDS, Malaria and Other Diseases

Women are exposed to diseases such as HIV/AIDS and malaria through a number of gender-specific ways, particularly sexual intercourse, rape, and working patterns (Jewkes, Dunkle, Nduna, & Shai, 2010). For this reason it is important to examine women’s exposure to and the prevalence of HIV/AIDS by looking at their occupational risks, sociocultural behaviors, and gender-specific roles and practices. An example of women’s specific vulnerability to HIV/AIDS is the increased exposure to domestic violence and employment in sex-based work.

The ICOWHI will support the development of education programs that promote and facilitate the HIV prevention strategies, targeting women in high-risk groups and areas. While HIV prevalence has leveled off in the developing world, deaths from AIDS continue to rise in sub-Saharan Africa and South east and Central Asia. Further, in many areas more than half of those living with HIV are women. Young women currently make up more than 60% of all 15- to 24-year-olds living with HIV/AIDS. Seventy-seven percent of all HIV-positive women live in sub-Saharan Africa. Specific to this region, young women living with HIV outnumber HIV-positive young men 3.6 to 1 (United Nations [UN] Population Fund, 2005). In other regions, epidemics are spreading from particular population groups—such as sex workers or injecting drug users—into the general population, with women and girls increasingly affected. As a result, in many poor countries, the birth of an HIV-infected child is not uncommon (Paintsil & Andiman, 2009). Although access to AIDS treatment has expanded, the need continues to grow. Prevention is the best solution to the rapid spread of AIDS, yet such measures are failing to keep pace with the spread of HIV. The ICOWHI intends to support preventative strategies such as education, and to reduce the prevalence of mother-to-child transmissions.

The ICOWHI will lobby for increased accessibility to antiretroviral therapy for women and children to ensure management and further preventions. The goal of ICOWHI is to ensure that testing and counseling becomes more widely available, particularly in high-risk areas and for high-risk women. Furthermore, the ICOWHI hopes to facilitate the development of a functioning health care infrastructure in those high-risk areas. This includes ensuring that these areas have enough health workers to meet the demands of the community. Importantly, the ICOWHI also will work to remove the discrimination and stigma associated with those infected and will educate those who are infected to effectively manage the disease and remove possibilities of further transmission.

HIV is an immunosuppressive illness, and the spread of HIV can significantly increase one’s vulnerability to other infectious diseases, in particular, malaria and tuberculosis (Alban & Andersen, 2007; Chaisson & Martinson, 2008). Malaria-control efforts are paying off; however, additional effort is needed as 150 to 300 children die each hour from malaria, amounting for 1 to 2 million deaths yearly (Breman, 2009). In total, malaria kills up to three million people per year worldwide, and, like many other diseases, most of the victims are from sub-Saharan Africa (Sachs, 2005). The prevalence and mortality rates surrounding malaria are astonishing considering that the disease is treatable and highly preventable. The ICOWHI intends to advocate for the sustainability of malaria reduction programs and maximize capacity building by targeted investments, such as the distribution of insecticide-treated bed nets and effective medicines to impoverished rural areas of Africa.

The incidence of tuberculosis is leveling off globally, but the number of new cases is still rising. Reaching global targets for tuberculosis control will require accelerated progress, especially in sub-Saharan Africa and the Commonwealth of Independent States. Whilst Africa is home to only 11% of the world’s population, it carries 29% of the global burden of tuberculosis cases and 34% of tuberculosis-related deaths (Chaisson & Martinson, 2008). The ability of African health care systems to respond to and manage the incidence of tuberculosis is constrained by limitations of funding, facilities, personnel, drug supplies, and laboratory capacity (Chaisson & Martinson, 2008). It is ICOWHI’s goal to reduce the prevalence of tuberculosis by pushing for improvements in domestic health facilities and laboratories, reduce the conditions that facilitate the transmission of infection, and educate health workers to promote early detection.

