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WomenandHealthLearning Package: Nutrition and Women’s Health
www.the-network.tufh.org
1
NUTRITION AND WOMEN’S HEALTH
Women andHealthLearningPackage
Developed byTheNetwork:TUFHWomenandHealthTaskforce
Second edition,September2006
Support for the production of theWomenandHealthLearningPackage (WHLP) has been provided
by TheNetwork: Towards Unity for Health (The Network: TUFH), Global Health through Education,
Training and Service (GHETS), andthe Global Knowledge Partnership. Copies of this and other
WHLP modules and related materials are available on TheNetwork:TUFH website at
http://www.the-networktufh.org/publications_resources/trainingmodules.asp or by contacting GHETS
by email at info@ghets.org, or by fax at +1 (508) 448-8346.
About the authors
Pilar Torre Medina-Mora, MPH
Full Professor, Department of Health Care, Division of Biological andHealth Sciences
Universidad Autónoma Metropolitana-Xochimilco
Mexico City, Mexico
Pilar Torre, a nutritionist, graduated from the Faculty of Nutrition, Ibero-American
University, Mexico, and holds a masters degree from the National Institute of Public Health,
Cuernavaca, Mexico. She began work at the Metropolitan Autonomous University,
Xochimilco Campus (UAM-X) in 1992, and has been a full professor since 2000. Before
entering the UAM, she worked at the Ministry of Healthand at the National Institute of
Nutrition, Mexico. Her academic interests include infant and child nutrition, breastfeeding
practices, and women’s healthand nutrition. She was the coordinator of the Research Unit on
Health and Society, and she teaches subjects related to infant and maternal healthand
nutrition. She also collaborated in the design of a new curriculum proposal to train nutrition
professionals at the UAM-X. Pilar Torre served as an external advisor to UNICEF, from 1982
to 1986, and to the High Commissioner of United Nations for Refugees from 1989 to1992, in
the implementation of emergency programs for Guatemalan refugees in the south-eastern
region of Mexico. She collaborates with a Mexican NGO dedicated to the improvement of
the nutritional status of indigenous children and women, in the state of Chiapas, Mexico,
since 1994. She has been a member of TheNetwork:TUFHTaskforce on WomenandHealth
since 2004. E-mail: ptorre@correo.xoc.uam.mx
Deyanira González de León Aguirre, MD, MPH
Full Professor, Department of Health Care, Division of Biological andHealth Sciences
Universidad Autónoma Metropolitana-Xochimilco
Mexico City, Mexico
Deyanira González de León graduated from the Faculty of Medicine, National Autonomous
University of Mexico, and holds a master’s degree from the Institute of Health Development,
Havana, Cuba. She began work at the Metropolitan Autonomous University, Xochimilco
Campus (UAM-X) in 1981, and has been a full professor since 1992. Her academic interests
Women andHealthLearning Package: Nutrition and Women’s Health
www.the-network.tufh.org
2
include health promotion and education, gender studies, and women’s sexual and
reproductive health. She was the coordinator of the Research Unit on Education and Health,
and is currently responsible for the project “Abortion Care in Mexico: Physicians’ Attitudes
towards Abortion”. She also conducted a project on womenand medicine in Mexico, and has
collaborated in other research projects at the UAM-X. She teaches subjects related to
women’s sexual and reproductive health in both undergraduate and graduate university
programs, and collaborated in the design of a new curriculum proposal to train nutrition
professionals at the UAM-X. Deyanira González de León served as an external advisor from
2001-2002 to Ipas Mexico, a non-profit agency working to improve women’s lives by
focusing on reproductive health. She has been a member of TheNetwork:TUFHWomenand
Health Taskforce since 2002, and previously served on theTaskforce Management
Committee (2004-2005). E-mail: deyagla@yahoo.com.mx and dgonzal@correo.xoc.uam.mx
Fernando Mora Carrasco, MD, PhD
Full Professor, Department of Health Care, Division of Biological andHealth Sciences
Universidad Autónoma Metropolitana-Xochimilco
Mexico City, Mexico
After studying medicine at the University of Chile and Microbiology at the University of
Illinois (1952-1962) Fernando Mora moved to Cuba, where he collaborated until 1969 in the
development of medical education and biomedical research. From 1969 until 1974 he was
professor at the Faculty of Medicine of the National Autonomous University of Mexico.
