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Women's health in Ethiopia can be broken down into several sections: general health status, women's status, maternal health, HIV, harmful traditional practices, and violence against women.
Ethiopia is the oldest independent and second most-populous country in Africa. A projection from the 2007 census, it has a total of 90 million inhabitants in 2015 (CSA 2015). [1]
The sex ratio between male and female is almost equal; women in the reproductive age group constitute 23.4% of the population. The total fertility rate declined from 5.5 in 2000 to 4.1 in 2014. [2]
The average life expectancy for an Ethiopian has increased from 45 years in 1990 to 64 years in 2014, which is higher than the African average (58 years) but lower than the global average of 70 years. [3] This makes Ethiopia one of the six countries that made top individual gains since 1990. The achievement is attributed to the dramatic drop in the under five mortality (U5MR) and an improvement in other socio-economic determinants of health. The U5MR has dropped from 204/1000 live births in 1990 to 64/1000 live births in 2013, the target for achieving MDG4 being 67/1000 live births. Thus Ethiopian has achieved the MDG 4 by the year 2013 well ahead of the proposed time for 2015.[ citation needed ]
In Ethiopia, women of reproductive age constitute about a quarter of the entire population of 90 million. Around 80% of the labor force is engaged in agriculture, and 84% live in rural parts of the country. Poverty is multidimensional, and its impact is different on men and women. 43% of rural women aged 10 years and above are economically active, mostly in agriculture.
Good progress has been registered in maternal mortality reduction, a 69% reduction according to UN estimates from the 1400/100000 live births in 1990 to 420/100,000 live births in 2013. [2]
Maternal wellbeing is crucial for the nations development. Majority of maternal deaths occur in the peripartum period. Deliveries attended by a skilled health care provider were shown to improve both maternal and neonatal survival. In Ethiopian most of the deliveries occur at home and unattended by skilled provider[ citation needed ]
Obstetric fistulas remains a leading health concern for women throughout Ethiopia.The ending of obstetric fistulas has been named as a Sustainable development need for Ethiopia and a plan is in place with an achievement goal of 2030. It has been found that by furthering the age of first pregnancy, can play a major role in limiting the occurrence of fistulas. Child marriage is a prevalent practice, most commonly in South Asia and Sub Saharan Africa. In Ethiopia, child marriage which is identified as anyone under the age of 18, exists at a rate of 40.3 percent as of 2016. The prevalence of this practice increases the chances of exposure to sexual abuse, partner violence, and lessens exposure to educational and economic opportunities. The concern for obstetric fistulas exceeds its medical ramifications, but is also identified in increased ostracization of those with fistulas due to its social stigma.[ citation needed ]
The main contributing risk factor for obstetric fistulas remains lack of awareness of fistulas and how to treat them. Amongst other risk factors including no skilled birth attendants, poor health-seeking behavior, poor referral system and transportation network, age and physical maturity, iatrogenic surgical damage, Educational status, sexual violence , poverty, and having child births too close together.
Obstetric fistulas if left untreated risk life long morbidity as well as possible psychological, social, and economic consequences. Currently the Hamlin Fistula Organization has five hospitals throughout Ethiopia and employs over 500 Ethiopians.
HIV Sero – prevalence in adults aged between 15–49 years in Ethiopia is estimated at 1.5% [5.5% urban, 0.7% rural]. However, the prevalence in women is about double than the prevalence in men, 1.9% versus 1%, respectively.[ citation needed ]
Seventy four percent of women had a FGM out of which, 6% have their vaginas sewn closed. [4] Around 8% of all marriages occur after through abduction.
The most common forms of violence against women in Ethiopia include physical violence (intimate partner violence) and sexual violence. A study done in Kofele, (Oromia region, Arsi, Ethiopia) in 2004 showed the lifetime and the 12 months prevalence of physical violence among married women was 64% and 55%, respectively. Another study performed in North-west Ethiopia (Dabat High school) in 2005 revealed that sexual harassment was seen in 44% of the students and rape was experienced by 33.3% of sexually active students. [5]
At the tertiary level of education the sexual violence was also alarmingly high as this was also confirmed by a study conducted at Addis Ababa University in 2004 on more than 600 students, where sexual harassment was experienced by 58% in life time and 41.8% in the last one year, rape was experienced by 12.7% of the students, and 27.5% of the student had escaped an attempted rape.
Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum, ureter, or bladder. It can result in incontinence of urine or feces. Complications may include depression, infertility, and social isolation.