Other strategies need to be implemented to ensure that women are not falling victim to treatable and preventable diseases and viruses. The human papilloma virus (HPV) is the primary cause of death from cancer in the developing world (Shaw, 2006), and globally almost all cases of cervical cancer are linked to genital infection with HPV (WHO, 2009). Prevalence of HPV is the highest in Africa, where one in five women are infected (WHO, 2009). The highly effective HPV vaccine is neither accessible nor utilized in developing countries due to cost; however, this vaccine is easily accessed within developed countries. Many preventative strategies are not implemented in developing countries, despite the fact that regular screening has positive links to reducing the prevalence of cervical cancer. The ICOWHI will encourage the increased accessibility and availability of the HPV vaccine and will lobby for domestic infrastructure to be implemented to ensure that more women are being screened for potentially preventable diseases.

Goal 7: Encourage Sustainable Development

Billions of people suffer ill health as a direct consequence of environmental factors. Environmental diseases such as diarrhea, dysentery, hepatitis, and typhoid are major preventable causes of death in developing countries (Chenoweth, Estes, & Lee, 2009). Fifty percent of people lack basic sanitation, and 20% live without clean drinking water. There also has been a global increase in slum populations as more than 50% of people now live in urban areas. In addition, overpopulation and inadequate infrastructure in both urban and slum areas create unsafe public spaces, high levels of pollution, and increased crime. Also, deforestation rates remain high despite improvements in some regions (Laurance, 2010).

Women, more so than men, suffer from poor health, diminished productivity, and missed opportunities for education due to poor urban environments (Kettel, 1996). In addition, women commonly experience a higher burden of urban environmental difficulties as a result of their common gender-based roles as household providers and maintainers. This places them at increased risk of experiencing inadequate space and housing whilst caring for children and reduced public transport facilities. These environmental hazards severely impact women’s quality of life.

Women’s vulnerability and poor health is closely linked to availability of basic infrastructure such as transportation and sanitation services (Grown et al., 2005). Access to such facilities will not only improve women’s health and safety, but also enhance economic independence and personal empowerment. The type of development, however must be closely considered. An example can be seen in the investment in major road projects in developing countries, where often this type of development will not meet the transport needs of many poor people, particularly women whose trips are primarily local and off road (Woodcock et al., 2007). Increasing transport access and use through sustainable development is encouraged and should be developed by improving walking and cycling infrastructures, increasing access to cycles, and investment in transport services for essential needs (Woodcock et al., 2007).

In order to minimize environmental illness, the ICOWHI wishes to support gender sensitive environmental health policy to protect and maintain healthy life spaces for women. This must include increasing the worldwide provision of basic sanitation and clean drinking water by lobbying for increased funding to rural and remote areas. Participation of women in policy formation will ensure environmentally sustainable development that recognizes the needs of women.

It is the ICOWHI’s goal to endorse the role of women as environmental and health policymakers at a government level to positively affect urban design and environmental health. Women need to be engaged at all levels of discussion from the local, domestic, and international levels.

Goal 8: Develop a Global Partnership for Development

The health of women and girls is a global issue, and therefore global co-operation and collaboration needs to occur in policy, practice, education, and research. In order for further improvement to take place, professional organizations need to be consulted and included in discussions surrounding women’s health; this includes research collaborations and partnerships, including public-private collaborations. Partnerships with parliamentarians, religious leaders, media, businesses, civil society groups, women’s and youth groups, research institutions, and nongovernmental organizations also must be considered (Shaw, 2006). These collaborative partnerships will facilitate the education of local communities and health care workers.

Improving women’s health globally is beneficial to men and women in both developed and developing countries. Men must work in effective partnerships to develop and support the improvement of women’s health globally. While the focus of the White Paper and ICOWHI is women, men are an essential part of the solution. Since the majority of policymakers are men, they must therefore be informed on women’s health issues and the appropriate measures that need to be taken. Strengthening leadership capacity will prioritize women’s health and hopefully result in a greater allocation of funds (ProCor, 2009; United Nations Population Fund, 2005).