Since 1974 he has been a full professor at the Metropolitan Autonomous University,
Xochimilco Campus, where he has been Director of the Division of Biological andHealth
Sciences and Coordinator of the Program in Medicine, among other responsibilities. He has
been an invited professor at the medical schools of Brown University and University of
California at San Francisco, in the USA, andthe University of Helsinki, in Denmark. He has
collaborated with the WHO and PAHO as a temporary advisor on different aspects of health
sciences education, and helped in the creation of medical schools in Georgetown, Guyana,
and Managua, Nicaragua. He has participated in TheNetwork:TUFH since its beginning in
1979, and with GHETS also from its conception in 2002. He has been chairman of the
Network: TUFH, and is currently vice-president of the GHETS Board of Directors. E-mail:
fmora@correo.xoc.uam.mx and fmora5@yahoo.com
Women andHealthLearning Package: Nutrition and Women’s Health
www.the-network.tufh.org
3
NUTRITION AND WOMEN’S HEALTH
Global Overview
Today it is well recognised that in developing countries, women are one of the most
vulnerable population groups in terms of their healthand nutritional status. Different
socioeconomic and cultural factors generate unfavourable nutritional outcomes for many
women, and this may in turn seriously affect their healthand overall quality of life.
Women’s nutritional conditions differ widely among and within countries. Such conditions
are worst in the less-developed regions and countries of the world, where poverty, social
disparities, discrimination, and different kinds of malnutrition affect large populations. The
nutritional andhealth status of women may be severely impaired in societies where the
political and cultural context allows extreme conditions of subordination, as well as in those
countries where the threat of hunger persists because of political conflicts, migration,
environmental degradation, or natural disasters. On the other hand, not all women who live in
developing countries experience nutritional problems in the same way, and such problems do
not have the same impact on all women. Economic and social inequalities have a strong
correlation with the differences in the nutritional status among women in these countries.
Poor women in general, with limited or no access to nutritious food, education, employment
or adequate health care, are more vulnerable to nutritional deficiencies. In developed
countries, women in lower income groups may also be affected by nutritional deficiencies
because of economic disparities and lack of social protection.
During the last decades, global organizations and women’s rights advocates have called on
governments to recognise the multiple determinants of women’s health, and there has been a
growing consensus about the need to integrate and widen health services to respond to a
broad variety of problems affecting them. Nutrition is a fundamental pillar of women’s well-
being, and women’s right to full and equal access to health care, including adequate nutrition
during pregnancy and lactation, has been recognised at many international conferences,
including the 1979 Convention on the Elimination of All Forms of Discrimination against
Women, the 1987 International Conference on Safe Motherhood, the 1990 World Summit for
Children, the 1994 International Conference on Population and Development, the 1995
Fourth World Conference on Women, andthe 2000 Millennium Goals Declaration, to name
just a few.
Experts have made recommendations to incorporate nutrition as an essential component of
primary health care, stressing that programs to deal with women’s nutritional problems must
be based on a life cycle approach. The nutritional needs of women substantially change
during the different stages of their lives. A life cycle approach allows a better recognition of
specific nutritional needs at every stage of women’s lives, as well as a more comprehensive
understanding of the cumulative effects of poor nutrition on women’s health.
In many countries, the nutritional deficiencies that affect thousands of women are still
neglected. Most of the strategies to respond to women’s nutritional needs—such as
micronutrient dietary supplementation programs, health education activities, and delivery of
medical services—have been mainly focused on pregnant and lactating women, giving little
or no attention to women in other moments of their lives.
