Providing health information to women. The role of magazines

OBJECTIVES: We were interested in health coverage in women's magazines in the United States and how it compared with articles in medical journals, women's health interests, and women's greatest health risks. METHODS: We examined 12 issues of Good Housekeeping (GH) and Woman's Day (WD) and 63 issues of the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA). We tallied the most common health questions of women presenting to the University of Michigan's Women's Health Resource Center (WHRC) during the same period. RESULTS: Less than a fifth of the magazine articles dealt with health-related topics. Of those, a third dealt with diet, with the majority emphasizing weight loss rather than eating for optimal health. Few of the articles cited research studies, and even fewer included the name of the journal in which the study was published. In JAMA and NEJM, less than one-fifth of original research studies dealt with women's health topics, most commonly pregnancy-related issues, hormone replacement therapy, breast and ovarian cancer, and birth defects. At the same time, the most common requests for information at the WHRC related to pregnancy, fertility, reproductive health, and cancer. CONCLUSION: The topics addressed in women's magazines do not appear to coincide with the topics addressed in leading medical journals, nor with women's primary health concerns or greatest health risks. Information from women's magazines may be leading women to focus on aspects of health and health care that will not optimize risk reduction.     

Reproductive health care strategy -- a gender-sensitive approach to family welfare

The author advocates a reproductive health care strategy to revitalize India's family welfare program. A major shift in focus is needed in population policy and programs to incorporate a gender-sensitive approach. That shift should help to clear the path toward improved health status for women and female children. Consensus reached at the UN's 1994 International Conference on Population and Development supported a change in population and development policies, affording women's empowerment, gender equality, and equity greater priority for a meaningful policy of human-centered sustainable development. Reproductive health care, reproductive health in practice, the quality of care in reproductive health, gender equality as a human right, and empowering women are discussed.     

Pakistan's health policy: appropriateness and relevance to women's health needs

The interface between national health policy and women's health needs is complex in developing countries like Pakistan. This paper aims to assess if Pakistan's national health policy 2001 is relevant and appropriate to women's health needs. Through review of existing data on women, a profile of women's health needs was developed which was transformed into framework of analysis. This framework indicates that Pakistani women's health needs are determined by gender disparities in health and health-related sectors. Comparison of national health policy with women's health needs framework reveals that although policy focuses on women's health through prioritization of gender equity, it is however addressed as an isolated theme without acknowledging the vital role gender inequalities in health and health-related sectors play in defining women's health needs. Moreover, gender equity is translated as provision of reproductive health services to married mothers, ignoring various critical overarching issues of women's life such as sexual abuse, violence, induced abortion, etc. Health systems strengthening strategies are though suggested but these fails to recognize main obstacles of utilization of healthcare services by women including non-availability of female healthcare providers and gender-based obstacles to healthcare utilization such as illiteracy, lack of empowerment to make decisions related to health, etc. In order to be relevant and appropriate to women's health needs the policy should: (1) use gender equity in health and health-related sectors as an approach to develop a healthy policy (2) expand the focus from reproductive health to life cycle approach to address all issues around women's life (3) strengthen health systems through creation of gender equity among all cadres of health providers (4) tailoring health interventions to counter gender-based obstacles to utilization of healthcare services and (5) dissemination interventions for behavior change.     

Trends in women's health services by type of physician seen: data from the 1985 and 1997-98 NAMCS.

As managed care enrollment has increased, controversy has arisen about the role of internists (IM), family physicians (FP), and obstetrician/gynecologists (ob/gyns) in the provision of women's health care. Efforts to improve training in women's health needs have also increased. Yet it is unclear how these trends have affected practice. We used the National Ambulatory Medical Care Survey (NAMCS), a nationally representative sample of office-based medical visits, to examine by physician specialty a) trends in the proportion of visits for women's health care and b) the content of nonillness care. Between 1985 and 1997-98, market share of reproductive health services increased for IMs (e.g., from 3.7% to 10.5% of contraceptive visits, p <.05) and decreased for FPs (from 30.5% to 20.5% for contraceptive visits, p <.05). Ob/Gyns increased their share of women's health care visits, with reproductive health visits increasing from 56.2% to 65.9% (p <.0001). The trend in hormone replacement therapy visits differed, with nonsignificant gains in market share for IMs and decreases for ob/gyns. Nonillness care (1997-98 data only) differed predictably by specialty, with IMs and FPs more often providing cholesterol screening while ob/gyns more often provided reproductive health services. Compared with IMs and FPs, ob/gyns were more likely to counsel women on reproductive health topics and equally likely to counsel on general health topics, but additional time spent in counseling was lower. Specialty differences in the provision of women's health services continue, though the scope of care provided by IMs has broadened. Still, women are unlikely to obtain a full range of preventive services in a single nonillness visit. Ensuring adequate coordination among physicians providing primary care to women continues to be a critical concern.     

