International Women’s Day has a long and distinguished history. From its early beginnings to the present it has been a day to reflect on progress made, to call for change and to celebrate the many ‘ordinary’ women who have played an extraordinary role in their communities and countries. This International Women’s Day – and its theme ‘Think equal, build smart, innovate for change’ – is no exception.
It is a theme of critical importance to public health practitioners, and one that emphasizes the ongoing quest to promote social protection, enhance access to services and build sustainable and inclusive infrastructure. ‘Thinking equal’, for example, means making gender equality a focus of all we do, whether increasing access to sexual and reproductive health services or considering the impact health sector policies have on socially prescribed gender roles. ‘Building smart’ means applying a gender lens to the critical imperative of our time – universal health coverage – and focusing on barriers to access and how they can be reduced. And ‘innovating for change’ means considering how we can improve policy and harness technology to meet the health needs of all women everywhere, whatever their social or economic status.
The WHO South-East Asia Region has made significant progress, especially on reproductive and maternal health. Between 1990 and 2015 maternal mortality was reduced by 69%, as compared with a global decline of 44%. Contraceptive use – a key indicator of access to family planning services – increased from 46% in 2000 to 60% in 2015. In the same period, the total fertility rate dropped from three to 2.4 children per woman – the most significant change among all WHO regions, reflecting women’s increased autonomy. The HPV vaccine, so crucial to preventing cervical cancer, is meanwhile gaining traction in the Region, as global calls to eliminate the disease grow in voice and volume.
There is, however, a long way to go: Despite progress, the Region’s performance in advancing gender equality and women’s empowerment is among the lowest in the world. We must all work to change that, with the health sector having a crucial role to play.
A good place to start thinking equal, for example, is by enhancing attention to adolescent health. By mainstreaming adolescent health at all levels, young women and girls will be better positioned to take control of their reproductive lives, empowering them to choose their own destiny, whether that means becoming a professional, entering politics, or starting their own business. Increasing access to family planning services more generally will significantly reduce the number of women in the Region treated for abortion-related complications – six million annually at present. It will also reduce the number of unwanted pregnancies that can negatively affect women’s health and limit their life-choices.
Health authorities should likewise build smart in their approaches to universal health coverage (UHC) so that fewer women are left behind. Whether for reasons of poverty, ethnicity, education or other factors, many women continue to face significant barriers to access, even as the coverage and quality of health services increases. These barriers must be addressed as a matter of priority, ensuring the social protection UHC offers is extended to all women everywhere. Importantly, when both women and men can access the services they need, when they need them, the burden of unpaid care in families (which typically falls on women and girls) is reduced and gender equality advanced.
Finally, to innovate for change, creative approaches to grassroots engagement and the use of new technology can be leveraged. That could mean working with community-based women’s groups to find ways to address gender-based violence or helping change norms around early marriage. It could also mean rolling out mHealth technologies to enhance health literacy and encourage timely health-seeking. To tap mHealth’s potential, however, it is essential we guard against the development of new forms of exclusion, including from the digital divide. All things considered, the health sector can – and must – focus on intensifying actions within the sector, at the same time as partnering with other sectors to find innovative ways to empower women and promote gender equality Region-wide.
On International Women’s Day, as every other day, WHO is committed to the goal of gender equality, to eliminating all forms of discrimination against women, and to ensuring that women’s right to health is not only recognized but also enjoyed. To go from where we are to where we need to be, sustaining the Region’s achievements, accelerating progress, and harnessing the full power of innovation is imperative. Only then will women’s health and the empowerment it promotes be advanced. And only then will the Region be poised to achieve gender equality – an outcome that will benefit all.