Women andHealthLearning Package: Nutrition and Women’s Health
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There is no doubt that the protection of women during pregnancy and lactation must be one
of the major priorities of health systems and social policies. The effect of women’s nutritional
status on pregnancy outcomes is particularly strong, and adequate maternal nutrition is
closely related to the survival and well-being of babies and children. However, not all women
are mothers, and their nutritional andhealth needs go far beyond motherhood and
reproduction.
Women of all ages in developing countries face elevated risks of nutritional deficiencies.
Therefore much more attention should be paid to the nutritional needs of girls, adolescents
and young women, in order to strengthen their overall health, protect them from the
cumulative effects of poor nutrition, and prevent problems later in life. In fact, thehealth
problems of many women in late adulthood and old age are mostly chronic and often
associated with previous nutritional deficiencies.
Research has suggested a link between nutritional deficiencies in early (including prenatal)
life, andthe development of chronic diseases—cardiovascular disease, diabetes mellitus,
hypertension, stroke, cancer, and osteoporosis, among others—some decades later (World
Health Organization 2000a, 2000b; Jacoby 2004). A possible link between early nutritional
deficiencies and obesity has also been suggested, and it remains an area of ongoing research
(Pan American Health Organization 2003). These associations are especially relevant for
women, since they generally live longer than men, and therefore the complications and
disabilities that result from these kinds of diseases are much more common among elderly
women.
Undernutrition affects large populations of boys and girls in developing countries. Its major
determinant is poverty, which usually combines with other important factors like poor
breastfeeding practices and inadequate complementary foods for babies, as well as lack of
basic health care, safe water and sanitation. Globally, about 150 million children under five
years are undernourished, which comprises 27% of the world’s population in this age group.
Twelve million of these children die every year, and protein-energy malnutrition is
implicated in more than 55% of all these deaths. Undernourished children are much more
likely to get sick and die from common infectious diseases. Chronic protein-energy
malnutrition leads to growth retardation and stunting and may severely impair mental and
cognitive abilities. Undernutrition and a variety of micronutrient deficiencies—iron, calcium,
iodine, and vitamins A and D, for example—often start before birth and may continue
throughout life (United Nations Children’s Fund 1998; World Health Organization 2000a).
The impact of undernutrition on young girls has received special attention. In many parts of
the world, poverty often interacts with sociocultural factors that make girls and adult women
less favoured than men. Female infants and children commonly receive less medical care and
also less and lower-quality food than male children. In a number of countries in the
developing world, these discriminatory attitudes result not only in higher rates of protein-
energy malnutrition among girls but also in an excess of mortality among them (Gómez 1993;
United Nations Children’s Fund 1998, 1999).
Undernourished girls are likely to reach adolescence in disadvantaged physical conditions,
and this may in turn have severe implications for their overall health, in particular when they
experience early pregnancies. Stunted and/or anaemic adolescent mothers are more likely to
have complications during childbirth andthe postpartum period, as well as to give birth to
premature and low-weight babies. Closely-spaced pregnancies and repeated childbearing,
Women andHealthLearning Package: Nutrition and Women’s Health
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along with heavy physical work, poor diets, discrimination and inadequate health care, may
severely undermine the nutritional status of many women, with consequences for both them
and for thehealthand nutrition of the next generation (World Health Organization 1997,
2000a; United Nations Population Fund 1997, 2000). Global data indicate that at the end of
the 20th century, an estimated 450 million adult women in developing countries were stunted
as a result of chronic protein-energy malnutrition during infancy and childhood (The World
Bank 1997).
Nutritional deficiencies during pregnancy usually lead to intrauterine growth retardation,
which is one of the main causes of foetal and infant undernutrition in developing countries.
Every year, 30 million newborns, or 23% of 126 million births per year, are affected by
intrauterine growth retardation; by contrast, in developed countries the rate is only about 2%
(World Health Organization 2000a). A significant proportion of infant mortality, in particular
within the first month of life, is also attributable to poor maternal healthand nutrition during
pregnancy andthe immediate postpartum period (United Nations Children’s Fund 1999).