Women's perceptions and experiences of sexual violence in marital relationships and its effect on reproductive health

In this article we explore women's perceptions and experiences of sexual violence in marital relationships and its effects on reproductive health. We conducted a qualitative study composed of key informant interviews, focus group discussions, and in-depth interviews in two low- to middle-income areas of Karachi, Pakistan. Results show sexual coercion and nonconsensual sex were common and not limited to abusive relationships. Difficulties in negotiating safe sex resulted in unwanted pregnancies, some leading to unsafe abortions. The women reported escalation of violence during pregnancy to be common. Social norms prevented disclosure of sexual violence leading to limited support or intervention or both. The link between women's social status, marital violence, and reproductive health is discussed.     

Issues to consider in operationalizing reproductive health

The International Conference on Population and Development (ICPD) served as the international launchpoint for a broadened reproductive health agenda, bringing global attention to a variety of underlying issues that impact on women's health and well-being, and highlighting the need to redress imbalances in gender equity that have had negative health and social consequences in particular for women and girls. To meet the challenges of the ICPD, programs must assess, prioritize and implement an expanded set of reproductive health interventions within an environment of diminishing resources. This paper argues that hidden social and health costs that particularly affect women must be included in the assessment and prioritization of reproductive health interventions. In addition, it argues that issues of gender and sexuality cannot be separated from the delivery of appropriate family planning and reproductive health care if we are to have a significant impact on improving the reproductive health of current and future generations.     

海南垦区2000～2008年妇科病普查普治情况分析

[目的]了解海南垦区部分单位妇女生殖状况及影响因素,制定有效的干预措施,提高妇女生殖健康水平。[方法]对2000～2008年9年间的海南垦区部分单位已婚妇科病普查资料进行回顾性分析,且按年代分别统计分析普查对象已婚妇女各种疾病所占的比例及疾病的变化。[结果]普查总例数为374518人次,患病率为19.09%。妇科常见病疾病谱分析结果表明,宫颈慢性疾病占首位;阴道疾病占次位,呈上升趋势;宫颈癌也呈上升趋势。[结论]妇女的生殖健康保护迫在眉睫,应引起社会广泛关注。工作重点为筛查宫颈疾病、子宫内膜腺癌,以预防生殖感染为目的,加大妇女病普查普治工作力度。     

Medicine, gender, and disability: disabled women's health care encounters

In this article I examine the intersection of gender and disability in the medical arena by considering disabled women's experiences of receiving health care in the United Kingdom. Drawing on the "social model of disability," I focus on the attitudes and practices of doctors. I use two sources of qualitative data: (i) 68 disabled women's narratives gathered in the United Kingdom in 1996-1997; (ii) interviews with 17 disabled women regarding their reproductive experiences in the United Kingdom. I suggest that disabled women health service users are at risk of experiencing oppressive medical practices because two forces of oppression appear to be frequently, and interactively, in play: patriarchy and disablism.     

已婚妇女生殖道感染患病情况及影响因素的研究

目的了解已婚妇女生殖道感染的患病情况及相关危险影响因素。方法对3067例22～60岁已婚妇女进行问卷调查、妇科检查和有关实验室检查,有关数据应用计算机SPSS／PC9.0软件进行统计分析。结果妇女人群生殖道感染的患病率为42.1％,其中,患一种生殖道感染的占82.5%,两种占15.9%,三种以上的占1.6％。经多因素logistic回归分析,年龄、职业、生殖道感染史、居住地、混用清洗外阴用具等因素为妇女生殖道感染患病的影响因素。结论妇女人群生殖道感染患病率较高,应引起有关人员及部门的重视。为降低妇女生殖道感染的患病率,应针对妇女生殖道感染患病影响因素进行有效的预防和干预。     

The impact of gender and hierarchy on women's reproductive health in a Kam village, Guizhou Province, China

This paper explores the power hierarchies that shape the reproductive health of Kam village women with the purpose of identifying key potential causes of reproductive morbidity. The analysis is based on one year's fieldwork undertaken in a minority ethnic village in Guizhou in southwest China. Data from women's narratives reveal the ways in which power hierarchies, including the sex/gender system, shape daily life, dominance and resistance as well as actual health outcomes. Findings demonstrate how the sex/gender system intersects with other aspects of the village hierarchy, and how both affect villagers' reproductive decisions and reproductive health. Suggestions are offered on how to improve women's sexual and reproductive health in Kam areas.     

