The implications of direct nutrition interventions on women's nutrition, birth outcome and stunting rates in children in South Asia are indisputable and well documented. In the last decade, a number of studies present evidence of the role of non-nutritional factors impacting on women's nutrition, birth outcome, caring practices and nutritional status of children. The implications of various dimensions of women's empowerment and gender inequality on child stunting is being increasingly recognised. Evidence reveals the crucial role of early age of marriage and conception, poor secondary education, domestic violence, inadequate decision-making power, poor control over resources, strenuous agriculture activities, and increasing employment of women and of interventions such as cash transfer scheme and microfinance programme on undernutrition in children. Analysis of the nutrition situation of women and children in South Asia and programme findings emphasise the significance of reaching women during adolescence, pre-conception and pregnancy stage. Ensuring women enter pregnancy with adequate height and weight and free from being anemic is crucial. Combining nutrition-specific interventions with measures for empowerment of women is essential. Improvement in dietary intake and health services of women, prevention of early age marriage and conception, completion of secondary education, enhancement in purchasing power of women, reduction of work drudgery and elimination of domestic violence deserve special attention. A range of programme platforms dealing with health, education and empowerment of women could be strategically used for effectively reaching women prior to and during pregnancy to accelerate reduction in stunting rates in children in South Asia.
Interventions resulting in public infrastructure changes were found to be less effective than household-based interventions; however, both are important aspects of improved health outcomes for women (128, 130). Public water infrastructure requires regular maintenance and periodic replacement and water from these sources is often contaminated (130). However, even public water points that provide good-quality water have had minimal impacts on health outcomes (136). One review estimated that water-source interventions were associated with a 27% reduction in diarrhea risk at all ages, whereas household-based interventions were associated with a 43% reduction (128). This could be associated with bias and confounding, as measuring WASH outcomes is not a blinded process (128). The differential impact could also be related to practice. As compared with public water sources, home water connections were associated with greater odds of handwashing and fecal waste disposal (136). As a significant portion of diarrheal disease is a result of person-to-person transmission and poor hygiene, interventions that improve domestic hygiene behaviors can have a significant impact (136). Behavior change communication and resource provision, e.g., soap and point-of-use water treatment resources, were also important and sustainable aspects of WASH interventions (131, 137).
Trying to balance the demands of family and work or school—and coping with media pressure to look and eat a certain way—can make it difficult for any woman to maintain a healthy diet. But the right food can not only support your mood, boost your energy, and help you maintain a healthy weight, it can also be a huge support through the different stages in a woman’s life. Healthy food can help reduce PMS, boost fertility, make pregnancy and nursing easier, ease symptoms of menopause, and keep your bones strong. Whatever your age or situation, committing to a healthy, nutritious diet will help you look and feel your best and get the most out of life.
The major differences in life expectancy for women between developed and developing countries lie in the childbearing years. If a woman survives this period, the differences between the two regions become less marked, since in later life non-communicable diseases (NCDs) become the major causes of death in women throughout the world, with cardiovascular deaths accounting for 45% of deaths in older women, followed by cancer (15%) and lung disease (10%). These create additional burdens on the resources of developing countries. Changing lifestyles, including diet, physical activity and cultural factors that favour larger body size in women, are contributing to an increasing problem with obesity and diabetes amongst women in these countries and increasing the risks of cardiovascular disease and other NCDs.
Choline: Some studies link low choline levels to increased risk of neural tube defects. Recommended levels have been established for this nutrient, but it's easy to get enough in your diet. Eggs are an excellent source of choline, for example. “Eating a few eggs a week should give you all you need,” Frechman says. “Most people can eat the equivalent of an egg a day without worrying about cholesterol.” Other choline-rich food sources include milks, liver, and peanuts.
Despite these differences, the leading causes of death in the United States are remarkably similar for men and women, headed by heart disease, which accounts for a quarter of all deaths, followed by cancer, lung disease and stroke. While women have a lower incidence of death from unintentional injury (see below) and suicide, they have a higher incidence of dementia (Gronowski and Schindler, Table I).
It's a cliché, to be sure, but a balanced diet is the key to good nutrition and good health. Following that diet, however, isn't always that easy. One challenge is that women often feel too busy to eat healthfully, and it's often easier to pick up fast food than to prepare a healthy meal at home. But fast food is usually high in fat and calories and low in other nutrients, which can seriously affect your health. At the other extreme, a multimillion dollar industry is focused on telling women that being fit means being thin and that dieting is part of good nutrition.
