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128-433: McMaster University Medical Centre delivers a wide range of women's health services including high-risk obstetrics and gynecology to patients throughout the region. It also serves as the home for a range of adult outpatient clinics and day surgery. The site hosts one of Canada's premier digestive disease programs which, in conjunction with McMaster University, conducts more digestive disease research than any other program in

256-649: A basic framework for defining the sector, the United Nations' International Standard Industrial Classification categorizes health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities." The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, patient advocates or other allied health professions . In addition, according to industry and market classifications, such as

384-951: A broad view encompassing many of the other MDG goals, such as poverty and status, and given that most deaths occur in the immediate intrapartum period, it has been recommended that intrapartum care (delivery) be a core strategy. New guidelines on antenatal care were issued by WHO in November 2016. In addition to death occurring in pregnancy and childbirth, pregnancy can result in many non-fatal health problems including obstetrical fistulae , ectopic pregnancy , preterm labor , gestational diabetes , hyperemesis gravidarum , hypertensive states including preeclampsia , and anemia . Globally, complications of pregnancy vastly outway maternal deaths, with an estimated 9.5 million cases of pregnancy-related illness and 1.4 million near-misses (survival from severe life-threatening complications). Complications of pregnancy may be physical, mental, economic and social. It

512-668: A broader understanding of women's health to include all aspects of the health of women has been urged, replacing "Women's Health" with "The Health of Women". WHO considers that an undue emphasis on reproductive health has been a major barrier to ensuring access to good quality health care for all women. Conditions that affect both men and women, such as cardiovascular disease , osteoporosis , also manifest differently in women. Women's health issues also include medical situations in which women face problems not directly related to their biology, such as gender-differentiated access to medical treatment and other socioeconomic factors. Women's health

640-569: A challenge for the design of ICT (information and communication technology) for home care. Because statistics show that over 80 million Americans have taken time off of their primary employment to care for a loved one, many countries have begun offering programs such as the Consumer Directed Personal Assistant Program to allow family members to take care of their loved ones without giving up their entire income. With obesity in children rapidly becoming

768-612: A clear correlation between worse quality and higher spending. Expand the OECD charts below to see the breakdown: The management and administration of health care is vital to the delivery of health care services. In particular, the practice of health professionals and the operation of health care institutions is typically regulated by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance . Most countries have credentialing staff in regulatory boards or health departments who document

896-412: A distinct difference compared to men's health. Even in developed countries , pregnancy and childbirth are associated with substantial risks to women with maternal mortality accounting for more than a quarter of a million deaths per year, with large gaps between the developing and developed countries. Comorbidity from other non-reproductive diseases such as cardiovascular disease contribute to both

1024-512: A financial burden and in developing countries where menstruation can be an impediment to a girl's education. In the Middle East and North Africa , period poverty and stigma have an influence on girls' education and general well-being. Misinformation and a lack of fundamental knowledge cause girls to miss school during their menstrual cycle and contribute to the prevailing stigma around getting your period. Equally challenging for women are

1152-609: A gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and Mexico . (see also international comparisons .) In the United States , where around 18% of GDP is spent on health care, the Commonwealth Fund analysis of spend and quality shows

1280-462: A girl's lack of choices. or abuse. Child marriage (see below) is a major contributor worldwide, since 90% of births to girls aged 15–19 occur within marriage. In 2013 about 289,000 women (800 per day) in the world died due to pregnancy-related causes, with large differences between developed and developing countries. In developed nations maternal mortality had been steadily falling and on average means 16 deaths per 100,000 live births, as measured by

1408-725: A global health priority because they have serious consequences for women and infants. Mother-to-child transmission of STIs can lead to stillbirths , neonatal death , low-birth-weight and prematurity , sepsis , pneumonia , neonatal conjunctivitis , and congenital deformities . Syphilis in pregnancy results in over 300,000 fetal and neonatal deaths per year, and 215,000 infants with an increased risk of death from prematurity, low-birth-weight or congenital disease. Diseases such as chlamydia and gonorrhoea are also important causes of pelvic inflammatory disease (PID) and subsequent infertility in women. Another important consequence of some STIs such as genital herpes and syphilis increase

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1536-403: A half of IVF pregnancies result in multiple-birth deliveries, which in turn are associated with an increase in both morbidity and mortality of the mother and the infant. Causes for this include increased maternal blood pressure, premature birth and low birth weight . In addition, more women are waiting longer to conceive and seeking ART. Child marriage (including union or cohabitation )

1664-828: A lack of bodily autonomy in the Arab world. According to data, the frequency of FGM among women between the ages of 15 and 49 is high: 94% in Djibouti, 87% in Egypt and Sudan, 19% in Yemen, and 7% in Iraq. FGC affects many religious faiths, nationalities, and socioeconomic classes and is highly controversial. The main arguments advanced to justify FGC are hygiene, fertility, the preservation of chastity , an important rite of passage , marriageability and enhanced sexual pleasure of male partners. The amount of tissue removed varies considerably, leading

1792-441: A licensed independent practitioner such as a physiotherapist , or a non-physician primary care provider such as a physician assistant or nurse practitioner . Depending on the locality and health system organization, the patient may see another health care professional first, such as a pharmacist or nurse . Depending on the nature of the health condition, patients may be referred for secondary or tertiary care. Primary care

1920-419: A major concern, health services often set up programs in schools aimed at educating children about nutritional eating habits, making physical education a requirement and teaching young adolescents to have a positive self-image. Health care ratings are ratings or evaluations of health care used to evaluate the process of care and health care structures and/or outcomes of health care services. This information