The WHO notes that there are many gaps in the data surrounding women’s health and often the quality of the data is questionable (ProCor, 2009; World Health Organization, 2009). The ICOWHI also intends to support organizations and systems that facilitate the production and collection of reliable data surrounding women’s health. High-quality data need to be available at the local, national, and international level (ProCor, 2009). These data will enhance the knowledge surrounding women’s health, will ensure that changes can be closely monitored, and data can be correctly analyzed in totality, therefore influencing more appropriate policy decisions. Once obtained, this data must be disseminated globally, not just amongst developed countries.

The role of health professionals is crucial in achieving these goals. The ICOWHI therefore intends to help coordinate ethical frameworks of migration to ensure developing countries do not experience a brain drain to developed countries. Further, it is important that health professional education models are dynamic and responsive to the needs of the contemporary health and social systems (Frenk et al., 2010). Women play a pivotal role in the provision of health care, formally as health professionals and informally as family caregivers, and it can be estimated that women make up 50% of the formal workforce in many countries (WHO, 2009). It is therefore important not only for the recipients of health care but also the providers that ethical codes of conduct are developed, monitored, and respected.

REDUCING VIOLENCE AGAINST WOMEN AND GIRLS GLOBALLY AND ENHANCING THE SUPPORT AVAILABLE TO THE VICTIMS OF VIOLENCE

Empowering women and girls against domestic and family violence is a priority for the ICOWHI in promoting gender equality (Ellsberg, Jansen, Heise, Watts, & Garcia-Moreno, 2008). Domestic violence includes physical, sexual, and psychological assault, forced isolation, economic deprivation, harassment, and any other action that causes a person to live in fear (Womens Health Outcomes Framework, 2002). Women and girls are more likely to be abused than men and boys, and they are at high risk if they are under 24 years of age, experienced abuse as a child, or if they live in remote or rural areas. At least one in three women will be the victim of abuse—physical, sexual, or psychological—at some point in her life (Rosenfield et al., 2010).

In addition, most forms of violence are not unique one-off events but rather often occur continually over a number of years (Watts & Zimmerman, 2002). Violence against women and girls is particularly harmful in that the consequences go far beyond the initial act to include psychological damage, loss of personal freedom, and diminished capacity to participate in public life (Rosenfield et al., 2010). Violence against women is not only a symptom of gender inequality, but it also serves to maintain this unequal balance of power (Watts & Zimmerman, 2002).

Unfortunately, only a minority of women who experience domestic violence go on to report the incident, meaning that violence against women remains a hidden problem with a number of associated human and health care costs (WHO, 2009). Reducing domestic violence must include culturally sensitive strategies to educate and empower high-risk groups to speak out against offenders. Through such strategies, ICOWHI hopes to contribute to significantly reducing violence and its impact on vulnerable women across their lifespan. In order to affect change globally, ICOWHI intends to develop worldwide coalitions and partnerships for the purpose of decreasing violence and improving women’s health, by facilitating partnerships between congress conveners and ICOWHI members. In addition, ICOWHI hopes to inform and educate health workers globally about the prevalence of gender-based violence and provide them with the tools to manage such cases appropriately. Reducing violence against women will not only improve the life of the individual but also will enhance the existence of the entire community.

ADDRESSING THE BURDEN OF CHRONIC DISEASES AND RECOGNIZING THE NEEDS OF WOMEN AND GIRLS ACROSS THE LIFE-SPAN

For arange of social, political, and economic factors, predominately policymakers have focused on issues impacting on women’s reproductive health. Globally, the world is facing an epidemic of chronic disease (Beaglehole, Reddy, & Leeder, 2007). Chronic diseases such as cancer, cardiovascular disease, and diabetes are the number one killer of women in the world and are responsible for huge individual and societal costs (Phillips & Currow, 2010; Reddy & Yusuf, 1998). Whilst often ignored by policymakers (Beaglehole & Yach, 2003) and not mentioned in the MDGs, ICOWHI recognizes the substantial impact chronic diseases have on women’s health, both in the developed and developing world and will lobby for an increased priority of such diseases in the post-2015 global health agenda (Asaria et al., 2010). Efforts must be made to increase the awareness of symptoms and risk factors for chronic diseases. A life course approach to health will reduce the risk of many chronic diseases. As the population ages, women are an increasing proportion of the population, yet their health care needs are poorly studied, recognized, and resourced (Richmond, 2008). We also need to be mindful of the impact of urbanization and globalization on the health and well-being of women and girls. Tailoring and targeting of policy and health care policy and interventions are required to meet the context of contemporary society.

