Padmini Murthy MD,MPH,MS, CHES
Asst Prof Dept of Health Policy and Management
Asst Prof Dept Family and Community Medicine Global Health Program Director NYMC
Medical Women's International Association Representative to the United Nations
HEALTHY WOMEN and GIRLS: GATEWAY TO A HEALTHY WORLD United Nations
May 2009
Introduction
 Globalization has changed the fabric of society, while the
health and human rights of women are remaining stagnant
or growing worse in many parts of the world. Some of what
the statistics document is so ugly as to seem incompatible
with the word civilization. Women in this day and age are
denied their fundamental right to enjoy a complete state of
heath as defined by the World Health Organization.
A Portrait of Women
 Women in developing countries face a
number of challenges to their health and
well-being
 Over half a million women die each year from
complications during pregnancy and
childbirth, the vast majority of them in Africa
and Asia. (1)
 This includes nearly 70,000 deaths from
unsafe abortion
Portrait of Women in Developing
Countries
 More women than ever before are being affected by
AIDS.
 Globally, nearly 16 million women are living with
HIV and constitute almost half (48%) of all HIVpositive adults (2)
 Fundamentally, these health problems are a
reflection of the inequalities of power that exist
between women and men in many societies around
the world
Women’s Health and Human Rights
 Globally women’s health issues and human
rights have been neglected by various
stakeholders, and this has translated into an
increased incidence of women’s mortality and
morbidity
Impact of Violence Against women
 The direct and indirect impact of violence
and gender discrimination against women
and girls often cannot be measured; however,
the resulting economic burden on the society
is enormous
Staggering Statistics
 According to studies, between 10% and 69%
of women report having been assaulted by an
intimate male partner at some time in their
lives.(3)
 A study conducted by Buvinic, Morrison, and
Shifter found that in Latin America the
proportion of women who were assaulted by
their partners is between 10% and 35%, while
in sub-Saharan Africa, it is between 13% and
45 %(3)
Classification of Violence
 Physical violence
 Sexual violence
 Psychological and emotional violence (including
coercive tactics)
 Threats of physical or sexual violence
Examples of Gender Based Violence
 Prebirth—Sex-selective abortion
 Infancy—Female infanticide, physical abuse,
neglect, poor nutrition, and lack of immunization
and medical care
 Girlhood—Child marriage, female genital mutilation
(FGM), trafficking, child prostitution, sexual abuse,
poor nutrition, lack of immunizations and medical
care, and minimal or lack of educational
opportunities(3,4)
Examples of Gender Based Violence
 Adolescence—Forced marriages, date rape, FGM, limited or lack of
social interaction, acid throwing, dowry deaths, sexual harassment
at school and workplace, mass rape during war and civil unrest,
lack of safe motherhood facilities, and forced prostitution and
trafficking. Other types of violence include economic and social
discrimination
 Young and middle aged women—Intimate partner abuse, marital
rape, dowry abuse, psychological and sexual abuse of women at the
workplace, rape, widow abuse, and lack of access to health care
including access to safe motherhood facilities
 Elderly women—Physical and mental abuse of elderly woman and
widows including rape and neglect (3,4)
Culturally Accepted Forms of
Violence
 Female Genital mutilation
 Dowry Harassment
 Acid throwing
 Practice of Sati
 chimutsa mapfiwa or wife inheritance
 Widow cleansing
Culturally Accepted Forms of
Violence
 Honor Killings
 Widow confinement
 Child marriages
 Forced marriages
Physical consequences of
violence
 Injuries to the abdomen and thorax, which can result
in damage to the tissues and vital organs such as the
heart, lungs and spleen
 Bruises, welts, contusions, and fractures
 Bleeding or hemorrhage (internal and external)
 1st-, 2nd-, or 3rd-degree burns
 Chronic pain and chronic fatigue syndromes
 Fibromyalgia (6,7)
Physical and Physiologocial
consequences of violence
 Functional and organic gastrointestinal disorders
 Reduced physical movements and body functions
 Ocular damage(6,7)
Psychological impact of violence
 Depression and anxiety
 Eating and sleep disorders
 Feelings of shame and guilt
 Phobias and panic disorder
 Physical inactivity
 Poor self-esteem
Effects of Violence on
Reproductive and infant health
 Unwanted or Unintended Pregnancies
 Unsafe and Forced Abortions
 Maternal complications : abruptio placenta
 Fetal complications: low birth weight,
intrauterine death
 Sexually transmitted disease
 Chronic pelvic pain
Strategies to address gender
based violence
 Male involvement and input when
implementing programs to prevent violence
against women has shown to be effective.
 Treatment programs for abusers
 Women Police Stations
 Stringent punishment for abusers
Universal Declaration of Human
Rights and Women’s Health
 Universal Declaration of Human Rights, adopted by
the United Nations (UN) in 1948, states that
“Everyone has the right to a standard of living
adequate for the health and well-being of himself
and of his family,” and “Motherhood and childhood
are entitled to special care and assistance (8)
Strategies to address gender
based violence
 Educating boys from childhood that violence
against women is an offence and a violation
of human rights is an important step in
designing preventive strategies.
 It is important to educate communities that
women are not chattel or movable property
but individuals who need to be valued and
not abused
Strategies to address gender based
violence
 Health care professionals should have the courage
to refuse to accept laws that infringe on human
rights of women
 Culturally sensitive programming is essential to a
human rights-based approach –a necessary
paradigm to holistically address both issues of
women’s health and human rights, especially gender
equality.
Strategies to address gender
based violence
 When applied in a culturally sensitive manner, human
rights principles are more effective in promoting
dignity and social justice for clients and providers at the
levels of clinical operations, facility management,
service delivery , national and international policy
Strategies to address gender based
violence
 Strategies to improve women’s health must be
incorporated into the principles of human rights
and gender equality and equity.
 Policy makers, politicians should be made aware of
the devastating impact certain policies laws can
have on women’s health and human rights ( ex:
Global Gag Rule)
Peace Women and Human Rights
 Women constitute 50% of the global population, but
their participation and full engagement in building
sustainable peace at national, regional, and global
levels still remains rather minimal.
 Though in nearly every country and region of the
world, we can point to areas in which there has been
some progress in achieving gender equality and
women's empowerment, that progress has been
uneven and the gains remain fragile. Virtually
nowhere are women’s rights given the priority they
deserve. “ ( Ambr A.K. Chowdhury)
Conclusion
 We have to mobilize global outrage - to challenge
the violence, support those women who suffer and
put pressure on those who can bring about change “(
Unknown – Amnesty international
References
 1.Singh S, Darroch JE, Vlassoff M, Nadeau J. Adding it up: the benefits of
investing in sexual and reproductive health care. 2003.
http://www.guttmacher.org/pubs/addingitup.pdf
2.UNAIDS. 2007 Report on the Global AIDS Epidemic
 3. International Center for Research on Women. Violence against women must
stop. 2005. http://www.icrw.org/docs/2005_brief_mdg-violence.pdf
 4. Interactive Population Centre. Violence against girls and women.
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http://www.unfpa.org/intercenter/violence/intro.htm
5. United Nations Children’s Emergency Fund. Domestic violence against women and girls.
June 2000. http://www.unicef-irc.org/publications/pdf/digest6e.pdf
6. World Health Organization. World report on violence and health. 2002.
7.United Nations Children’s Emergency Fund. Child protection from violence, exploitation
and abuse. http://www.unicef.org/protection/index_27374.ht8
8.Universal Declaration of Human Rights, Article 25. 1948.
http://www.un.org/Overview/rights.html