2048-459: A major problem in global health and is considered a sentinel event in judging the quality of health care systems. Adolescent pregnancy represents a particular problem, whether intended or unintended, and whether within marriage or a union or not. Pregnancy results in major changes in a girl's life, physically, emotionally, socially and economically and jeopardises her transition into adulthood. Adolescent pregnancy, more often than not, stems from

2176-583: A much larger focus on reproductive health than that of developed countries alone, but also infectious diseases such as malaria in pregnancy and non-communicable diseases (NCD). Many of the issues that face women and girls in resource poor regions are relatively unknown in developed countries, such as female genital cutting , and further lack access to the appropriate diagnostic and clinical resources. Pregnancy presents substantial health risks , even in developed countries, and despite advances in obstetrical science and practice. Maternal mortality remains

2304-442: A number of cultural factors that reinforce this practice. These include the child's financial future, her dowry , social ties and social status, prevention of premarital sex , extramarital pregnancy and STIs. The arguments against it include interruption of education and loss of employment prospects, and hence economic status, as well as loss of normal childhood and its emotional maturation and social isolation. Child marriage places

2432-400: A primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care , health education , and every time they require an initial consultation about a new health problem. The International Classification of Primary Care (ICPC)

2560-675: A process that Iris Young has called "internal exclusion", as opposed to "external exclusion", the barriers to access. This invisibility effectively masks the grievances of groups already disadvantaged by power inequity, further entrenching injustice. Behavioral differences also play a role, in which women display lower risk taking including consume less tobacco, alcohol, and drugs, reducing their risk of mortality from associated diseases, including lung cancer , tuberculosis and cirrhosis . Other risk factors that are lower for women include motor vehicle accidents . Occupational differences have exposed women to less industrial injuries , although this

2688-410: A result of disease or from medical or surgical intervention. When menopause occurs prematurely the adverse consequences may be more severe. Health care Health care , or healthcare , is the improvement of health via the prevention , diagnosis , treatment , amelioration or cure of disease , illness , injury , and other physical and mental impairments in people. Health care

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2816-633: A short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a hospital emergency department . Secondary care also includes skilled attendance during childbirth , intensive care , and medical imaging services. The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers, such as psychiatrists , clinical psychologists , occupational therapists , most dental specialties or physiotherapists , do not necessarily work in hospitals. Some primary care services are delivered within hospitals. Depending on

2944-989: A significant part of a country's economy , development, and industrialization . Health care is an important determinant in promoting the general physical and mental health and well-being of people around the world. An example of this was the worldwide eradication of smallpox in 1980, declared by the WHO, as the first disease in human history to be eliminated by deliberate healthcare interventions. The delivery of modern health care depends on groups of trained professionals and paraprofessionals coming together as interdisciplinary teams . This includes professionals in medicine , psychology , physiotherapy , nursing , dentistry , midwifery and allied health , along with many others such as public health practitioners , community health workers and assistive personnel , who systematically provide personal and population-based preventive, curative and rehabilitative care services. While

3072-433: A third of all health problems experienced by women during their reproductive years (aged 15–44), of which unsafe sex is a major risk factor, especially in developing countries. Reproductive health includes a wide range of issues including the health and function of structures and systems involved in reproduction, pregnancy , childbirth and child rearing, including antenatal and perinatal care. Global women's health has

3200-413: Is sexually active , including adolescents. In many parts of the world access to contraception and family planning services is very difficult or non existent and even in developed counties cultural and religious traditions can create barriers to access. Reported usage of adequate contraception by women has risen only slightly between 1990 and 2014, with considerable regional variability. Although global usage

3328-494: Is a standardized tool for understanding and analyzing information on interventions in primary care based on the reason for the patient's visit. Common chronic illnesses usually treated in primary care may include, for example, hypertension , diabetes , asthma , COPD , depression and anxiety , back pain , arthritis or thyroid dysfunction . Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations . In

3456-510: Is around 55%, it may be as low as 25% in Africa. Research shows that women in the Middle East and North Africa use contraception at low rates. Only 14% of women who completed a survey in Jordan said they used condoms with their spouses. Worldwide 222 million women have no or limited access to contraception . Some caution is needed in interpreting available data, since contraceptive prevalence

3584-413: Is being made in reducing child marriage, particularly for girls under fifteen, the prospects are daunting. The indicator for this will be the percentage of women aged 20–24 who were married or in a union before the age of eighteen. Efforts to end child marriage include legislation and ensuring enforcement together with empowering women and girls. To raise awareness, the inaugural UN International Day of

3712-696: Is commonest in South Asia (48% of women), Africa (42%) and Latin America and the Caribbean (29%). The highest prevalence is in Western and Sub-Saharan Africa. The percentage of girls married before the age of eighteen is as high as 75% in countries such as Niger . Approximately one in five young women in the Middle East and North Africa were married before becoming eighteen, and one in twenty-five married before turning fifteen. In Egypt , 17% of women in

3840-417: Is considered necessary, regardless of whether the funding is from private insurance schemes or national health insurance . Allied health professionals , such as physical therapists , respiratory therapists , occupational therapists , speech therapists , and dietitians , also generally work in secondary care, accessed through either patient self-referral or through physician referral. Tertiary care

3968-427: Is defined as marriage under the age of eighteen and is an ancient custom. In 2010 it was estimated that 67 million women, then, in their twenties had been married before they turned eighteen, and that 150 million would be in the next decade, equivalent to 15 million per year. This number had increased to 70 million by 2012. In developing countries one third of girls are married under age, and 1:9 before 15. The practice

