Fact Sheet on Women's Health (Western Pacific Region)

Fact sheet
10 November 2009

Women's reproductive health encompasses a wide range of issues:

Unintended pregnancy

  • Significant increase in pregnancies in the adolescent age group (10 to 19 years) in Lao People's Democratic Republic, Papua New Guinea, the Philippines and some Pacific island countries (Kiribati, Marshall Islands, Nauru). The Philippines contributes 1% to global adolescent pregnancy distribution.
  • Pregnancy in early and mid-adolescence age group greatly contributes to infant and maternal mortality and morbidity in some countries in the Region.
  • Contraceptive prevalence rate for married women is less than 50% in Cambodia, Lao PDR, Papua New Guinea, the Philippines and the Solomon Islands.
  • Unsafe abortion» Unsafe abortion in the 15- to 19-year-old age bracket is 20 per 1000 women.
  • Sexual wellbeing» Increasing cases of sexually transmitted infections, including HIV and reproductive tract infections in women

Unsafe abortion

  • Unsafe abortion in the 15- to 19-year-old age bracket is 20 per 1000 women.

Sexual wellbeing

  • Increasing cases of sexually transmitted infections, including HIV and reproductive tract infections in women

Pregnancies/deliveries

  • An estimated 40 million to 50 million pregnancies occur annually in the Region
  • An estimated 30 500 to 50 000 maternal deaths occur annually in the Region.
  • Some 300 000 newborn deaths occur annually within the first day of birth
  • Less than half of deliveries are attended by skilled birth attendants in some countries.

Women and alcohol/substance abuse

Women are more likely to abstain from alcohol than men.

  • In Western Pacific A countries (i.e., Australia and Japan), 77% of women are current drinkers (87% of men).
  • In Western Pacific B countries (i.e., China, the Philippines and Viet Nam), 30% of women are drinkers (84% of men).
  • Men are more than twice as likely to report both heavy episodic drinking (binge drinking) and chronic heavy drinking. However, gender gaps are smaller among late adolescents and expected to decrease in WPR B countries in the future.

Country data

  • Viet Nam: 0.6% females rate as heavy drinkers (5.7% of males)
  • Lao PDR: 1.8% females rate as heavy drinkers (3.8% of males)
  • Japan: 4.9% females rate as heavy drinkers (22.7% of males)
  • Australia: 7.2% females rate as heavy drinkers (6.7% of males)
  • China: 0.3% females binge drink (7.5% of males)
  • Philippines: 1.6% females binge drink (13.2% of males)
  • China: 0.2% of females are alcohol dependent (6.6% of males)
  • Singapore: 0.2% of females are alcohol dependent (1.1% of males)
  • Korea: 1.7% of females are alcohol dependent (6.9% of males)

Even women who do not drink to excess face more problems than their male counterparts:

  • Women who drink run the risk of getting breast cancer and that risk is directly related to the amount of alcohol they consume.
  • Females face more brain damage and memory loss than men who drink the same amount for the same period of time.
  • Women not only get drunk on less alcohol than men but they also suffer worse hangovers.
  • Compared to boys and men, girls and women become addicted to alcohol, nicotine and illegal and prescription drugs, and develop substance-related diseases at lower levels of use and in shorter periods of time.
  • Young drug users, whether they are injection users or not, are at a high risk of contracting herpes simplex virus 2 and syphilis. Women are significantly more prone to develop sexually transmitted infections that their male drug-using counterparts.
  • Women who have more than 15 drinks a week have an increased risk of experiencing mental illness, specifically depression and anxiety.
  • Female alcoholics experience more severe cardiovascular effects from heavy alcohol drinking than those observed in male alcoholics and these effects are noted at an earlier stage of drinking and at a lower consumption level than those noted in men.
  • Liver cirrhosis develops faster in women.
  • Binge drinking increases risky sexual behaviour, particularly in women
  • Women who are married to alcoholics are three times more likely to abuse alcohol themselves, compared to wives of non-alcoholics.
  • Alcohol and drug use during pregnancy may have severe repercussions for the child.

Mental Health

Suicide rates

  • Global trends show a higher male to female suicide rate (approximately 3 to 1) while the Western Pacific generally shows a more equal gender ratio.
  • In the Western Pacific Region, recent data shows that the highest rates of suicide for women are in countries with Asian cultural heritage, such as China, the Republic of Korea and Japan.
  • A recognized sub-population at risk of suicide in China are young females, particularly those in rural areas. Among nations reporting suicide mortality data to the WHO, China is the only country in the world where female suicide is actually higher than male suicide.
  • Several Pacific Island countries also appear to have elevated female over male suicide rates. Studies have documented high rates among young women of Indian ethnicity in Fiji. The findings also demonstrate greater rates overall for young women in Fiji (38 per 100 000 for females aged between 15 and 24) and American Samoa (70 per 100 000).

