Women’s health
and well-being

Good-quality care during pregnancy and childbirth is essential to prevent maternal mortality and stillbirths. Globally in 2016, an estimated 78% of women were attended by a skilled health worker during childbirth²⁴ and only 58% of pregnant women had four or more antenatal care visits.²⁵ Based on data from 79 countries, only 52% of women globally received postpartum care in 2016.²⁶ Many more lives could be saved, and illness and disability prevented, by improving the quality of antenatal care, care at the time of childbirth, and postnatal care for mothers and newborns, and by improving coverage of and tackling inequities in access to and quality of health services, including basic infrastructure.

Statistics on mortality and disease burden are a vital source of information. However, they often fail to give a complete picture of women’s progress, beyond survival, to enjoyment of health and well-being. While some health factors threaten women’s lives, others profoundly affect their physical and mental health and overall well-being. Examples are the estimated 200 million girls and women alive today who have undergone female genital mutilation,²⁷ the 15 million girls who marry before age 18 each year,²⁸ and the nearly one in three women subjected to physical or sexual violence by an intimate partner.²⁹

The data show that, in many places, women are taking control of these and other areas of their health. Increasingly they are claiming their sexual and reproductive health and rights, for example by using modern contraceptive methods for family planning. Usage rose from 48% to 58% between 1990 and 2015 among married or in-union women aged 15–49. While contraceptive prevalence has improved globally, this figure has plateaued and needs to be scaled up to achieve universal access.³⁰ Increased contraceptive use prevents unintended pregnancy, which in turn reduces the rate of induced abortion. Globally, there were 35 abortions per 1000 women aged 15–44 each year from 2010 to 2014, down slightly from 40 per 1000 in 1990–1994. The decline has been uneven, with the abortion rate having declined markedly – by 41% – in developed countries since 1990, but remaining roughly the same in developing countries.³¹ Current evidence suggests abortion rates do not differ in countries where abortion is highly restricted and those where abortion is broadly legal.³²
Despite progress, data from 45 countries show that only one in two women aged 15-49 years (married or in union) makes her own decisions regarding sexual relations, contraceptive use and health care.³³
Cervical cancer is another consideration for women’s sexual health. An estimated one million-plus women worldwide, the majority (more than 80%) in low- and middle-income countries, are currently living with cervical cancer, many with no access to services for prevention, curative treatment or palliative care. The human papilloma virus, which is transmitted sexually, is one of the main causes of cervical cancer. A safe and effective vaccine exists, which when provided to girls between 9 and 13 years old protects against this virus, and technologies to screen and treat women living with cervical cancer are becoming more available but still serve only a minority of affected women. This highlights the importance of taking a life-course approach to health.³⁴

Socioeconomic factors are important determinants of women’s health. Conversely, women’s health and empowerment, including through their political, sociocultural and economic participation, can effect transformative socioeconomic improvements. For example, higher levels of education for girls and women’s political participation are both associated with better health for women and children, which in turn contributes significantly to socioeconomic development.³⁵ With respect to political participation, although the number of countries with a female head of state increased from 8 in 2005 to 17 in January 2017, women’s representation in politics overall is stagnating.³⁶
Inequities in access to adequate health services and rights are also significant determinants of women’s health and well-being. These inequities may be shaped by social norms on gender inequality, and/or by laws that limit women’s autonomy over their health and their participation in society, the labour force and politics. Another barrier in some countries is the lack of supportive legislation for specific subgroups, such as migrants and indigenous women, who are often underserved and marginalized. Access to clean energies in the home will also decrease the burden of disease and death.