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4096-544: Is defined as the "area for study, research and practice that places a priority on improving health and achieving health equity for all people worldwide". In 2015 the World Health Organization identified the top ten issues in women's health as being cancer, reproductive health, maternal health, human immunodeficiency virus (HIV), sexually transmitted infections, violence, mental health, non communicable diseases, youth and aging. Women's life expectancy

4224-644: Is delivered by health professionals and allied health fields . Medicine , dentistry , pharmacy , midwifery , nursing , optometry , audiology , psychology , occupational therapy , physical therapy , athletic training , and other health professions all constitute health care. The term includes work done in providing primary care , secondary care , tertiary care , and public health . Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions and health policies . Providing health care services means "the timely use of personal health services to achieve

4352-416: Is estimated that 10–20 million women will develop physical or mental disability every year, resulting from complications of pregnancy or inadequate care. Consequently, international agencies have developed standards for obstetric care. Of near miss events, obstetrical fistulae (OF), including vesicovaginal and rectovaginal fistulae , remain one of the most serious and tragic. Although corrective surgery

4480-610: Is greater than that of men, and they have lower death rates throughout life, regardless of race and geographic region. Historically though, women had higher rates of mortality, primarily from maternal deaths (death in childbirth). In industrialised countries, particularly the most advanced, the gender gap narrowed and was reversed following the Industrial Revolution . Despite these differences, in many areas of health, women experience earlier and more severe disease, and experience poorer outcomes. Despite these differences,

4608-450: Is influenced not just by their biology but also by conditions such as poverty , employment, and family responsibilities. Women have long been disadvantaged in many respects such as social and economic power which restricts their access to the necessities of life including health care , and the greater the level of disadvantage, such as in developing countries, the greater adverse impact on health. Women's reproductive and sexual health has

4736-530: Is likely to change, as is risk of injury or death in war. Overall such injuries contributed to 3.5% of deaths in women compared to 6.2% in the United States in 2009. Suicide rates are also less in women. The social view of health combined with the acknowledgement that gender is a social determinant of health inform women's health service delivery in countries around the world. Women's health services such as Leichhardt Women's Community Health Centre which

4864-450: Is located on the same site as McMaster Children's Hospital (Mac Kids). The McMaster Medical Center site is equipped with an offsite helipad for quicker patient transfer to the hospital. This Helipad was built to allow for quicker and safer transfers to hospitals. The building itself is a brutalist structure designed by Eb Zeidler and opened in 1969. Controversial for its design and appropriation of Royal Botanical Gardens land, in 2014

4992-512: Is of particular concern due to widespread discrimination against women in the world, leaving them disadvantaged . A number of health and medical research advocates, such as the Society for Women's Health Research in the United States, support this broader definition, rather than merely issues specific to human female anatomy to include areas where biological sex differences between women and men exist. Women also need health care more and access

5120-416: Is often defined as "the percentage of women currently using any method of contraception among all women of reproductive age ( i.e. , those aged 15 to 49 years, unless otherwise stated) who are married or in a union. The "in-union" group includes women living with their partner in the same household and who are not married according to the marriage laws or customs of a country." This definition is more suited to

5248-574: Is often used as the term for the health care services that play a role in the local community. It can be provided in different settings, such as Urgent care centers that provide same-day appointments or services on a walk-in basis. Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health , and patients with all types of acute and chronic physical, mental and social health issues, including multiple chronic diseases . Consequently,

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5376-498: Is possible it is often not available and OF is considered completely preventable. If repaired, subsequent pregnancies will require cesarean section. While unusual in developed countries, it is estimated that up to 100,000 cases occur every year in the world, and that about 2 million women are currently living with this condition, with the highest incidence occurring in Africa and parts of Asia. OF results from prolonged obstructed labor without intervention, when continued pressure from

5504-505: Is seen from the analysis carried out each year by Bloomberg. Clearly this kind of analysis is flawed in that life expectancy is only one measure of a health system's performance, but equally, the notion that more funding is better is not supported. In 2011, the health care industry consumed an average of 9.3 percent of the GDP or US$ 3,322 ( PPP-adjusted ) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508),

5632-622: Is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly specialized and not widely accessed. Experimental medicine and some types of uncommon diagnostic or surgical procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centers. Many types of health care interventions are delivered outside of health facilities. They include many interventions of public health interest, such as food safety surveillance, distribution of condoms and needle-exchange programs for

5760-545: Is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital . Examples of tertiary care services are cancer management, neurosurgery , cardiac surgery , plastic surgery , treatment for severe burns , advanced neonatology services, palliative, and other complex medical and surgical interventions. The term quaternary care

5888-521: Is the legal age of marriage. Organizations with campaigns to end child marriage include the United Nations and its agencies, such as the Office of the High Commissioner for Human Rights , UNFPA, UNICEF and WHO. Like many global issues affecting women's health, poverty and gender inequality are root causes , and any campaign to change cultural attitudes has to address these. Child marriage

6016-460: Is the proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care (p. 31). There remain significant barriers to accessing contraception for many women in both developing and developed regions. These include legislative, administrative, cultural, religious and economic barriers in addition to those dealing with access to and quality of health services. Much of

6144-642: Is the subject of international conventions and agreements such as The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW, 1979) (article 16) and the Universal Declaration of Human Rights and in 2014 a summit conference ( Girl Summit ) co-hosted by UNICEF and the UK was held in London (see illustration) to address this issue together with FGM/C. Later that same year

6272-414: Is translated into report cards that are generated by quality organizations, nonprofit, consumer groups and media. This evaluation of quality is based on measures of: Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies . Providing health care services means "the timely use of personal health services to achieve