Depression in women

  • Depressive disorders account for nearly 42% of the disability from neuropsychiatric disorders among women compared to 29.3% among men.
  • Majority of leading mental health problems of the elderly occur in women: depression, organic brain syndromes and dementias.
  • Up to 20% of those attending primary health care in developing countries suffer from anxiety and/or depressive disorders. » In most centres, these patients are not recognized and therefore not treated.» Communication between health workers and women patients is extremely authoritarian in many countries, making a woman's disclosure of psychological and emotional distress difficult, and often stigmatized

Women and chronic diseases

Cardiovascular diseases: heart attack, strokes and diabetes

  • Prevalence of overweight in women above 30 years is projected to increase from 31% in 2005 to 44% in 2015, which is likely to increase the prevalence of diabetes and heart disease.
  • Globally, almost 80% of diabetes deaths occur in low and middle-income countries; almost half of diabetes deaths occur in people under the age of 70 years; 55% of diabetes deaths are in women.

Chronic Obstructive Pulmonary Disease (COPD)

  • COPD now affects men and women almost equally with increased tobacco use among women in high-income countries and the higher risk of exposure to indoor air pollution (i.e., biomass fuel used for cooking and heating) in low-income countries.

Cancer

  • It is estimated that in 2008 there were 3 689 000 incident cases of cancer (2 213 000 in men and 1 476 000 in women) and 2 575 000 deaths from cancer (approximately 1 629 000 in men and 946 000 in women).
  • In women, breast cancer was the commonest incident form of cancer, followed by stomach cancer, lung cancer, colorectal cancer, liver cancer and cervix cancer.
  • Lung cancer was the commonest cancer cause of death in women followed by stomach cancer, liver cancer, oesophagus cancer, breast cancer and colorectal cancer.

Women and HIV

  • In the Western Pacific Region, an estimated 1.3 million people are living with HIV/AIDS, of which 340,000 are women. The spread of HIV in Asia is driven by three high-risk types of behaviour: » unprotected commercial sex » injecting drug use » unprotected sex between men
  • In most countries in the Region, the largest infected population group is men who buy sex.
  • The percentage of HIV positive women has risen from 19% in 2000 to 24% in 2007. Most HIV positive women were infected by their husbands or boyfriends; others were infected while working in commercial sex and while injecting drugs.
  • Prevalence among men is still higher than among women, but this is beginning to change and women and girls are increasingly at the centre of the epidemic.
  • Women are not only vulnerable to HIV infection, but they also largely bear the devastating impact of HIV and AIDS as care givers within the households. They also face stigma and discrimination and in some situation deprived of their property and inheritance rights.
  • Mother-to-child transmission» Efforts to prevent women becoming infected, especially during pregnancy and breast-feeding, are the priority in preventing paediatric HIV infection.» There has been increasing number of pregnant women screened for HIV. » More HIV pregnant women have received antiretroviral prophylaxis to prevent mother-to-child transmission from 13% in 2007 to 23% in 2008.

Women and Tobacco

Second-hand smoke

  • There is no safe level of secondhand smoke.
  • Exposure to second-hand smoke is a major public health concern in the Region, particularly in China, the Lao People's Democratic Republic, Malaysia, Mongolia, Nauru, Republic of Korea, Samoa, Tonga, Vanuatu and Viet Nam. » In Vietnam, men smoke 30 times more than women and two third of women are exposed to second-hand smoke at home. » Global Youth Tobacco Survey shows that 50% of girl students, aged 13 to 15, are exposed to second hand some at home and 64% exposed in public places.» Exposure to second-hand smoke increases the risk of breast cancer in young premenopausal non-smoking women.» Exposure to second hand smoke among women has been linked to cardiovascular disease.

Female smokers

  • 8.4% of girl students, aged 13 to 15, are currently smoking in the Region.
  • Women who smoke and simultaneously take oral contraceptives further increase their risk of heart disease.
  • Women develop lung cancer more rapidly than men at lower exposure to smoking.
  • In New Zealand, girls smoking prevalence increased from 23.9% in 2007 to 39.9% in 2009.
  • In Palau, 53.7% of girl students currently use other tobacco products, including chewing betel nuts with tobacco, increasing risk of oral cancer.

Tobacco marketing

  • Aggressive marketing and promotion of tobacco products targets women and young girls in Asia.
  • Proliferation of flavoured and coloured cigarettes, the use of attractive packaging of cigarettes to entice women and girls has been noted in many countries.
  • Marketing of new products, such as smokeless tobacco and Shisha pipes, are especially targeting women and the youth.

Tobacco control efforts

  • WHO Framework Convention on Tobacco Control—also seeks to address issues on women and tobacco and to provide concrete solutions to address smoking, exposure to second-hand smoke, marketing and promotion to women and girls and tobacco chewing in some Pacific Island countries.
  • Regional Action Plan for the Tobacco Free Initiative 2010-2014--includes gender and equity in comprehensive tobacco control interventions and to address the need for education, advocacy and social mobilization in support of women and tobacco issues.
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