Specific micronutrient deficiencies may affect maternal and foetal health. Iodine deficiency
during pregnancy may cause foetal brain damage and mental retardation in infants. Vitamin
A deficiency increases the risk in pregnant women of infection and anaemia, may cause
blindness during pregnancy and early lactation, and has been associated to an elevated risk of
HIV mother-to-child transmission. Folate deficiency may cause severe foetal neural tube
defects like anencephaly and spina bifida. Iron deficiency weakens the maternal body,
impairs intrauterine growth and increases the risk of both maternal and foetal morbidity and
mortality (World Health Organization 2000a).
Anaemia is one of the most common nutritional problems affecting women in developing
countries, where iron deficiency usually combines with other micronutrient deficiencies such
as folate and vitamin B. In addition, the diet of the poorest populations is often monotonous
and mainly based on staple foods, which are low in iron and contain absorption inhibitors.
Other important factors involved in the occurrence of anaemia include malaria and
hookworm infestations, chronic infections such as HIV, and congenital conditions like sickle
cell disease, among others. Available data indicate that in developing countries the
prevalence rates of anaemia among women of reproductive age are extremely elevated (see
table 1). In pregnant womenthe rates vary from 40-60%, and among other women from 20-
40%. In developed countries, many women are also affected by anaemia, but the prevalence
rates are lower (World Health Organization 1992, 2000a; Rush 2000).
The poor nutritional status of women in developing countries has been associated with
maternal mortality. Maternal deaths do not result from malnutrition alone, however, but
mainly from a lack of access to obstetric care and from previous conditions that may be
aggravated by poor nutrition. For example, maternal deaths caused by obstructed labour are
more common in malnourished adolescents and young women with a short stature and small
pelvic size; and deaths resulting from haemorrhage during childbirth andthe immediate
postpartum period may be associated with severe anaemia (Rush 2000).
Obesity and overweight are also among the most relevant nutritional problems of women
worldwide. The obesity epidemic has rapidly been increasing around the world over recent
decades, affecting virtually all social and age groups in both developedand developing
countries. An estimated 200 million adults worldwide were obese in 1995, a number which
had risen to 300 million by 2000. In addition, more than 17 million children under five years
Women andHealthLearning Package: Nutrition and Women’s Health
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were overweight (World Health Organization 2000a, 2000b). Child obesity is associated with
many health problems, and it has been observed that the most important long-term
consequence of childhood and adolescent obesity is its persistence into adulthood (Pan
American Health Organization 2003).
In a number of developing countries, obesity currently affects all income groups of adult men
and women, but it is rapidly increasing among poor urban populations. The increase in
obesity in these countries is attributed to the conjunction of complex societal factors, such as
urbanization, economic growth and modernization, globalisation of food markets, and
changes in diet and physical activity patterns. In many cities of the developing world, diet has
become higher in fats, refined sugars and processed foods, andthe consumption of relatively
cheaper but higher-calorie, lower-nutrient foods has been progressively adopted by poor
populations. These changes in diet patterns combine with a more sedentary life and a marked
decreased of physical activity among urban populations (Pan American Health Organization
2003; Jacoby 2004).
Obesity is a chronic disease, and its consequences include an elevated risk of premature death
and a variety of serious health problems such as heart disease, hypertension and stroke,
diabetes, cancer, osteoarthritis, and accidents, among others (World Health Organization
1997, 2000a). An estimated 35 million deaths from chronic diseases were expected to occur
worldwide in 2005, with 80% of them in low-income and middle-income developing
countries. Along with tobacco smoking and physical inactivity, obesity is responsible for
many of these deaths among adults aged 30-69 years (Strong et al. 2005). Obesity is also
associated with nonfatal but debilitating conditions like sleep apnoea, low back pain, skin
diseases, and infertility, which reduce the overall quality of life in overweight and obese
persons and are often the primary reason for consultation with health services (World Health
Organization 1997, 2000a). In addition, obesity may seriously impair mental healthby
causing anxiety, depression or eating disorders; obese persons are often stigmatised as weak-
willed, lazy and unhygienic in their personal habits, because of generalised negative attitudes
towards obesity and dominant perceptions about body image (Pan American Health
Organization 2003).