CONCLUSION

Women and girls have distinct needs and potential and face different obstacles. Women continue to experience inferior health outcomes across a number of conditions, despite human rights advances and improvements in certain areas of health and development. Improvements in women’s health on a global level must be developed from basic principles of human rights and gender equality and equity (Mane, 2010). The ICOWHI intends to act on the goals outlined above and implement practical and achievable strategies to ensure these goals are met. This must occur through enhanced collaboration with a range of partners and by empowering women and enhancing access to knowledge at local, regional, national, and international levels. The time has now come to take action to ensure the health and well-being of women and girls globally.

Footnotes

The views expressed in this article are those of the authors, and do not necessarily represent the views of the U.S. Department of Health and Human Services or the U.S. federal government.

The strategies are clear. A plan is in place. The needed resources are attainable. The time to act is now. (United Nations Population Fund, 2005)

Contributor Information

PATRICIA M. DAVIDSON, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Broadway, New South Wales, Australia

SARAH J. McGRATH, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Broadway, New South Wales, Australia

AFAF I. MELEIS, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA

PHYLLIS STERN, Department of Family Health Care Nursing, Indiana University School of Nursing, Indianapolis, Indiana, USA.

MICHELLE DiGIACOMO, Centre for Cardiovascular and Chronic Care, University of Technology, Sydney; and Curtin University of Technology, Broadway, New South Wales, Australia.

TESSA DHARMENDRA, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Broadway, New South Wales, Australia.

ROSALY CORREA-de-ARAUJO, Office on Disability, U.S. Department of Health and Human Services, Washington, DC, USA.

JACQUELYN C. CAMPBELL, School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA

MARGARETHE HOCHLEITNER, Medical University Innsbruck, Innsbruck, Austria.

DeANNE K. H. MESSIAS, College of Nursing and Women’s and Gender Studies Program, University of South Carolina, Columbia, South Carolina, USA

HAZEL BROWN, School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA.

ANNE TEITELMAN, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

SIRIORN SINDHU, Department of Surgical Nursing, Mahidol University, Bangkok, Thailand.

KAREN REESMAN, Department of Nursing, College of Health Sciences, Appalachian State University, Boone, North Carolina, USA.

SOLINA RICHTER, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.

MARILYN S. SOMMERS, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA

DORIS SCHAEFFER, School of Public Health, University of Bielefeld, Bielefeld, Germany.

MARILYN STRINGER, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

CAROLYN SAMPSELLE, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA.

DEBRA ANDERSON, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.

JOSEFINA A. TUAZON, College of Nursing, University of the Philippines Manila, Manila, the Philippines

YINGJUAN CAO, Nursing Department, Qilu Hospital of Shadong University, Shadong, China.

ELEANOR KRASSEN COVAN, School of Health and Applied Human Sciences, University of North Carolina, Wilmington, Wilmington, North Carolina, USA.