"Eyes Wide Shut": narratives of women living with hepatitis C in Australia

Hepatitis C is the leading notifiable infectious disease in Australia and in the last few years, the number of new diagnoses among young women is beginning to outnumber men. For many, infection with hepatitis C virus (HCV) results in a chronic condition, which, in addition to a range of symptoms, carries with it the stigma attached to injecting drug use. Despite the growing prevalence of HCV, women's health has barely begun to address the gender specific impact of this illness on women. We report the results of a qualitative study of young women's experiences of living with HCV with a specific focus on the meaning of this condition and its impact on their lives. In 1999--2000, twenty-five in-depth interviews were conducted with women between the ages of 18 and 43 years, who were current or past injecting drug users and who had been diagnosed with HCV. One focus group discussion was held with health workers who provide treatment and care to this population. A number of key issues were identified that women believed impacted negatively on their lived experiences of HCV. Of most concern was the meaning of HCV and the social stigma attached. Stigma coupled with the lack of knowledge and awareness among health professionals and the high cost of treatment contributed to women's reluctance to seek support and care. HCV has yet to be taken up by the women's health movement as a key issue, especially for young women and we argue that this trend needs to be reversed.     

The popular approach to women's health issues: a content analysis of women's magazines in the 1970's

This study reports the results of a content analysis of three "established" and three "new" popular women's magazines. A sample of 203 articles/features on women's health topics was drawn from a stratified systematic random sample of 157 issues over a ten year period. The two types of magazines were compared for amount of coverage given to women's health issues and specific health-related themes. Health themes covered in the magazines were also compared with statistical data on serious health conditions experienced by women, and leading causes of mortality and morbidity. Established magazines were found to give more overall coverage to women's health than did the new magazines, particularly focusing on diet and exercise. However, little attention was given to the serious health problems women actually experience. Implications of results are discussed and directions for future research outlined.     

Barriers to and attitudes towards promoting husbands' involvement in maternal health in Katmandu, Nepal

Couple-friendly reproductive health services and male partner involvement in women's reproductive health have recently garnered considerable attention. Given the sensitive nature of gender roles and relations in many cultures, understanding the context of a particular setting, potential barriers, and attitudes towards a new intervention are necessary first steps in designing services that include men. In preparation for a male involvement in antenatal care intervention, this qualitative study specifically aims to: (a) understand the barriers to male involvement in maternal health and (b) explore men's, women's, and providers' attitudes towards the promotion of male involvement in antenatal care and maternal health. In-depth interviews were conducted with fourteen couples and eight maternal health care providers at a public maternity hospital in Katmandu, Nepal. Additionally, seventeen couples participated in focus group discussions. The most prominent barriers to male involvement in maternal health included low levels of knowledge, social stigma, shyness/embarrassment and job responsibilities. Though providers also foresaw some obstacles, primarily in the forms of hospital policy, manpower and space problems, providers unanimously felt the option of couples-friendly maternal health services would enhance the quality of care and understanding of health information given to pregnant women, echoing attitudes expressed by most pregnant women and their husbands. Accordingly, a major shift in hospital policy was seen as an important first step in introducing couple-friendly antenatal or delivery services. The predominantly favorable attitudes of pregnant women, husbands, and providers towards encouraging greater male involvement in maternal health in this study imply that the introduction of an option for such services would be both feasible and well accepted.     

Macro-level gender equality and alcohol consumption: a multi-level analysis across U.S. States

Higher levels of women's alcohol consumption have long been attributed to increases in gender equality. However, only limited research examines the relationship between gender equality and alcohol consumption. This study examined associations between five measures of state-level gender equality and five alcohol consumption measures in the United States. Survey data regarding men's and women's alcohol consumption from the 2005 Behavioral Risk Factor Surveillance System were linked to state-level indicators of gender equality. Gender equality indicators included state-level women's socioeconomic status, gender equality in socioeconomic status, reproductive rights, policies relating to violence against women, and women's political participation. Alcohol consumption measures included past 30-day drinker status, drinking frequency, binge drinking, volume, and risky drinking. Other than drinker status, consumption is measured for drinkers only. Multi-level linear and logistic regression models adjusted for individual demographics as well as state-level income inequality, median income, and % Evangelical Protestant/Mormon. All gender equality indicators were positively associated with both women's and men's drinker status in models adjusting only for individual-level covariates; associations were not significant in models adjusting for other state-level characteristics. All other associations between gender equality and alcohol consumption were either negative or non-significant for both women and men in models adjusting for other state-level factors. Findings do not support the hypothesis that higher levels of gender equality are associated with higher levels of alcohol consumption by women or by men. In fact, most significant findings suggest that higher levels of equality are associated with less alcohol consumption overall.     