6400-436: Is vital to a woman's autonomy and well-being, and contraception can protect girls and young women from the risks of early pregnancy and older women from the increased risks of unintended pregnancy. Adequate access to contraception can limit multiple pregnancies, reduce the need for potentially unsafe abortion and reduce maternal and infant mortality and morbidity. Some barrier forms of contraception such as condoms , also reduce

6528-557: The Dalkon Shield . Abortion is the intentional killing of an unborn child, as compared to spontaneous termination ( miscarriage ). Abortion is closely allied to contraception in terms of women's control and regulation of their reproduction, and is often subject to similar cultural, religious, legislative and economic constraints. Where access to contraception is limited, women turn to abortion. Consequently, abortion rates may be used to estimate unmet needs for contraception. However

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6656-659: The General Assembly of the United Nations passed a resolution, which inter alia Urges all States to enact, enforce and uphold laws and policies aimed at preventing and ending child, early and forced marriage and protecting those at risk, and ensure that marriage is entered into only with the informed, free and full consent of the intending spouses (5 September 2014) Amongst non-governmental organizations (NGOs) working to end child marriage are Girls not Brides, Young Women's Christian Association (YWCA),

6784-619: The Global Industry Classification Standard and the Industry Classification Benchmark , health care includes many categories of medical equipment, instruments and services including biotechnology , diagnostic laboratories and substances, drug manufacturing and delivery. For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States. The United States dominates

6912-544: The International Center for Research on Women (ICRW) and Human Rights Watch (HRW). Although not explicitly included in the original Millennium Development Goals, considerable pressure was applied to include ending child marriage in the successor Sustainable Development Goals adopted in September 2015, where ending this practice by 2030 is a target of SDG 5 Gender Equality (see above). While some progress

7040-470: The MENA region perpetuate gender-based power dynamics within communities and lead to discrepancies in healthcare access. In a speech, UNFPA executive director Thoraya Ahmed Obaid outlined these difficulties and emphasized the need to change cultural and societal norms in order to improve the health of women in the area. Even after succeeding in accessing health care, women have been discriminated against,

7168-556: The Netherlands (11.9%, 5,099), France (11.6%, 4,118), Germany (11.3%, 4,495), Canada (11.2%, 5669), and Switzerland (11%, 5,634) were the top spenders, however life expectancy in total population at birth was highest in Switzerland (82.8 years), Japan and Italy (82.7), Spain and Iceland (82.4), France (82.2) and Australia (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years,

7296-481: The biopharmaceutical field, accounting for three-quarters of the world's biotechnology revenues. The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the medical model of health which focuses on the eradication of illness through diagnosis and effective treatment. Many important advances have been made through health research, biomedical research and pharmaceutical research , which form

7424-503: The maternal mortality ratio (MMR). By contrast rates as high as 1,000 deaths per 100,000 live births are reported in the rest of the world, with the highest rates in Sub-Saharan Africa and South Asia , which account for 86% of such deaths. These deaths are rarely investigated, yet the World Health Organization considers that 99% of these deaths, the majority of which occur within 24 hours of childbirth, are preventable if

7552-536: The social model of health and disability , which emphasizes the societal changes that can be made to make populations healthier. Results from health services research often form the basis of evidence-based policy in health care systems. Health services research is also aided by initiatives in the field of artificial intelligence for the development of systems of health assessment that are clinically useful, timely, sensitive to change, culturally sensitive , low-burden, low-cost, built into standard procedures, and involve

7680-409: The urethra and introitus, with or without excision of the clitoris ( infibulation ). In this type a small opening is created to allow urine and menstrual blood to be discharged. Type 4 involves all other procedures, usually relatively minor alterations such as piercing . While defended by those cultures in which it constitutes a tradition, FGC is opposed by many medical and cultural organizations on

7808-468: The 2014 Girl Summit (see below). In addition the likely pregnancies at a young age are associated with higher medical risks for both mother and child, multiple pregnancies and less access to care with pregnancy being amongst the leading causes of death amongst girls aged 15–19. Girls married under age are also more likely to be the victims of domestic violence . There has been an international effort to reduce this practice, and in many countries eighteen

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7936-690: The 20–24 age group, 13% in Morocco , 28% in Iraq , 8% in Jordan , 6% in Lebanon , and 3% in Algeria were married or engaged before turning 18. Most child marriage involves girls. For instance in Mali the ratio of girls to boys is 72:1, while in countries such as the United States the ratio is 8:1. Marriage may occur as early as birth, with the girl being sent to her husbands home as early as age seven. There are

8064-473: The Girl Child in 2012 was dedicated to ending child marriage. Women's menstrual cycles, the approximately monthly cycle of changes in the reproductive system, can pose significant challenges for women in their reproductive years (the early teens to about 50 years of age). These include the physiological changes that can effect physical and mental health, symptoms of ovulation and the regular shedding of

8192-470: The MENA region. Women in the MENA region are more vulnerable to HIV because of gender inequity, gender-based violence , and restricted access to comprehensive healthcare systems. Female genital mutilation (also referred to as female genital cutting) is defined by the World Health Organization (WHO) as "all procedures that involve partial or total removal of the external female genitalia , or other injury to

8320-483: The MMR and 5.2 the proportion of deliveries attended by skilled health personnel (physician, nurse or midwife). Early reports indicated MDG 5 had made the least progress of all MDGs. By the target date of 2015 the MMR had only declined by 45%, from 380 to 210, most of which occurred after 2000. However this improvement occurred across all regions, but the highest MMRs were still in Africa and Asia, although South Asia witnessed

