Gender and Women Health Pinar Okyay MD Ph

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Gender and Women Health Pinar Okyay, MD, Ph. D Department of Public Health, School

Gender and Women Health Pinar Okyay, MD, Ph. D Department of Public Health, School of Medicine Adnan Menderes University, Aydin Turkey

“Have a son and your name continues!

“Have a son and your name continues!

“Last year only one girl child was born in our village. All other families

“Last year only one girl child was born in our village. All other families had sons” Kristof, Nicholas D. 1993. "Peasants of China discover new way to weed out girls. " The New York Times, 21 July, 1.

Today, the vast majority in Asia, I in different populations, 60 million girls at

Today, the vast majority in Asia, I in different populations, 60 million girls at least, otherwise expected to be alive, are missing due to gender selective abortion, infanticide or neglect.

Oomman N, Ganatra BR. , Sex selection: the systematic elimination of girls. Reprod Health

Oomman N, Ganatra BR. , Sex selection: the systematic elimination of girls. Reprod Health Matters. 2002 May; 10(19): 184 -8.

In CHINA: • 21 of 31 (%67. 7) provinces have higher ratio than 108.

In CHINA: • 21 of 31 (%67. 7) provinces have higher ratio than 108. 0 (expected sex ration at birth) • 40 million single men by 2020 Gu B, Roy K. Sex ratio at birth in China, with reference to other areas in East Asia: what we know. Asia Pac Popul J. 1995 Sep; 10(3): 17 -42.

Gender and Women Health • In many societies, women systematically fail to achieve or

Gender and Women Health • In many societies, women systematically fail to achieve or fail to use some basic human rights according to men. • Most of the time, women's health status and problems related to affect: – morbidity – disability – mortality DISCRIMINATION ALL THROUGH THE LIFE OF WOMEN

 • • • Violence • Social pressure • Increase in morbidity ADOLESENT/ADULT OLDERS

• • • Violence • Social pressure • Increase in morbidity ADOLESENT/ADULT OLDERS • Unwanted pregnancies, • Increase in STDs morbidity • Sexuel /problems on harassment/abuse quality of life • Turnpike sex • Smoking and substanve abuse Neglect Cannot benefit from the services CHILDHOOD • Sex selective abortion • Female mutilation • Nutrition problems

Female Genital Mutilation (FGM) • An estimated 100 to 140 million girls and women

Female Genital Mutilation (FGM) • An estimated 100 to 140 million girls and women worldwide are currently living with the consequences of FGM. • Each year 2 million girls at risk! WHO, Female Genital Mutilation The prevention and the management of the health complications Policy guidelines for nurses and midwives, 2001.

FGM / Problems • Obstetric • Menstruel • Phychological • Urinary • Other problems.

FGM / Problems • Obstetric • Menstruel • Phychological • Urinary • Other problems. . WHO, A systematic review of the health complications of female genital mutilation including sequelae in childbirth, 2001.

Violence and Women World scale: Today one of every 3 women are subjected to

Violence and Women World scale: Today one of every 3 women are subjected to different forms of violence. (Heise, Ellsberg, Gottemoeller, 1999).

Discrimination against women • ". . . any distinction, exclusion or restriction made on

Discrimination against women • ". . . any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field. " (UN, CEDAW-1994)

Violence Pandemia depends on gender • Researches from various countries between the years 1986

Violence Pandemia depends on gender • Researches from various countries between the years 1986 -1997: women within the percentage of 16 -41, were physically attacked by men with whom they had close relations. • Violence exposed is the 10 th cause of death in the 15 -44 age group women. • 7% of all women deaths in the world are associated with violence. WHO, 1998

Turkey • Domestic violence Of women; – 84% slap – 70% being punched –

Turkey • Domestic violence Of women; – 84% slap – 70% being punched – 43% being beated hard – 55% threatened with death • Home is the place violence most experienced. • In the violence acts, the aggresive is mostly husband or the man with close emotional relationships. CEDAW Report of Turkey-1993