Changing gender roles and health impacts among female workers in export-processing industries in Sri Lanka

Since the economic liberalization in 1977, a large number of Sri Lankan women have entered the labour market and engaged in income-generating activities. Some women choose to travel abroad as domestic workers, while others choose to work in export-processing industries. This process has a profound impact on gender and gender roles in Sri Lanka. Young rural women have changed their traditional women's roles to become independent daughters, efficient factory workers and partially modernized women. Even though changing gender roles are identified as a positive impact of industrial work, the new social, cultural, and legal environments of industrial work have negative impacts on these women's lives. This paper explores health impacts of changing gender roles and practices of young rural women, focusing on the experiences of female workers in export-processing industries. Further, it contributes to the literature on gender and health, and on qualitative approaches within health geographic studies. A model is formulated to suggest a conceptual framework for studying women's health. The model describes the determinant factors of individual health status based on the question of who (personal attributes) does what (type of work) where (place), when and how (behaviours). These are also determinant factors of gender and gender roles of a society. The three types of health problems (reproductive, productive and mental health) of a woman, in this case a female industrial worker, are determined by her gender roles and practices associated with these roles.     

云南省农村妇女生育健康基础服务需要量研究

采用问卷调查与收集现有资料相结合的方法,对云南农村已婚育龄妇女的生育健康基础服务需要量进行了调查研究。结果表明;农村妇女对生育健康服务的需要是综合性的,既包括预防性服务也包括治疗性服务;当前农村育龄妇女面临的主要生育健康问题是以妊高症为主的孕期并发症与合并症、产伤、产后出血、生殖道感染、避孕方法的副作用和并发症等;贫困妇女对服务的需要量更大。要有效地改善农村妇女的生育健康状况,有关部门应向其提供综合性的生育健康基础服务,并把主要生育健康问题列为工作重点。     

2333例城市妇女绝经后生殖健康状况调查

为了解城市妇女绝经后的生殖健康问题，采用整群分层随机抽样方法在１５个省、市的１００个社区抽取 已婚绝经后妇女２ ３３３例进行问卷调查、妇科检查和实验室检查，应用ＳＰＳＳ／１０．０进行数据的统计分析。结果显示绝经 后妇女妇科常见病患病率顺序依次为生殖道感染３２．２％、盆腔肿物１．９％和子宫脱垂／阴道壁膨出１．６％。在生殖道感 染中，慢性宫颈炎占１２．９％、老年性阴道炎１２．８％、细菌性阴道病３．２％、念珠菌性阴道炎２．３％和生殖道沙眼衣原体 感染 ２．２％。有 ２１.６％的妇女近２ w有与妇科常见病有关的症状，其中 ３０． ９％的妇女到医院就医，４７．４％的妇女被诊 断为阴道炎，但治疗方法仅是应用抗生素。有４１．９％的妇女从未进行过妇女病普查普治。提示生殖道感染严重影响着 绝经后妇女的生殖健康，医务人员的治疗水平亟待提高。要重视对绝经后妇女常见病的普查普治，以提高妇女的生活质 量。     

农村已婚育龄妇女生殖保健状况调查

目的: 了解农村已婚育龄妇女生殖保健状况, 为更好地开展妇幼卫生保健工作提供依据。方法: 采用分层整群抽样法抽取咸宁市 3个县的 26个村共 3 612名已婚育龄妇女进行有关生育、保健等生殖健康状况及需求的调查。结果: 农村已婚育龄妇女初婚年龄平均为 21. 6岁、平均孕次 2. 03次, 平均活产子女数 0 .89。已婚育龄妇女接受新婚教育的比例为 12 10%,夫妇双方婚检的参与率为 32. 00%, 文化程度越高, 参与婚前检查和产前检查的比例越高。45. 76%的已婚育龄妇女接受过生殖健康服务, 接受服务的主要地点集中在乡镇计生所 (72. 29% ), 相关信息的获取途径主要为电视 (75. 94% )。已婚育龄妇女对生殖健康服务的需求高, 其中以提供产前检查服务为最高 (93 .80% )。结论: 农村已婚育龄妇女生殖健康服务基础薄弱, 文化程度与个人生殖保健水平呈正相关, 农村已婚育龄妇女生殖保健存在问题较多, 对生殖健康服务的需求迫切。