Bài giảng Sức khỏe toàn cầu và giới tính trình bày các nội dung chính sau: Giới và sức khỏe toàn cầu, nguyên nhân tử vong hàng đầu ở phụ nữ 2001, sự khác biệt nguy cơ thụ đắc về mặt sinh học,... Mời các bạn cùng tham khảo để nắm nội dung chi tiết.
Sức Khỏe Tồn Cầu Giới Tính Global Health and Gender GS TS Lê Hoàng Ninh Giới sức khỏe tồn cầu • • • • • • Women Gender and 10/90 Gap HIV/AIDS and Women Maternal and Reproductive Health Missing Women Gender Based Violence Research on Gender and Global Health Gender and 10/90 GAP 10/90 GAP = only 10% current global funding for research is spent on diseases that afflict 90% of the world’s population In developing countries• Women have less access to health care and gender analysis to health research is lacking • There are distinct differences in patterns of health and health outcomes when gender analysis is applied Nguyên nhân tử vong hàng đầu phụ nữ 2001 HIV/AIDS 1.3 million Malaria 592,000 Maternal Conditions 509,000 Tuberculosis 500,000 Source: World Health Report 2002, World Health Organization HIV/AIDS and Women More than 50% of those living with HIV are women < 1% globally have access to anti-retrovirals In sub-Saharan Africa nearly twice as many women as men are infected HIV/AIDS and Women Potential reasons • • • • Biological differences of risk of acquisition Economic vulnerability leading to transactional sex Coerced sex/rape/marriage Inability to negotiate condom use HIV/AIDS and Women Sự khác biệt nguy thụ đắc mặt sinh học • Several studies have shown that it is easier for a woman to contract HIV/AIDS from a sexual contact with an infected man than it is for a man with an infected woman • The presence of an untreated STI increases the risk to contract 10X STIs often not give rise to any symptoms in women so they remain untreated or unrecognised • Coerced sex increases risk of micro-lesions; more frequent for women, although also important in young boys Gender and Global Health • • • • • • Women Gender and 10/90 Gap HIV/AIDS and Women Maternal and Reproductive Health Missing Women Gender Based Violence Research on Gender and Global Health Tử vong mẹ (Maternal Deaths) Reasons for Maternal Deaths in Low Income Countries Low income countries - 53% attended during delivery 30% receive postnatal care Violence Against Women Internationally Definitions: types of “female mutilation” Circumcision (type I - sunna) cutting of the hood of the clitoris (least severe) - least practiced Excision (type II - reduction) removal of clitoris and labia minora Infibulation (Type III - “pharaonic circumcision”) cutting of clitoris, labia minora and medial part of labia Two sides of the vulva are sewn with catgut and a small opening is left for menses Age: few days old (Ethiopia), years (Egypt, Central Africa), Adolescence (Nigeria, Tanzania) Documented Female Circumcision Violence Against Women-Internationally Health Sequelae of Female Circumcision 83% women will have a medical complication Immediate: hemorrhage (within 10 days) urethral damage or other adjacent organs, tetanus, infection, urinary retention from pain Long term: chronic infections, scarring, pelvic infections, dysmenorrhea, dyspareunia (painful intercourse), difficulty with urination Effects on Childbirth: need for de-infibulation delayed labor-increased mortality fistulas Unknown Effects: ?HIV transmission, sexuality, psychological trauma A Life Cycle Approach Period of the Life Major Problems Cycle causing undernutrition and missing women Priority Action Infancy-childhood Cultural consciousness about infanticide; nutritional and health needs of female children Male Preference A Life Cycle Approach Period of the Life Major Problems Cycle causing undernutrition and missing women Priority Action Adolescence Delay early marriage; Teach family planning; Female literacy; Nutritional supplementation Early Reproductive Role Female literacy and health: additional year schooling = 3.4% reduction in mortality A Life Cycle Approach Period of the Life Major Problems Cycle causing undernutrition and missing women Priority Action Reproductive Years Multiple roles for the family Reduction of women’s workload; Economic independence Frequency cycling, depleting with pregnancies Family planning; Iron supplementation A Life Cycle Approach Period of the Life Major Problems Cycle causing undernutrition and missing women Priority Action Later Years Public policy change for female land ownership; Social services for elder abuse Marginalization and Dependency Gender and Global Health • • • • • • Women Gender and 10/90 Gap HIV/AIDS and Women Maternal and Reproductive Health Missing Women Gender Based Violence Research on Gender and Global Health Gender “Mainstreaming” Mainstream gender issues and awareness into programs at WHO, UN, World Bank, public health initiatives Mainstream gender issues into research www.who.int/gender/en www.globalforumhealth.org BURDEN OF BLINDNESS IN MEN AND WOMEN Source: Abou-Gareeb, Lewallen, Bassett and Coutright Gender and blindness: a meta-analysis of population based prevalence surveys Opthalmic Epidemiology 2001; 8:39-56 Source: Abou-Gareeb, Lewallen, Bassett and Coutright Gender and blindness: a meta-analysis of population based prevalence surveys Opthalmic Epidemiology 2001;8:39-56 Higher prevalence of blindness among women:Why? • Do the greater life spans of women account for the greater burden of degenerative blindness? - But more women are blind at all older ages Must be another explanation • Is there differential mortality among blind men/women? - Available evidence does not seem to suggest this Higher prevalence of blindness among women: Why? • Studies show that women have a higher biological predisposition to cataract than men, and a socio-cultural predisposition to trachoma (i.e through child care activities, household environment etc) • Differential use of eye-care services due to differences in gender roles and behaviors • Studies have found distinct differences between men and women in surgical coverage across age groups – access to cataract surgery/trachoma Gender Mainstreaming at World Health Organization • Gender and Women’s Health Department at WHO • Gender Team at WHO promote awareness into programs at WHO and public health work • Gender Task Force – senior level managers report gender mainstreaming to Director General .. .Giới sức khỏe tồn cầu • • • • • • Women Gender and 10/90 Gap HIV/AIDS and Women Maternal and Reproductive