There remain significant barriers to accessing contraception for many women in both developing and developed regions. These include legislative, administrative, cultural, religious and economic barriers in addition to those dealing with access to and quality of health services. Much of the attention has been focussd on preventing adolescent pregnancy. The Overseas Development Institute (ODI) has identified a number of key barriers, on both the supply and demand side, including internalising socio-cultural values, pressure from family members, and cognitive barriers (lack of knowledge), which need addressing. Even in developed regions many women, particularly those who are disadvantaged, may face substantial difficulties in access that may be financial and geographic but may also face religious and political discrimination. Women have also mounted campaigns against potentially dangerous forms of contraception such as defective intrauterine devices (IUD)s, particularly the Dalkon Shield.
Oaks BM, Young RR, Adu-Afarwuah S, Ashorn U, Jackson KH, Lartey A, Maleta K, Okronipa H, Sadalaki J, Baldiviez LM et al. Effects of a lipid-based nutrient supplement during pregnancy and lactation on maternal plasma fatty acid status and lipid profile: results of two randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids 2017;117:28–35.
Infrastructure ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, ↑ school attendance, NC wage employment ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities ↓ maternal mortality, ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities ↓ water point distance, ↑ time savings, ↑/NC women's hygiene, ↑/NC water quality, ↓/NC diarrheal morbidity, ↓ intestinal parasite prevalence, NC wage employment, ↑ participation in income-generating activities
Integrated health care Health clinics ↑ knowledge about FP, NC use of FP ↑ knowledge about diabetes, ↓ incidence of diabetes, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, NC mortality (from coronary artery disease), ↓ depression, ↑/NC health care utilization, ↑ knowledge about FP, ↑/NC use of FP, ↑/NC STI screening, NC STI incidence, ↑ cervical cancer screening, ↑ mammography ↓/NC anemia, ↑ Hgb, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, ↓ pre-eclampsia, ↓ maternal mortality, ↓/NC placental malaria, ↓ parasitemia, ↓/NC depression, NC health care utilization, ↑/NC hospital deliveries, NC cesarean delivery, ↑/↓ knowledge about FP, ↑/NC use of FP, ↑ STI screening, ↓ STI incidence, ↑ cervical cancer screening, ↑ mammography ↑ knowledge about diabetes, ↓ diabetes, ↑ glycemic control, ↑ hypertension screening and Tx, ↓ hypertension, NC mortality (from coronary artery disease), ↑ health care utilization, ↓ depression, ↑ mammography, ↑ cervical cancer screening
Violence against women may take many forms, including physical, sexual, emotional and psychological and may occur throughout the life-course. Structural violence may be embedded in legislation or policy, or be systematic misogyny by organisations against groups of women. Perpetrators of personal violence include state actors, strangers, acquaintances, relatives and intimate partners and manifests itself across a spectrum from discrimination, through harassment, sexual assault and rape, and physical harm to murder (femicide). It may also include cultural practices such as female genital cutting.
Breast cancer is the second most common cancer in the world and the most common among women. It is also among the ten most common chronic diseases of women, and a substantial contributor to loss of quality of life (Gronowski and Schindler, Table IV). Globally, it accounts for 25% of all cancers. In 2016, breast cancer is the most common cancer diagnosed among women in both developed and developing countries, accounting for nearly 30% of all cases, and worldwide accounts for one and a half million cases and over half a million deaths, being the fifth most common cause of cancer death overall and the second in developed regions. Geographic variation in incidence is the opposite of that of cervical cancer, being highest in Northern America and lowest in Eastern and Middle Africa, but mortality rates are relatively constant, resulting in a wide variance in case mortality, ranging from 25% in developed regions to 37% in developing regions, and with 62% of deaths occurring in developing countries.
WASH interventions were typically community-based. WASH interventions were delivered to households and communities through community mobilization, mass media, home visits, and infrastructural development (126, 130, 136–138). There were some examples of facility-based delivery of WASH interventions, such as in health clinics and schools (139, 140); however, this was not representative of the majority of delivery platform coverage. Health clinic delivery platforms had limited reach, often targeting pregnant women and women with young children. In an evaluation of WASH interventions delivered in India (141), more demanding behavioral practices, such as handwashing and consistent use of latrines, required more intense contact (e.g., multiple home visits) than less intense interventions, such as sweeping of courtyards, that could be effectively delivered in small group meetings such as those in health clinics and community centers. More research is needed to evaluate the benefits and barriers of different delivery platforms for women across the life course.