Surveys from both developedand developing countries have shown that obesity rates are in
general higher in women, although overweight is more frequent in men (see table 2). Obesity
presents a major risk for thehealthand well-being of women. Currently, all health
consequences of obesity described above affect many women in both developedand
developing countries, but obesity may also have specific negative effects on reproductive
health.
It has been documented, for example, that high maternal pre-pregnancy weight and excessive
weight gain during pregnancy are often associated with adverse pregnancy outcomes,
including greater risks of gestational diabetes, childbirth complications, caesarean sections,
hypertension and pre-eclampsia, and post-partum obesity. Women with severe (morbid)
obesity are more likely to experience even poorer outcomes such as stillbirths or neonatal
deaths. Studies have shown that obesity is frequently associated with hormonal and menstrual
disorders, as well as with polycystic ovary syndrome, infertility, and higher risks of
endometrial, ovarian, cervical, and breast cancer. It has also been reported that obesity may
reduce the effectiveness of some hormonal contraceptives, and implies technical difficulties
for inserting intrauterine devices and for performing surgical sterilisation or abortions (World
Health Organization 1997; Lederman 2001; Grims & Shields 2005).
Women andHealthLearning Package: Nutrition and Women’s Health
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In many countries, professional education for physicians and nurses has little emphasis on
nutrition. It is common that when nutritional topics are presented to students the problems
and solutions show serious restrictions. In the particular case of women, curricular contents
are usually selected from a narrow perspective about their healthand nutritional needs.
Currently, the nutritional problems affecting women in the developing world present
important challenges for health systems and social policies and should receive more attention
in university programs.
Regional Overview: Mexico
The current nutritional andhealth profiles of the Mexican population reflect notable failures
in the field of social policies. Protein-energy malnutrition and infectious diseases are still
relevant public health matters among poor rural and urban populations, and they remain
common causes of death during infancy and childhood, and even later in life. By contrast,
overweight and obesity affect a large proportion of the adult urban population and are rapidly
increasing among young children and lower income groups; over the last decades, the high
prevalence rates of obesity have been a major factor in the increase of chronic diseases,
which today constitute the leading causes of general mortality in the country.
A general profile of the Mexican population is presented in Table 3. It is important to note
that the information contained in this table, as well as in this section, may not give an
adequate overview of the social reality prevailing in the country, since average data cannot
reflect extensive social inequalities and a wide dispersion of income and ethnicity.
Available information shows that the nutritional status of Mexican women differs widely
within the country, according to geographical regions, urban and rural areas, and income
groups. Nutritional deficiencies, anaemia and stunting, for example, are more common in
poor women who live in the less-developed regions of the country, in rural and indigenous
communities or in marginal urban areas. On the other hand, overweight and obesity currently
affect women of all income groups, but rates are higher in the more economically advanced
regions and big cities. Available information also shows that women’s nutritional needs seem
to remain far too low on the national agenda of health priorities.
The prevalence rates of anaemia among pregnant and nonpregnant women increased between
1988 and 1999 (table 4). In 1999, an estimated 21% of all women aged 12-49 were anaemic
(27.8% of pregnant womenand 20.8% for nonpregnant women). Among all nonpregnant
women, the rate of anaemia was higher (about 25%) in indigenous minorities. (Shamah et al.
2003). As a result of the cumulative effects of undernutrition, many adult women had short
statures, with an average height of 1.52m for those in reproductive age. Specific
micronutrient deficiencies affected many women; 40% of nonpregnant women had iron and
vitamin C deficiencies, and 5% were deficient in vitamin A and folate (Rivera & Sepúlveda
2003).