8448-603: The MMR is highest, the risk is 175 times higher. In setting the MDG targets, skilled assisted birth was considered a key strategy, but also an indicator of access to care and closely reflect mortality rates. There are also marked differences within regions with a 31% lower rate in rural areas of developing countries (56 vs. 87%), yet there is no difference in East Asia but a 52% difference in Central Africa (32 vs. 84%). With

8576-623: The McMaster Medical Centre was designated a landmark by the Ontario Association of Architects . Women%27s health Women's health differs from that of men's health in many unique ways. Women's health is an example of population health , where health is defined by the World Health Organization (WHO) as "a state of complete physical, mental and social well-being and not merely

8704-824: The Population Division of the UN Department of Economic and Social Affairs . Contraceptive use was part of Goal 5B (universal access to reproductive health), as Indicator 5.3. The evaluation of MDG5 in 2015 showed that amongst couples usage had increased worldwide from 55% to 64%. with one of the largest increases in Subsaharan Africa (13 to 28%). The corollary, unmet need, declined slightly worldwide (15 to 12%). In 2015 these targets became part of SDG5 (gender equality and empowerment) under Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights, where Indicator 5.6.1

8832-459: The United Nations considers access to contraception a human right that is central to gender equality and women's empowerment that saves lives and reduces poverty, and birth control has been considered amongst the 10 great public health achievements of the 20th century. To optimise women's control over pregnancy, it is essential that culturally appropriate contraceptive advice and means are widely, easily, and affordably available to anyone that

8960-522: The United States, infertility affects 1.5 million couples. The rates of infertility in the Middle East and North Africa (MENA) are difficult to measure due to varying definitions of the condition. When infertility is defined as failure to have a successful birth, the MENA region has a very high rate at 33%. Morocco has the highest percentage of infertility among the MENA countries with an infertility rate of 56.8%. Rates of infertility, defined as failure to conceive (clinical infertility), are probably lower in

9088-416: The United States, the 2013 National Health Interview Survey found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician. In the United States, primary care physicians have begun to deliver primary care outside of

9216-476: The United States, the leading causes of maternal death are cardiovascular disease (15% of deaths), endocrine, respiratory and gastrointestinal disorders, infection , hemorrhage and hypertensive disorders of pregnancy (Gronowski and Schindler, Table II). In 2000, the United Nations created Millennium Development Goal (MDG) 5 to improve maternal health. Target 5A sought to reduce maternal mortality by three quarters from 1990 to 2015, using two indicators , 5.1

9344-470: The WHO and other bodies to classify FGC into four types. These range from the partial or total removal of the clitoris with or without the prepuce ( clitoridectomy ) in Type I, to the additional removal of the labia minora , with or without excision of the labia majora (Type II) to narrowing of the vaginal orifice ( introitus ) with the creation of a covering seal by suturing the remaining labial tissue over

9472-471: The ability to recognise medical emergencies. The direct causes of these maternal deaths are hemorrhage , eclampsia , obstructed labor , sepsis and unskilled abortion . In addition malaria and AIDS can also endanger pregnancy. In the period 2003–2009 hemorrhage was the leading cause of death, accounting for 27% of deaths in developing countries and 16% in developed countries. Non-reproductive health remains an important predictor of maternal health. In

9600-407: The absence of disease or infirmity". Often treated as simply women's reproductive health , many groups argue for a broader definition pertaining to the overall health of women, better expressed as "The health of women". These differences are further exacerbated in developing countries where women, whose health includes both their risks and experiences, are further disadvantaged. While the rates of

9728-470: The absence of disease or infirmity". Women's health is an example of population health , the health of a specific defined population. Women's health has been described as "a patchwork quilt with gaps". Although many of the issues around women's health relate to their reproductive health , including maternal and child health, genital health and breast health , and endocrine ( hormonal ) health, including menstruation , birth control and menopause ,

9856-405: The appropriate infrastructure, training, and facilities were in place. In these resource-poor countries, maternal health is further eroded by poverty and adverse economic factors which impact the roads, health care facilities, equipment and supplies in addition to limited skilled personnel. Other problems include cultural attitudes towards sexuality, contraception, child marriage , home birth and

9984-707: The attention has been focused on preventing adolescent pregnancy. The Overseas Development Institute (ODI) has identified a number of key barriers, on both the supply and demand side , including internalising socio-cultural values, pressure from family members, and cognitive barriers (lack of knowledge), which need addressing. Even in developed regions many women, particularly those who are disadvantaged , may face substantial difficulties in access that may be financial and geographic but may also face religious and political discrimination. Women have also mounted campaigns against potentially dangerous forms of contraception such as defective intrauterine devices (IUD)s, particularly

10112-514: The availability of antibiotics , oxytocics , anticonvulsants , the ability to manually remove a retained placenta , perform instrumented deliveries , and postpartum care that is financially accessible, such as through insurance. Research has shown the most effective programmes are those focussing on patient and community education, prenatal care, emergency obstetrics (including access to cesarean sections ) and transportation. As with women's health in general, solutions to maternal health require

10240-701: The available procedures have carried great risk for women throughout most of history, and still do in the developing world, or where legal restrictions force women to seek clandestine facilities . Access to safe legal abortion places undue burdens on lower socioeconomic groups and in jurisdictions that create significant barriers. These issues have frequently been the subject of political and feminist campaigns where differing viewpoints pit health against moral values. Globally, there were 87 million unwanted pregnancies in 2005, of those 46 million resorted to abortion, of which 18 million were considered unsafe, resulting in 46,068,000 deaths. The majority of these deaths occurred in

