Producing a devastating impact on school attendance, employment, worker productivity, community participation and quality of life, poor health stands out as one of the most significant problems disproportionately trapping girls and women in a cycle of poverty and preventing them from thriving as equal members of society. Many disadvantages associated with a lack of basic health care confront them right from birth, simply because they are girls.
We must increase investments in the health of girls and women. Doing so will enable them to be empowered to pursue all professional, educational, social and political opportunities.
A lack of decision-making and political power, lower economic status and inadequate education all play a role in perpetuating insufficient access to basic health care among girls and women. The consequences are deadly and life-long, for pregnant women and new mothers as well as their babies and entire families.
According to our colleagues at PATH, the risk of a woman dying from pregnancy in developing countries is 1 in 17, in part because 57 million women each year give birth without the help of a trained health worker and at home. This increases the risk of infection and even death for either the mother or the child.UNICEF estimates that the lack of skilled attendants at birth in developing countries leads to 2 million preventable maternal deaths, stillbirths and newborn deaths each year.
Malnutrition also prevents girls and women from reaching their fullest potential. TheScaling Up Nutrition movementexplains, “malnourished mothers often have malnourished children,” creating a never-ending cycle of anemia, vitamin deficiencies, stunting and wasting. These outcomes, of course,lead to an array of other complications.
Extreme poverty only exacerbates the inequalities women and girls face. The burden ofneglected tropical diseases, for instance, highlights how disease not only causes poverty but worsens it, disproportionately, for girls and women.
NTDs are parasitic and bacterial infections that afflict more than 1.4 billion of the world’s poorest people. According to a 2013Hudson Institute report , “because NTDs have a significant effect on women and children, addressing these infections is imperative to reaching gender equality, increasing school attendance, and improving maternal and child health.” Soil-transmitted helminths are particularly dangerous for pregnant women and newborns because they cause pregnancy complications, anemia and low birth weights. The Carter Centerfound that because women are primarily the caretakers of children, who are “reservoirs of trachoma infection,” women are at greater risk for trachoma and blindness.
Consider these two women’s stories:
Sulochana Behara, from Dhalapathar village in Odisha state in India, faces the stigma commonly associated with NTDs. She has five healthy daughters for whom she is having trouble finding grooms; people incorrectly believe that the swelling of her leg caused bylymphatic filariasis is hereditary and that her daughters will also develop this disability.
Khasirimi Mkala, who lives in a Kenyan village surrounded by water and with no roads or hospitals, used to feed her entire family with the crops she grew on her farm; however, with massive swelling in her legs, also caused by LF, it is now too difficult for her to work and too painful to walk.
The call to action
Dr. Margaret Chan, director-general of the World Health Organization,stated: “We must all join forces to make sure that the health of women and girls is not jeopardized simply because they were born female.”
What does this united front for girls and women look like? How can we provide them with the chance to lead healthy, productive lives — and achieve an optimal return on investment for nearly every development effort?
1. Cross-sector collaboration. Health must be addressed in tandem with other development efforts to ensure sustainability and cost-effectiveness.One important strategy is linking water, sanitation, and hygiene — or WASH — programs with maternal and child health, given that women and girlscould spend up to six hours daily collecting water. For example, a group of WASH and NTD partners recently published an importantmanual for implementers to identify synergies.
2. Strengthen health systems. Expanding the capacity of drug distribution and other health services, improving coverage, increasing the number of health care workers and identifying sustainable financing mechanisms will all yield positive outcomes for the health of girls and women. Country ownership in building robust health systems is absolutely vital.
4. Improve nutrition. Thefirst 1,000 days of life are the most critical time for establishing the foundation for a healthy life. It will be essential to scale up efforts to provide the essential care and interventions required to prevent irreversible outcomes. Efforts such as theGlobal Nutrition for Growth Compact are accelerating progress. Integrated vitamin supplementation and deworming programs are also improving nutrition outcomes while removing the threat of NTDs in children.
5. Increase education. With greater education and awareness, girls and women will be able to make more informed health decisions, including identifying when they may need urgent care and why treatment and prevention for diseases are so important. In turn, this knowledge will empower them to make decisions that can safeguard their health and that of their families.As a recent CARE report points out, greater attendance in school will provide girls with leadership, self-esteem and knowledge to help them navigate professional, health and social choices throughout their lives. However, girls must be healthy — free of NTDs and other infectious diseases — to go to school and learn.
With improved health outcomes, girls and women will be able to participate more socially, economically and politically. When we create the possibility for all girls and women to prosper, we can expect to achieve a more hopeful, productive and equal world.
Michael W. Marine, a former U.S. ambassador to Vietnam, was appointed CEO of the Sabin Vaccine Institute in April 2010. Marine joined Sabin's leadership team in December 2009 after serving 8 months on the Joint Action Committee of the Global Network for Neglected Tropical Diseases, an advocacy and resource mobilization initiative of Sabin. He was a member of the U.S. State Department's Foreign Service for 32 years.