Three shocking inequities in women’s health—and what we’re doing to change them

May 29, 2019 by PATH

Phiona Nakabuye (left), a village health worker trained by PATH's Sayana® Press pilot program, with Carol Nabisere (right), age 18, who chose to receive Sayana® Press after being counseled in the various forms of contraception. Uganda. PATH/Will Boase.

Phiona Nakabuye (left), a village health worker trained by PATH's Sayana® Press pilot program, with Carol Nabisere (right), age 18, who chose to receive Sayana® Press after being counseled in the various forms of contraception. Uganda. PATH/Will Boase.

Advances in medicine are improving women’s health worldwide, but the inequities between different countries, communities, and peoples remains outrageous and immoral. Learn how PATH is closing the gaps.

Though global statistics in women's health are trending up, close examination of the data reveals patchwork progress. Inequities in women's health persist—and in some cases, are getting worse—along geographic, economic, and racial lines.

We’ve highlighted three of these shocking inequities in women’s health—and what we’re doing to change them.

A prototype of the Ellavi uterine balloon tamponade. This simple device could save hundreds of thousands of lives, but developing it and bringing it to market has been anything but simple. Photo: PATH/Dave Simpson.

PATH developed prototypes of a low-cost uterine balloon tamponade (UBT) as proof of concept, then partnered with Sinapi Biomedical, a South African medical devices manufacturer, to refine, produce, and scale the device. PATH/Dave Simpson.

Inequity #1. Every day, 830 women die from preventable causes related to pregnancy and childbirth. 821 of those deaths—99 percent of the global total—occur in low- and middle-income countries.

Among those preventable causes, postpartum hemorrhage—excessive uterine bleeding after childbirth—is by far the deadliest. Though it accounts for 25 percent of all maternal deaths worldwide, 99 percent of postpartum hemorrhage deaths occur in low- and middle-income countries. It is unacceptable that lifesaving interventions are readily available in some places, but those very same interventions are too expensive in others.

These inequities are not only defined by geography and economics. They are also defined by color. Though deaths from postpartum hemorrhage are rare in high-income countries when compared to their low- and middle-income counterparts, the racial inequity among those that do occur is unacceptable. Black women in the United States are three times more likely than white women to suffer a pregnancy-related death.

To address this global injustice, PATH has advanced a low-cost uterine balloon tamponade—a minimally invasive intervention that effectively treats postpartum hemorrhage. PATH is also working with partners to gain regulatory approval and roll out the new device. Widespread use of the tamponade could save the lives of 169,000 women by 2030.

A trainer in Guatemala teaches a lab technician how to run the careHPV(TM) test as part of PATH's Scale-Up Project to reduce cervical cancer incidence in Central America through expanded screening using human papillomavirus testing. PATH/Rose Slavkovsky.

A trainer in Guatemala teaches a lab technician how to run the careHPV(TM) test as part of PATH's Scale-Up Project to reduce cervical cancer incidence in Central America through expanded screening using human papillomavirus testing. PATH/Rose Slavkovsky.

Inequity #2. Each year, more than 300,000 women die of cervical cancer. About 260,000 of those deaths—85 percent of the global total—occur in low- and middle-income countries.

Much of this inequity comes down to a lack of basic prevention and screening. For certain countries and communities, managing cervical cancer through preventive programs is considered the norm—and easily taken for granted. For example, young girls are vaccinated against human papillomavirus (HPV)—the leading cause of cervical cancer—and women have regular screenings that allow pre-cancerous lesions to be identified and treated.

However, for communities of color in high-income countries, and for all those living in low-income countries, the lack of screening and prevention means the majority of cancer cases aren’t diagnosed until late stages.

That’s why PATH is working to bring prevention and screening for cervical cancer to women around the world. We’ve developed a low-cost HPV DNA test and self-testing kits for cervical cancer that allow for earlier detection and improved outcomes.

Aminata Gaye, 29, (in pink) explains to Mossan Faye, 21, how to self-inject the contraceptive Sayana® Press at the Dominique Health Center in Pikine, Senegal. PATH/Gabe Bienczycki.

Aminata Gaye, 29, (in pink) explains to Mossan Faye, 21, how to self-inject the contraceptive Sayana® Press at the Dominique Health Center in Pikine, Senegal. PATH/Gabe Bienczycki.

Inequity #3. Despite increased access to contraception worldwide, more than 200 million women who want to use modern contraceptives are still unable to do so.

They either lack access altogether or are impeded by social, cultural, political, or economic barriers. And when women lack access to contraception, they lack control over their health, the size of their families, their careers, and their futures. The unmet need for contraception remains highest in Africa, where nearly 25 percent of all reproductive-age women lack access to modern methods.

To meet this need, PATH develops technologies that give women control over their sexual and reproductive health. Our projects range from helping introduce and scale the first self-injectable birth control (Sayana® Press) and designing a one-size-fits-most silicone diaphragm (Caya®) to developing a next-generation female condom (Woman’s Condom). PATH also forges efficient supply chains to ensure women have dependable access to the contraceptive and reproductive health supplies they need.

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