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 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.
Statistics on rape and other acts of sexual assault are commonly available in industrialized countries, and have become better documented throughout the world. Inconsistent definitions of rape, different rates of reporting, recording, prosecution and conviction for rape can create controversial statistical disparities, and lead to accusations that many rape statistics are unreliable or misleading.
There have been several studies concerning women in Ethiopia. Historically, elite and powerful women in Ethiopia have been visible as administrators and warriors. This never translated into any benefit to improve the rights of women, but it had meant that women could inherit and own property and act as advisors on important communal and tribal matters. As late as the first part of the 20th century, Queen Menen, consort of Emperor Haile Selassie I, had a decisive role in running the Ethiopian Empire. Workit and Mestayit regents to their minor sons have been held responsible for their provinces. They owed their rights to landed property because of a special type of land tenure that expected tenants to serve as militia to overlords, irrespective of gender. In 1896, Empress Tayetu Betul, wife of Emperor Menelik II, actively advised the government and participated in defending the country from Italian invasion. Prominent and other landowning women fought against the second invasion in 1935–41. With the assistance of European advisors, women in the ensuing period were kept out of the army and politics, even as advisors. Instead, they were restricted to family and household work of raising children and cooking. With a steady increase in female representation in education, they have started to undertake nursing, teaching, and other similarly supportive roles. Over the 2018–2019 period, their gradual participation in state politics has been increasing at a steady pace.
Health in Ethiopia has improved markedly since the early 2000s, with government leadership playing a key role in mobilizing resources and ensuring that they are used effectively. A central feature of the sector is the priority given to the Health Extension Programme, which delivers cost-effective basic services that enhance equity and provide care to millions of women, men and children. The development and delivery of the Health Extension Program, and its lasting success, is an example of how a low-income country can still improve access to health services with creativity and dedication.
Tropical diseases, especially malaria and tuberculosis, have long been a public health problem in Kenya. In recent years, infection with the human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS), also has become a severe problem. Estimates of the incidence of infection differ widely.
The Tajikistan health system is influenced by the former Soviet legacy. It is ranked as the poorest country within the WHO European region, including the lowest total health expenditure per capita. Tajikistan is ranked 129th as Human Development Index of 188 countries, with an Index of 0.627 in 2016. In 2016, the SDG Index value was 56. In Tajikistan health indicators such as infant and maternal mortality rates are among the highest of the former Soviet republics. In the post-Soviet era, life expectancy has decreased because of poor nutrition, polluted water supplies, and increased incidence of cholera, malaria, tuberculosis, and typhoid. Because the health care system has deteriorated badly and receives insufficient funding and because sanitation and water supply systems are in declining condition, Tajikistan has a high risk of epidemic disease.
Surveys of victims of crime have been undertaken in many cities and countries, using a common methodology to aid comparability, and have generally included questions on sexual violence. The United Nations has conducted extensive surveys to determine the level of sexual violence in different societies. According to these studies, the percentage of women reporting having been a victim of sexual assault ranges from less than 2% in places such as La Paz, Bolivia (1.4%), Gaborone, Botswana (0.8%), Beijing, China (1.6%), and Manila, Philippines (0.3%), to 5% or more in Istanbul, Turkey (6.0%), Buenos Aires, Argentina (5.8%), Rio de Janeiro, Brazil (8.0%), and Bogota, Colombia (5.0%).
The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.
A landlocked sub-Saharan country, Burkina Faso is among the poorest countries in the world—44 percent of its population lives below the international poverty line of US$1.90 per day —and it ranks 185th out of 188 countries on UNDP's 2016 Human Development Index. Rapid population growth, gender inequality, and low levels of educational attainment contribute to food insecurity and poverty in Burkina Faso. The total population is just over 20 million with the estimated population growth rate is 3.1 percent per year and seven out of 10 Burkinabe are younger than 30. Total health care expenditures were an estimated 5% of GDP. Total expenditure on health per capita is 82 in 2014.