Turkey • Turkey Demographic and Health Survey 2003: – The percentage of justification of

Turkey • Turkey Demographic and Health Survey 2003: – The percentage of justification of the thusband in hitting or beating his wife is 39%. • Rural 57% • Lower education level 62% – Reasons of the violence: Şiddet nedenleri: If she; • Burns the food • Argues with him • Refuses to have sex with him

Pablo Picasso/The Rape of the Sabin Women

Pablo Picasso/The Rape of the Sabin Women

In the World • Completed rape at least once during the life of women

In the World • Completed rape at least once during the life of women completed rape USA 14 -20% Canada: 40% • 12 -25 percent of all adult women have been specified that they were victims of rape or attempted rape. Koss et al. , 1997; Killpatrick et al. , 1992; Randall and Haskell, 1995

A systematic weapon : Rape • In South Africa every 83 second one woman

A systematic weapon : Rape • In South Africa every 83 second one woman is raped. A report by the U. N. (1996) • Special Rapporteur on Rwanda estimated that at least 250 000 women were raped during the genocide. • During the 1992 -1995 conflict in Bosnia-Herzegovina between 20 000 and 50 000 women were raped Integrated Regional Information Networks (IRIN) WHO, Sexuel violence in conflict setting and the risk of HIV, 2004.

Sexually Transmitted Disease • Young women know very little information on STDs and because

Sexually Transmitted Disease • Young women know very little information on STDs and because of the fear of being branded as sexual active they hardly try to learn information. • Woman equipping less power as a decision maker has resulted with late diagnosis and treatment.

Sex trade/tourism. . • 4 million people in sex abuse traffic is estimated in

Sex trade/tourism. . • 4 million people in sex abuse traffic is estimated in the world. • The revenue / year of organized criminal organizations is 7 billion dollars • 500, 000 women and children for the sex trade is estimated to infiltrate into European Union countries in 1995.

Older Ages and Women • The expected duration of life in our country, the

Older Ages and Women • The expected duration of life in our country, the birth (DIE-2000) -71. 0 years for women -66. 4 years for men • At least 35 countries in the world in the birth of the expected life span for women has reached 80 years. Women live average 6 -8 years more than men. (WHO)

Older Ages and Women • A long way with diseases. . Health care access

Older Ages and Women • A long way with diseases. . Health care access problems In our country, all illiterate population over 65 years is 24% and 74% are women. Elderly women than elderly men are poor and lack social protection.

Blindness • The most important reason for blindness is cataracts, and according to the

Blindness • The most important reason for blindness is cataracts, and according to the results of studies in five countries, 53 -72% of all with cataracs are women. • Blindness connected to cataract may be reduced at a rate of 12. 5% if only women and men have the same operation rates. Abou-Garaeb, Lewallen, Bassett Courtright. Gender and Blindness: a metaanalysis of population based prevalence surveys. Ophthalmic epidemiology 2001; 8: 39 -56.

In Disaster • Women, with lower rates of education and years of education, more

In Disaster • Women, with lower rates of education and years of education, more work at home, • at disaster their preparedness and education are less, • they have little information about the preparation and risk approach.

 • Target: Gender Equality • Strategy: Gender mainstreaming

• Target: Gender Equality • Strategy: Gender mainstreaming

Equity in Health • The Convention on the Elimination of All Forms of Discrimination

Equity in Health • The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)-1979 / Turkey 1985 • Madrid-2001 – Political and technical process – Health systems should be settled identfying of men and women biological differences and gender – Gender-related evaluation indicators should be identified and data shoul be collected – Research on gender must be supported

What we know about gender on the women health Key word: “gender” Turkish MEDLINE:

What we know about gender on the women health Key word: “gender” Turkish MEDLINE: 14 Ulaknet National Medicine dizini: 3 Key words: “gender identity AND women” Pub. Med: 1019 METHOD: Gender Analysis

Atatürk, Founder of the Modern Turkey; Thank you. .

Atatürk, Founder of the Modern Turkey; Thank you. .