10368-662: The basis for evidence-based medicine and evidence-based practice in health care delivery. Health care research frequently engages directly with patients, and as such issues for whom to engage and how to engage with them become important to consider when seeking to actively include them in studies. While single best practice does not exist, the results of a systematic review on patient engagement suggest that research methods for patient selection need to account for both patient availability and willingness to engage. Health services research can lead to greater efficiency and equitable delivery of health care interventions, as advanced through

10496-501: The best possible health outcomes". Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy , low income). Limitations to health care services affect negatively

10624-502: The best possible health outcomes". Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy , low income). Limitations to health care services affects negatively

10752-665: The childbearing years. If a woman survives this period, the differences between the two regions become less marked, since in later life non-communicable diseases (NCDs) become the major causes of death in women throughout the world, with cardiovascular deaths accounting for 45% of deaths in older women, followed by cancer (15%) and lung disease (10%). These create additional burdens on the resources of developing countries. Changing lifestyles, including diet, physical activity and cultural factors that favour larger body size in women, are contributing to an increasing problem with obesity and diabetes amongst women in these countries and increasing

10880-690: The completion of the MDG campaign in 2015, new targets are being set for 2030 under the Sustainable Development Goals campaign. Maternal health is placed under Goal 3, Health, with the target being to reduce the global maternal mortality ratio to less than 70. Amongst tools being developed to meet these targets is the WHO Safe Childbirth Checklist. Improvements in maternal health, in addition to professional assistance at delivery, will require routine antenatal care, basic emergency obstetric care, including

11008-539: The composite female genital mutilation/cutting (FMG/C). It has affected more than 200 million women and girls who are alive today. The practice is concentrated in some 30 countries in Africa, the Middle East and Asia. Female genital mutilation is still common, impacting around 50 million women and girls in the five countries of Yemen , Egypt , Sudan , Djibouti , and Iraq in the Middle East and North Africa (MENA) region, as adolescent women frequently experience

11136-470: The context of global population aging , with increasing numbers of older adults at greater risk of chronic non-communicable diseases , rapidly increasing demand for primary care services is expected in both developed and developing countries. The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy. Secondary care includes acute care : necessary treatment for

11264-646: The country. The McMaster University Medical Centre is the largest facility located at McMaster University. It is a multi-use research hospital that ranks among the largest public buildings in Canada. It is connected to the Life Sciences Building and the Michael DeGroote Centre for Learning & Discovery, which houses many well-funded research groups in areas of genetics , infectious diseases and several specific conditions. MUMC

11392-438: The definitions of the various types of health care vary depending on the different cultural , political, organizational, and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process and may also include the provision of secondary and tertiary levels of care. Health care can be defined as either public or private . Primary care refers to

11520-687: The developing world. The United Nations considers these avoidable with access to safe abortion and post-abortion care. While abortion rates have fallen in developed countries, but not in developing countries. Between 2010 and 2014 there were 35 abortions per 1000 women aged 15–44, a total of 56 million abortions per year. The United nations has prepared recommendations for health care workers to provide more accessible and safe abortion and post-abortion care. An inherent part of post-abortion care involves provision of adequate contraception. Important sexual health issues for women include Sexually transmitted infections (STIs) and female genital cutting (FGC). STIs are

11648-550: The female genital organs for non-medical reasons". It has sometimes been referred to as female circumcision , although this term is misleading because it implies it is analogous to the circumcision of the foreskin from the male penis. Consequently, the term mutilation was adopted to emphasise the gravity of the act and its place as a violation of human rights. Subsequently, the term cutting was advanced to avoid offending cultural sensibility that would interfere with dialogue for change. To recognise these points of view some agencies use

11776-452: The fetus in the birth canal restricts blood supply to the surrounding tissues, with eventual fetal death , necrosis and expulsion. The damaged pelvic organs then develop a connection (fistula) allowing urine or feces, or both, to be discharged through the vagina with associated urinary and fecal incontinence , vaginal stenosis , nerve damage and infertility. Severe social and mental consequences are also likely to follow, with shunning of

11904-430: The girl in a relationship where she is in a major imbalance of power and perpetuates the gender inequality that contributed to the practice in the first place. Also in the case of minors, there are the issues of human rights, non-consensual sexual activity and forced marriage and a 2016 joint report of the WHO and Inter-Parliamentary Union places the two concepts together as Child, Early and Forced Marriage (CEFM), as did

12032-422: The grounds that it is unnecessary and harmful. Short-term health effects may include hemorrhage, infection, sepsis, and even result in death, while long term effects include dyspareunia , dysmenorrhea , vaginitis and cystitis . In addition FGC leads to complications with pregnancy, labor and delivery. Reversal (defibulation) by skilled personnel may be required to open the scarred tissue. Amongst those opposing

12160-524: The growth, development and health of women. The life course perspective is one of the key strategies of the World Health Organization. Gender differences in susceptibility and symptoms of disease and response to treatment in many areas of health are particularly true when viewed from a global perspective . Much of the available information comes from developed countries , yet there are marked differences between developed and developing countries in terms of women's roles and health. The global viewpoint

12288-406: The health care system more than do men. While part of this is due to their reproductive and sexual health needs, they also have more chronic non-reproductive health issues such as cardiovascular disease , cancer , mental illness , diabetes and osteoporosis . Another important perspective is realising that events across the entire life cycle (or life-course ), from in utero to aging effect