REFERENCES

  1. Alban A, Andersen NB. HIV/AIDS’ spread and impact on other health-related millennium development goals—secondary publication. Danish Medical Bulletin. 2007;54:163–166. [PubMed] [Google Scholar]
  2. Asaria P, Beaglehole R, Chisholm D, Gaziano TA, Horton R, Leeder S, Strong K. Chronic disease prevention: The importance of calls to action. International Journal of Epidemiology. 2010;39(1):309–310. doi: 10.1093/ije/dyn245. [DOI] [PubMed] [Google Scholar]
  3. Beaglehole R, Reddy S, Leeder SR. Poverty and human development: The global implications of cardiovascular disease. Circulation. 2007;116:1871–1873. doi: 10.1161/CIRCULATIONAHA.107.736926. [DOI] [PubMed] [Google Scholar]
  4. Beaglehole R, Yach D. Globalisation and the prevention and control of non-communicable disease: The neglected chronic diseases of adults. The Lancet. 2003;362(9387):903–908. doi: 10.1016/S0140-6736(03)14335-8. [DOI] [PubMed] [Google Scholar]
  5. Bobbitt-Zeher D. The gender income gap and the role of education. Sociology of Education. 2007;80(1):1–22. [Google Scholar]
  6. Breman JG. Eradicating malaria. Science Progress. 2009;92(Pt 1):1–38. doi: 10.3184/003685009X440290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Chaisson R, Martinson N. Tuberculosis in Africa—Combating an HIV-driven crisis. The New England Journal of Medicine. 2008;358:1089–1092. doi: 10.1056/NEJMp0800809. [DOI] [PubMed] [Google Scholar]
  8. Chenoweth D, Estes C, Lee C. The economic cost of environmental factors among North Carolina children living in substandard housing. American Journal of Public Health. 2009;99(S3):S666–S674. doi: 10.2105/AJPH.2008.141671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Correa-de-Araujo R. Serious gaps: How the lack of sex/gender-based research impairs health. Journal of Women’s Health. 2006;15:1116–1122. doi: 10.1089/jwh.2006.15.1116. [DOI] [PubMed] [Google Scholar]
  10. Ellsberg M, Jansen H, Heise L, Watts C, Garcia-Moreno C. Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: An observational study. The Lancet. 2008;371(9619):1165–1172. doi: 10.1016/S0140-6736(08)60522-X. [DOI] [PubMed] [Google Scholar]
  11. Frenk J, Chen L, Bhutta Z, Cohen J, Crisp N, Evans T, Zurayk H. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376:1923–1958. doi: 10.1016/S0140-6736(10)61854-5. [DOI] [PubMed] [Google Scholar]
  12. Grown C, Gupta GR, Pande R. Taking action to improve women’s health through gender equality and women’s empowerment. Lancet. 2005;365(9458):541–543. doi: 10.1016/S0140-6736(05)17872-6. [DOI] [PubMed] [Google Scholar]
  13. Jewkes R, Dunkle K, Nduna M, Shai N. Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: A cohort study. The Lancet. 2010;376(9734):41–48. doi: 10.1016/S0140-6736(10)60548-X. [DOI] [PubMed] [Google Scholar]
  14. Kettel B. Women health and the environment. Social Science and Medicine. 1996;42:1367–1379. doi: 10.1016/0277-9536(95)00285-5. [DOI] [PubMed] [Google Scholar]
  15. Laurance W. Habitat destruction: Death by a thousand cuts. Conservation Biology for All. 2010;1(9):73–88. [Google Scholar]
  16. Lavin AT. Creating an agenda for school-based health promotion: A review of 25 selected reports. Journal of School Health. 1992;62(6):212–228. doi: 10.1111/j.1746-1561.1992.tb01231.x. [DOI] [PubMed] [Google Scholar]
  17. Mane P. Conclusion: Promoting a human rights-based approach to women’s health. In: Murthy P, Smith CL, editors. Women’s global health and human rights. Jones and Bartlett Publishers; Burlington, MA: 2010. [Google Scholar]
  18. Marmot M. Social determinants of health inequalities. The Lancet. 2005;365(9464):1099–1104. doi: 10.1016/S0140-6736(05)71146-6. [DOI] [PubMed] [Google Scholar]
  19. Marmot M, Friel S, Bell R, Houweling T, Taylor S. Closing the gap in a generation: Health equity through action on the social determinants of health. The Lancet. 2008;372(9650):1661–1669. doi: 10.1016/S0140-6736(08)61690-6. [DOI] [PubMed] [Google Scholar]