The 2010 maternal mortality rate per 100,000 births for Tanzania was 790. This is compared with 449 in 2008 and 610.2 in 1990. The UN Child Mortality Report 2011 reports a decrease in under-five mortality from 155 per 1,000 live births in 1990 to 76 per 1,000 live births in 2010, and in neonatal mortality from 40 per 1,000 live births to 26 per 1,000 live births. The aim of the report The State of the World's Midwifery is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child
Addis Ababa Fistula Hospital, also known as AAFH and Hamlin's Addis Ababa Fistula Hospital, is a women's health care hospital based in Addis Ababa, Ethiopia. The hospital was founded by Australian physicians Catherine Hamlin and Reginald Hamlin, to care for women with childbirth injuries. It is the only hospital of its kind dedicated exclusively to treating women with obstetric fistula, a condition in the developing world where maternal health provisions are poor. All patients are treated free of charge.
Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.
Gender inequality can be found in various areas of Salvadoran life such as employment, health, education, political participation, and family life. Although women in El Salvador enjoy equal protection under the law, they are often at a disadvantage relative to their male counterparts. In the area of politics, women have the same rights as men, but the percentage of women in office compared to men is low. Though much progress has been made since the Salvadoran Civil War ended in 1992, women in El Salvador still face gender inequality.
Women in South Sudan are women who live in and are from South Sudan. Since the Independence of South Sudan on 9 July 2011, these women have gained more power but still face issues of inequality. Many women in this area do not have adequate access to health resources and education. While these women often face inequality, there has been progress since South Sudan's official declaration of independence. In recent years, this inequality has gained national attention and people have become more interested in the issue of child marriage that this area faces. Along with this, there has started to be a focus on the very high level of maternal mortality in South Sudan. With a maternal mortality rate of 789 deaths per 100,000 live births, South Sudan has one of the highest rates in the world.
Both maternal and child health are interdependent and substantially contributing to high burden of mortality worldwide. Every year, 289 000 women die due to complications in pregnancy and childbirth, and 6.6 million children below 5 years of age die of complications in the newborn period and of common childhood diseases. Sub-Saharan Africa (SSA), which includes Tanzania, contribute higher proportion of maternal and child mortality. Due to considerable proportion of mortality being attributed by maternal and child health, the United Nations together with other international agencies incorporated the two into Millennium Development Goals (MDGs) 4 and 5. In this regard, Tanzania through the Ministry of Health and Social Welfare (MoHSW) adopted different strategies and efforts to promote safe motherhood and improve child survival. Similarly, in an effort to improve maternal and child health, Tanzania's government has declared maternal and child health services to be exempt from user fees in government facilities.
Sustainable Development Goals is a post Millennium Development Goal agenda by experts in the world which will be implemented within the next 15 years until 2030. It has seventeen goals and 169 targets as a whole where SDG 3 deal with ensuring health lives and promote well-being for all at all ages. Sustainable Development Goal 3 has nine targets and four sub targets related with different areas of health. One of the targets target 3.1 is a target to achieve a reduction of global maternal mortality ratio to less than 70 per 100,000 live births .Maternal death is defined as "The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
Gender inequality in Nepal refers to disparities and inequalities between men and women in Nepal, a landlocked country in South Asia. Gender inequality is defined as unequal treatment and opportunities due to perceived differences based solely on issues of gender. Gender inequality is a major barrier for human development worldwide as gender is a determinant for the basis of discrimination in various spheres such as health, education, political representation, and labor markets. Although Nepal is modernizing and gender roles are changing, the traditionally patriarchal society creates systematic barriers to gender equality.
In 2017, 1.1 million women were living in Lesotho, making up 51.48% of the population. 33% of women are under 15 years of age, 61.4% are between 15 and 64 years old and 5.3% are over 64 years old. They received full legal status in 2008 with the passage of The Lesotho Bank Savings and Development Act of 2008. Women in Lesotho die at a disproportionate rate from HIV/AIDs. Historically, women have wielded power as heads of households, with control over household financial decisions. The government has taken steps to ensure more equal representation of genders in government with quotas, and women in Lesotho are more highly educated than men. Still, domestic abuse, sexual violence, lack of social mobility, and aforementioned health crises are persistent issues. Social and economic movements, like the mass immigration of men to South Africa, and the rise of the garment industry, have contributed to both the progress and problems facing women in Lesotho today.
The Association for Rehabilitation and Re-Orientation of Women for Development, abbreviated as TERREWODE, is a leading Ugandan nonprofit organization. It pioneered best practices for the elimination of obstetric fistula in Uganda over 16 years. The organization focuses on maternal and reproductive health. Headquartered in Soroti, TERREWODE's efforts target the empowerment and education of young women in rural communities. TERREWODE's activism focuses on women's rights to maternal, reproductive and sexual health, as well as the treatment and social reintegration of victims of obstetric fistula.