12416-644: The health of women compared to men are most evident in those related to reproduction , but sex differences have been identified from the molecular to the behavioral scale. Some of these differences are subtle and difficult to explain, partly due to the fact that it is difficult to separate the health effects of inherent biological factors from the effects of the surrounding environment they exist in. Women's XX sex chromosomes compliment, hormonal environment, as well as sex-specific lifestyles, metabolism, immune system function, and sensitivity to environmental factors are believed to contribute to sex differences in health at

12544-465: The inner lining of the uterus ( endometrium ) accompanied by vaginal bleeding (menses or menstruation ). The onset of menstruation ( menarche ) may be alarming to unprepared girls and mistaken for illness. Menstruation can place undue burdens on women in terms of their ability to participate in activities, and access to menstrual aids such as tampons and sanitary pads . This is particularly acute amongst poorer socioeconomic groups where they may represent

12672-637: The largest fall, from 530 to 190 (64%). The smallest decline was seen in the developed countries, from 26 to 16 (37%). In terms of assisted births, this proportion had risen globally from 59 to 71%. Although the numbers were similar for both developed and developing regions, there were wide variations in the latter from 52% in South Asia to 100% in East Asia . The risks of dying in pregnancy in developing countries remains fourteen times higher than in developed countries, but in Sub-Saharan Africa, where

12800-448: The leading causes of death in the United States are remarkably similar for men and women, headed by heart disease , which accounts for a quarter of all deaths, followed by cancer , lung disease and stroke . While women have a lower incidence of death from unintentional injury and suicide , they have a higher incidence of dementia . The major differences in life expectancy for women between developed and developing countries lie in

12928-420: The leading causes of death, cardiovascular disease , cancer and lung disease , are similar in women and men, women have different experiences. Lung cancer has overtaken all other types of cancer as the leading cause of cancer related death in women, followed by breast cancer , colorectal , ovarian , uterine and cervical cancers. While smoking is the major cause of lung cancer, amongst nonsmoking women

13056-609: The levels of physiology, perception, and cognition. Women can have distinct responses to drugs and thresholds for diagnostic parameters. All of these necessitate caution in extrapolating information derived from biomarkers from one sex to the other. Young women and adolescents are at risk from STIs, pregnancy and unsafe abortion , while older women often have few resources and are disadvantaged with respect to men, and also are at risk of dementia and abuse, and generally poor health. Women experience many unique health issues related to reproduction and sexuality and these are responsible for

13184-526: The managed care (insurance-billing) system through direct primary care which is a subset of the more familiar concierge medicine . Physicians in this model bill patients directly for services, either on a pre-paid monthly, quarterly, or annual basis, or bill for each service in the office. Examples of direct primary care practices include Foundation Health in Colorado and Qliance in Washington. In

13312-410: The more restrictive concept of family planning , but omits the contraceptive needs of all other women and girls who are or are likely to be sexually active, are at risk of pregnancy and are not married or "in-union". Three related targets of MDG5 were adolescent birth rate, contraceptive prevalence and unmet need for family planning (where prevalence+unmet need = total need), which were monitored by

13440-413: The mortality and morbidity of pregnancy, including preeclampsia . Sexually transmitted infections have serious consequences for women and infants, with mother-to-child transmission leading to outcomes such as stillbirths and neonatal deaths , and pelvic inflammatory disease leading to infertility . In addition, infertility from many other causes, birth control , unplanned pregnancy , rape and

13568-651: The necessary goals in achieving the targets of the Millennium Development Goals, while the United Nations has declared ending FGC a target of the Sustainable Development Goals, and for February 6 to known as the International Day of Zero Tolerance for Female Genital Mutilation, concentrating on 17 African countries and the 5 million girls between the ages of 15 and 19 that would otherwise be cut by 2030. In

13696-514: The necessities of life including health care . Despite recent improvements in Western nations, women remain disadvantaged with respect to men. The gender gap in health is even more acute in developing countries where women are relatively more disadvantaged. In addition to gender inequity, there remain specific disease processes uniquely associated with being a woman which create specific challenges in both prevention and health care. Deeply ingrained cultural, religious, and patriarchal systems within

13824-400: The organization and policies of the national health system, patients may be required to see a primary care provider for a referral before they can access secondary care. In countries that operate under a mixed market health care system, some physicians limit their practice to secondary care by requiring patients to see a primary care provider first. This restriction may be imposed under

13952-544: The patient. There are generally five primary methods of funding health care systems : In most countries, there is a mix of all five models, but this varies across countries and over time within countries. Aside from financing mechanisms, an important question should always be how much to spend on health care. For the purposes of comparison, this is often expressed as the percentage of GDP spent on health care. In OECD countries for every extra $ 1000 spent on health care, life expectancy falls by 0.4 years. A similar correlation

14080-592: The physiological and emotional changes associated with the cessation of menses ( menopause or climacteric). While typically occurring gradually towards the end of the fifth decade in life marked by irregular bleeding the cessation of ovulation and menstruation is accompanied by marked changes in hormonal activity, both by the ovary itself ( oestrogen and progesterone ) and the pituitary gland ( follicle stimulating hormone or FSH and luteinizing hormone or LH). These hormonal changes may be associated with both systemic sensations such as hot flashes and local changes to

14208-577: The practice are local grassroots groups, and national and international organisations including WHO, UNICEF, UNFPA and Amnesty International . Legislative efforts to ban FGC have rarely been successful and the preferred approach is education and empowerment and the provision of information about the adverse health effects as well the human rights aspects. Progress has been made but girls 14 and younger represent 44 million of those who have been cut, and in some regions 50% of all girls aged 11 and younger have been cut. Ending FGC has been considered one of

