1. IMPROVING WOMEN’S HEALTH POLICY & INTERVENTIONS
DR CHITRA RAGHUNANDAN
DIR. PROFESSOR
OBS & GYNE DEPT, L.H.M.C & S.S.K.H, NEW DELHI
DR SHILPA DHINGRA
ASST. PROFESSOR

2. Women’s health a major development task for us
An unfinished agenda
Challenges include reducing
Maternal mortality
Unwanted fertility
Sexually transmitted infection ( HIV, AIDS)
Female feticide & Violence against women.

3. LIFE CYCLE OF WOMEN & HEALTH ISSUES
INFANCY AND CHILDHOOD(0-9 YEARS)
Sex selection
Genital mutilation
Discriminating nutrition
Discriminating Health care

4. ADOLESCENCE ( 10-15 YEARS) Early child bearing and abortion
STD & HIV Infection
Undernutrition and Anemia
Increase substance abuse

5. REPRODUCTIVE AGE(20-44 YEARS)
Unwanted / Unplanned pregnancies
Abortions
STI & AIDS
Pregnancy Complications
Anemia

6. POST REPRODUCTIVE (45 YEARS & ABOVE)
Gynecological Malignancies
Cardiovascular diseases
Osteoporosis
Osteoarthritis
Diabetes Mellitus
LIFE TIME
Gender Violence
Enviornmental and occupational hazards
Depression

7. HARD FACTS MATERNAL MORTALITY
India accounts for 20% of maternal deaths.
Every minute one women dies of pregnancy and childbirth.
MMR is 330/ 100,000 live births.
Greater than Bangladesh & Pakistan

8. HARD FACTS POPULATION PARABLES Indian population is 1.2 billion.
India occupies 2.4% of world land.
17.5% of world population.
One out of 6 people in world live in India.
35% population below the poverty line.

9. HARD FACTS
The total number of HIV Rose from 8 million in 1990 to 34 million in 2010
Prevalence of HIV in children- 3.4 million
People newly infected in million
India has population of 1 Billion out of which half in sexually active group
Total number of people with HIV in India is 23.9 lakhs in 2009 with children accounting for 3.5%
Parent to child transmission: 5.4% of all routes

10. HARD FACTS FEMALE FETICIDE / GENDER ISSUE Sex Ratio 940/ 1000.
Deficit of 3 crore women.
60 million girls missing.
2000 girls aborted everyday in India.
A girl child is killed and disowned every hour.
35% of girls sexually abused between 12 to 16 years.

11. KEY ISSUES, POLICY & INTERVENTIONS
Complication of pregnancy and childbirth are major cause of death and disability among women of reproductive age leading to high maternal mortality in India.
PREVENTION
Improving diet supplimentation of pregnant and lactating women.
Health care providers and skilled midwife.
Strengthening referral system for effective management of complications.
Tertiary level centers fully equipped.

12. Uncontrolled fertility / Sexually transmitted infection
Unequal power between men and women in sexual relationship exposes women to involuntary exposure to sex, sexually transmitted infections and unwanted pregnancy.

13. PREVENTION Empowering women with education and employment.
Family planning and sexual counselling.
Sex education of young adolescents.
Promotion of mutual consent and condom uses.

14. Female feticide, Domestic violence, rape and sexual abuse occur in all regions, class and age.
Affects 30% women worldwide.

15. PREVENTION Law Counselling Support services Medicare Raise awareness
Mobilize support

16. STAKE HOLDERS Family Society Health Professionals
Strong & Sustained government agencies
Well endowed resourses.

17. INTERVENTIONS
Strengthen the performance of overall health system specially district level.
Effective programs to promote increased utilization of maternal health services / EOC.
Women access to basic and comprehensive emergency obstetric care.
Availability of skilled birth attendant.
Information on maternal morbidity
Maternal death audits.

18. Quality of care where health services are available and affordable
NEEDS
Skilled staff / Professionals.
Effective client provider interaction.
Adequate supply of drugs.
Communication programmes.
Information to poor women and family
On health problems and importance of seeking care.

19. Focused Interventions
Ante- natal services
Basic Ante-natal care
Prompt detection/Management and referal of ante-natal complications
TT Injection
Iron and folic acid supplementation
Treatment of other associated infection

20. Safe Delivery Post-Partum Care Skilled birth attendant
Timely detection and referral of intra-natal complications
Tertiary level Obstretics care
Post-Partum Care
Family planning services
Monitoring for post-partum sepsis

21. Preventing unwanted pregnancy
Emergency contraception
Medical termination of pregnancy
Management of unsafe abortion complications
Post- abortal contraception

22. Prevention of RTI & STI
Promotion of barrier contraception and distribution
Symptomatic management of RTI
Screening and treatment of sex-workers
Screening for cervical cancer

23. Positive Health promotions
Public education program for
adequate nutrition
Decision on family size
Safer sex
Male participation
Education and employment
School Health Program
On reproductive health, dangers of substance abuse

24. Eradication of social problems
Law, public education and services to eradicate
Domestic violence
Sexual assault
Forced prostitution
Early childhood marriages
Strict regulation of use and abuse of medical technology

25. INTERVENTIONS STI treatment education. Social marketing of condoms.
Voluntary testing of HIV and counselling.
Women controllerd barrier methods for preventing STI / pregnancy.

26. To summarise…… Women Health requires
Favourable health policies.
Strengthening and expanding health services.
Positive attitude and approach.
Long term basis … improvement in nutrition, education and employment opportunities for women for positive impact on health.

27. Thank you