  20. Paintsil E, Andiman WA. Update on successes and challenges regarding mother-to-child transmission of HIV. Current Opinion in Pediatrics. 2009;21(1):94–101. doi: 10.1097/MOP.0b013e32831ec353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Patel R, Burke T. Urbanization—An emerging humanitarian disaster. The New England Journal of Medicine. 2009;361:741–743. doi: 10.1056/NEJMp0810878. [DOI] [PubMed] [Google Scholar]
  22. Phillips J, Currow D. Cancer as a chronic disease. Collegian: Journal of the Royal College of Nursing Australia. 2010;17(2):47–50. doi: 10.1016/j.colegn.2010.04.007. [DOI] [PubMed] [Google Scholar]
  23. Pinn V. Sex and gender factors in medical studies: Implications for health and clinical practice. Journal of the American Medical Association. 2003;289(4):397–400. doi: 10.1001/jama.289.4.397. [DOI] [PubMed] [Google Scholar]
  24. ProCor. Women and health: Today’s evidence, tomorrow’s agenda. 2009 Retrieved from http://www.procor.org/news/news_show.htm?doc_id=1105981.
  25. Read J, Gorman B. Gender and health inequality. Annual Review of Sociology. 2010;36:371–386. [Google Scholar]
  26. Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998;97:596–601. doi: 10.1161/01.cir.97.6.596. [DOI] [PubMed] [Google Scholar]
  27. Richmond R. The changing face of the Australian population: Growth in centenarians. Medical Journal of Australia. 2008;188:720–723. doi: 10.5694/j.1326-5377.2008.tb01854.x. [DOI] [PubMed] [Google Scholar]
  28. Rosenfield A, Min C, Bardfield J. Introduction. In: Murthy P, Smith CL, editors. Women’s global health and human rights. Jones and Bartlett Publishers; Burlington, MA: 2010. pp. 3–7. [Google Scholar]
  29. Sachs JD. Achieving the millennium development goals—The case of malaria. The New England Journal of Medicine. 2005;352(2):115–117. doi: 10.1056/NEJMp048319. [DOI] [PubMed] [Google Scholar]
  30. Sankaran G. From Alma-Ata to millennium development goals: Status of women’s health in the 21st century. In: Murthy P, Smith CL, editors. Women’s global health and human rights. Jones and Bartlett Publishers; Burlington, MA: 2010. pp. 519–532. [Google Scholar]
  31. Shaw D. Women’s right to health and the Millennium Development Goals: Promoting partnerships to improve access. International Journal of Gynaecology & Obstetrics. 2006;94:207–215. doi: 10.1016/j.ijgo.2006.04.029. [DOI] [PubMed] [Google Scholar]
  32. Terjesen S, Sealy R, Singh V. Women directors on corporate boards: A review and research agenda. Corporate Governance: An International Review. 2009;17:320–337. [Google Scholar]
  33. United Nations (UN) The Millennium Development Goals report. Author; New York, NY: 2006. [Google Scholar]
  34. United Nations (UN) The Millennium Development Goals report. Author; New York, NY: 2010. [Google Scholar]
  35. United Nations (UN) UN women. Author; New York, NY: 2011. Entity for gender equality and the empowerment of women. Retrieved from http://www.unwomen.org/about-us/about-un-women. [Google Scholar]
  36. United Nations (UN) Population Fund. State of world population 2005. The promise of equality: Gender equity, reproductive health and the Millennium Development Goals. Author; New York, NY: 2005. [Google Scholar]
  37. Watts C, Zimmerman C. Violence against women: Global scope and magnitude. Lancet. 2002;359(9313):1232–1237. doi: 10.1016/S0140-6736(02)08221-1. [DOI] [PubMed] [Google Scholar]
  38. Wilson G. Diseases of poverty. In: Allen T, Thomas A, editors. Poverty and development in the 1990’s. Oxford University Press; Oxford, England: 1992. pp. 29–51. [Google Scholar]
  39. Woodcock J, Banister D, Edwards P, Prentice AM, Roberts I. Energy and transport. Lancet. 2007;370(9592):1078–1088. doi: 10.1016/S0140-6736(07)61254-9. [DOI] [PubMed] [Google Scholar]
  40. Womens Health Outcomes Framework Women and violence. Newsletter. 2002 Jan;3 [Google Scholar]
  41. World Health Organization (WHO) Women and health report. Author; Geneva, Switzerland: 2009. [Google Scholar]

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