14336-553: The prevention of transmissible diseases. They also include the services of professionals in residential and community settings in support of self-care , home care , long-term care , assisted living , treatment for substance use disorders among other types of health and social care services. Community rehabilitation services can assist with mobility and independence after the loss of limbs or loss of function. This can include prostheses , orthotics , or wheelchairs . Many countries are dealing with aging populations, so one of

14464-577: The priorities of the health care system is to help seniors live full, independent lives in the comfort of their own homes. There is an entire section of health care geared to providing seniors with help in day-to-day activities at home such as transportation to and from doctor's appointments along with many other activities that are essential for their health and well-being. Although they provide home care for older adults in cooperation, family members and care workers may harbor diverging attitudes and values towards their joint efforts. This state of affairs presents

14592-450: The promise of controlling these diseases. Other important health issues for women include cardiovascular disease, depression , dementia , osteoporosis and anemia . In 176 out of 178 countries for which records are available, there is a gender gap in favor of women in life expectancy . In Western Europe , this has been the case at least as far back as 1750. Gender remains an important social determinant of health , since women's health

14720-529: The region but there is a lack of data on the exact numbers. There is a dearth of research on clinical infertility in the MENA region, with the exception of Iran , which is attributed to a societal reluctance to discuss infertility openly. Many couples seek assisted reproductive technology (ART) for infertility. In the United States in 2010, 147,260 in vitro fertilization (IVF) procedures were carried out, with 47,090 live births resulting. In 2013 these numbers had increased to 160,521 and 53,252. However, about

14848-461: The reproductive tract such as reduced vaginal secretions and lubrication . While menopause may bring relief from symptoms of menstruation and fear of pregnancy it may also be accompanied by emotional and psychological changes associated with the symbolism of the loss of fertility and a reminder of aging and possible loss of desirability . While menopause generally occurs naturally as a physiological process it may occur earlier ( premature menopause ) as

14976-436: The risk of STIs and HIV infection. Access to contraception allows women to make informed choices about their reproductive and sexual health, increases empowerment, and enhances choices in education, careers and participation in public life. At the societal level, access to contraception is a key factor in controlling population growth , with resultant impact on the economy, the environment and regional development. Consequently,

15104-495: The risk of acquiring HIV by three-fold, and can also influence its transmission progression. Worldwide, women and girls are at greater risk of HIV/AIDS . STIs are in turn associated with unsafe sexual activity that is often unconsensual . In the Middle East and North Africa (MENA) , a large number of HIV-positive women contracted the virus from their spouses or partners. In comparison to men, taboos, and discrimination against women living with HIV are more pervasive throughout

15232-440: The risk of developing cancer is three times greater than among nonsmoking men. Despite this, breast cancer remains the most common cancer in women in developed countries, and is one of the major chronic diseases of women, while cervical cancer remains one of the most common cancers in developing countries, associated with human papilloma virus (HPV), a sexually transmitted infection . HPV vaccine together with screening offers

15360-455: The risks of cardiovascular disease and other NCDs. Women who are socially marginalised are more likely to die at younger ages than women who are not. Women who have substance abuse disorders, who are homeless, who are sex workers, and/or who are imprisoned have significantly shorter lives than other women. At any given age, women in these overlapping, stigmatised groups are approximately 10 to 13 times more likely to die than typical women of

15488-552: The same age. Women's health is positioned within a wider body of knowledge cited by, amongst others, the World Health Organization , which places importance on gender as a social determinant of health . While women's health is affected by their biology, it is also affected by their social conditions, such as poverty , employment, and family responsibilities, and these aspects should not be overshadowed. Women have traditionally been disadvantaged in terms of economic and social status and power, which in turn reduces their access to

15616-432: The struggle for access to abortion create other burdens for women. Women's experience of health and disease differ from those of men, due to unique biological, social and behavioral conditions. Biological differences vary from phenotypes to the cellular biology , and manifest unique risks for the development of ill health. WHO defines health as "a state of complete physical, mental and social well-being and not merely

15744-410: The terms of the payment agreements in private or group health insurance plans. In other cases, medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred. In other countries patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist)

15872-626: The use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). Health care extends beyond the delivery of services to patients, encompassing many related sectors, and is set within a bigger picture of financing and governance structures. A health system , also sometimes referred to as health care system or healthcare system , is the organization of people, institutions, and resources that deliver health care services to populations in need. The healthcare industry incorporates several sectors that are dedicated to providing health care services and products. As

16000-583: The use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). Health systems are the organizations established to meet the health needs of targeted populations. According to the World Health Organization (WHO), a well-functioning healthcare system requires a financing mechanism, a well-trained and adequately paid workforce , reliable information on which to base decisions and policies , and well-maintained health facilities to deliver quality medicines and technologies. An efficient healthcare system can contribute to

16128-664: The women. Apart from lack of access to care, causes include young age, and malnourishment . The UNFPA has made prevention of OF a priority and is the lead agency in the Campaign to End Fistula, which issues annual reports and the United Nations observes May 23 as the International Day to End Obstetric Fistula every year. Prevention includes discouraging teenage pregnancy and child marriage, adequate nutrition, and access to skilled care, including caesarean section. The ability to determine if and when to become pregnant,

16256-401: The work of health professionals who act as a first point of consultation for all patients within the health care system . The primary care model supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care. Such a professional would usually be a primary care physician , such as a general practitioner or family physician . Another professional would be

16384-489: Was established in 1974 and was the first women's health centre established in Australia is an example of women's health approach to service delivery. Women's health is an issue which has been taken up by many feminists , especially where reproductive health is concerned and the international women's movement was responsible for much of the adoption of agendas to improve women's health. Factors that specifically affect

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