According to information about the nutritional status of children under five years, collected in
1999 at the national level, the percentages of boys and girls affected by undernutrition were
very similar. For example, 8% of boys and 7% of girls had low weight according to their age,
and the prevalence of stunting was of 18% and 17%, respectively (Instituto Nacional de
Salud Pública 2001). Mortality statistics indicate that deaths attributed to protein-energy
Women andHealthLearning Package: Nutrition and Women’s Health
www.the-network.tufh.org
8
malnutrition and other nutritional deficiencies decreased between 1990 and 2003. However,
data presented in Table 5 show that the percentages of deaths because of this cause are
slightly higher in women during childhood, early adolescence and even old age (Instituto
Nacional de Estadística, Geografía e Informática 2003). In addition, protein-energy
malnutrition and nutritional anaemia were among the twenty primary causes of general
mortality in women in 2003 (Secretaría de Salud 2005).
Overweight and obesity among women have been dramatically increasing over the last
decades (Table 6). At the national level, more than 56% of women of reproductive age were
overweight or obese in 1999 (Rivera and Sepúlveda 2003). In Mexico City, where more than
one fifth of the country’s total population is concentrated, the prevalence rates of overweight
and obesity among low-income adults—both men and women—sharply increased within the
period 1995-2002 (table 7); more than 65% of womenand 52% of men were overweight or
obese in 2002, andthe prevalence rates of obesity were higher in women than men (Instituto
Nacional de Nutrición 1995, 2003).
Four diet-related chronic diseases—diabetes, heart disease, stroke and hypertension—were
the leading causes of general mortality among women in 2003, accounting for more than 36%
of total female deaths (Secretaría de Salud 2005). Breast cancer, which is strongly associated
with overweight and obesity, is also a frequent cause of death among Mexican women. This
kind of cancer has had a marked ascending trend during the last decades; an estimated 706
women died because of breast cancer in 1970, while in 2002 the number of annual deaths had
increased to 3860. On the other hand, diet-related chronic diseases are clearly associated with
premature deaths among women. In 2002, diabetes, breast cancer, stroke, and heart disease
accounted for more than one-fifth of the total deaths in women of reproductive age
(Secretaría de Salud 2004).
Women andHealthLearning Package: Nutrition and Women’s Health
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9
APPENDIX
Table 1: Estimated prevalence of anaemia in womenby region, around 1988*
Region
Pregnant
women
(%)
Non pregnant
women
(%)
All
women
(%)
World
51
35
37
Developing countries 56 43 44
Developed countries 18 12 13
Africa
52
42
44
Eastern 47 41 42
Middle 54 43 45
Northern 53 43 45
Southern 35 30 30
Western 56 47 48
Asia**
60
44
45
Eastern** 37 33 33
South-eastern 63 49 50
Southern 75 58 60
Western 50 36 38
Latin America
39
30
31
Caribbean 52 36 37
Central 42 39 39
South 37 25 26
Northern America
17
10
11
Europe
17
10
11
Oceania**
71
66
67
USSR***
15
12
12
Source: World Health Organization, 1992. The prevalence of anaemia in women: a tabulation of
available information. Geneva: WHO (WHO/MCH/MSM/92.2).
*Figures may not add up exactly to total due to rounding.
** Japan, Australia and New Zealand were excluded from the regional estimates but are
included in the total for developed countries.
*** Data collected before political changes. USSR: former Union of Soviet Socialist Republics.
Women andHealthLearning Package: Nutrition and Women’s Health
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Table 2: Prevalence of obesity among womenand men in selected countries, 1989-1996
Countries
Year
Age
(years)
Men
(%)
Women
(%)
Australia
1989
25-64
11.5
13.2
Bahrain
1992
20-65
6.5
11.2
Brazil
1989
25-64
6
13
Canada
1991
18-74
15
15
China
1992
20-45
1.2
1.6
Czech Republic
1988
20-65
16
20
England
1995
16-64
15
16.5
Finland
1993
20-75
14
11
Islamic Republic of Iran
1994
20-74
2.5
7.7
Japan
1993
20+
1.7
2.7
Netherlands
1995
20-59
8
8
New Zealand
1989
18-64
10
13
Peru*
1996
adults
13.8
26.5
Saudi Arabia
1993
15+
12
18
South Africa**
1990
15-64
8
44
Tanzania
1989
35-64
0.6
3.6
United States of America
1994
20-74
20.0
25.0
Source: World Health Organization, 1998. Obesity: preventing and managing the global
epidemic. Geneva: WHO. Pan American Health Organization, 2003. Obesity in the Americas: the
challenge to promote healthy nutrition and active living. Washington, DC: PAHO.
* Low socio-economic level.
** Black population, Cape Peninsula.
[...]... WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org Case Study: Chiapas – Tutor’s Notes Observed health problems _ Interview _ Quality Capture _ Quality WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org... 6 What role can health services play to improve women s nutritional conditions during pregnancy and lactation? 7 What resources and facilities are available in the communities you serve to assist women in poor healthand nutritional status? WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org Case Study: Chiapas Case Study: Chiapas – Tutor’s Notes The community case... 2004 The Cairo consensus at ten: Population, reproductive healthandthe global effort to end poverty New York: UNFPA WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org 11 Table 4: Prevalence of anaemia among Mexican women of reproductive age (12-49 years), 1988 and 1999 Description 1988 (%) 1999 (%) Pregnant women 18.2 27.8 Non pregnant women ND 20.8 All women. .. describe the reproductive profile of women: 1 Reproductive status at the time of the visit, with four categories: a) Not pregnant, not lactating (NPNL) WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org Case Study: Chiapas b) Pregnant (P) c) Lactating (L) d) Pregnant and lactating (PL) 2 Total number of pregnancies, by age group and live births per woman 3 Age of women. .. activity andhealth Geneva: WHO RECOMMENDED WEBSITES American Medical Women s Association http://www.amwa-doc.org Association of Reproductive Health Professionals http://www.arhp.org WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org 16 Engender Health http://www.engenderhealth.org Family Care International http:/www.fci.org International Centre for Research on Women. .. case: 1 Identify the characteristics (data, categories, variables) that were used to describe the reproductive and anthropometric profiles of women 2 Analyze with the team the relevance of the maternal clinical record (MCR) 3 Analyze with the team the characteristics of the reproductive and anthropometric profile of thewomen under study Compare these data with that of other women around the world 4 Analyze... inequities and socio-economic inequalities influence women s social status, as well as their healthand nutritional conditions 5 Stress on the need for analyzing women s healthand nutritional conditions from a life cycle approach 6 Analyze the connections between women s reproductive healthandthe nutritional risks associated to pregnancy and lactation 7 Discuss alternative ways to face and solve these... pregnant and lactating Source: Encuesta nutricional en la zona de conflicto Chiapas, 1994 WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org Case Study: Chiapas Questions for students 1 Analyze the reproductive profile of women included in the case scenario (including their age at first birth; intervals between deliveries; total number of pregnancies, by age group and. .. ninety-five women of reproductive age (15-49 years old) were studied in the five communities Out of these, 243 (82%) were either pregnant or had at least one child less than five years old The remaining 18% were either single or their children were older than 5 years We present here data from 227 clinical records, mainly because they were completed WomenandHealthLearning Package: Nutrition andWomen s Health. .. la Zona Metropolitana de la Ciudad de México 2002 México: INCMNSZ WomenandHealthLearning Package: Nutrition andWomen s Health www .the- network .tufh. org 13 REFERENCES Gómez, Elsa, 1993 Sex discrimination and excess female mortality in childhood In: Gómez, Elsa (editor): Gender, womenandhealth in the Americas Washington: Pan American Health Organization, Scientific Publication 541, pp 43-61 Grimes, . Learning Package
Developed by The Network: TUFH Women and Health Taskforce
Second edition, September 2006
Support for the production of the Women and Health. Women and Health Learning Package: Nutrition and Women s Health
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NUTRITION AND WOMEN S HEALTH
Women and Health Learning