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Women’s health is nation’s wealth: HOW HAVE WOMEN FARED DURING COVID 19?

Updated: Sep 5, 2021

Often, we hear about women’s independence in society. According to us, it is more of inter-dependence. Both woman and man have an equal role to play, but it is the woman who embarks on the journey of giving life. Unless we ensure that a woman has access to universal healthcare, especially to prevent maternal deaths and take on the non-communicable diseases, we cannot claim that we have addressed all issues of women,” observed Dr Hema Divakar, CEO of ARTIST for Her and past president of FOGSI (1).

This mantra includes covering the broad umbrella of women’s healthcare – from the womb to tomb approach, as every health issue faced by a woman is complex (1).

Meeting women’s health needs and eliminating gender inequality are moral imperatives and fundamental human rights, and investment in women’s health should therefore not require justification (2). Although women live longer than men, they have specific unmet health needs and higher morbidity (3). Women not only provide most of the informal care in homes and communities, they also represent 70% of the global health workforce, making them central to overall population health (4).

How have women fared during the COVID-19 pandemic?

Sex-disaggregated data for COVID-19 show that there seem to be sex differences in mortality and vulnerability to the disease. Emerging evidence in the first stages of the pandemic, suggested that more men than women were dying, potentially due to sex-based immunological or gendered differences, such as patterns and prevalence of smoking (5). In Israel although mortality among men is still higher than women, women of many age groups have a higher incidence of infection than men

Source: Golbal health 50\50

Source: Global health 50\50

As with the experience from previous pandemics women are more vulnerable to infection as frontline health care workers or caregivers in the family and community (7).

Women’s burdens grow as they are often the focal point of community responses, take part in front-line service delivery or behavioural change initiatives, and women take on additional care burdens within the family. Women often embrace these roles, despite the harm to their

own health, including mental health, well-being and economic security (6). Women also face secondary health impacts in terms of increased maternal mortality and reduced access to sexual and reproductive health services

Women and the economic fragility of COVID-19

Compounded economic impacts are felt especially by women and girls who are gen­erally earning less, saving less, and holding insecure jobs or living close to poverty (8).

Across the globe, women earn less, save less, hold less secure jobs, are more likely to be employed in the informal sector. They have less access to social protections and are the majority of single-parent households. Their capacity to absorb economic shocks is therefore less than that of men (8).

Unpaid care work has increased, with children out-of-school, heightened care needs of older persons and overwhelmed health services. All the domestic duties and responsibilities, things like childcare, preparing food for the extra youngsters who would normally be at school, and looking after sick family members, fall disproportionately on women” (9). As women take on greater care demands at home, their jobs will also be disproportionately affected by cuts and lay-offs (8).

Source: United Nations Policy Brief. The Impact of COVID-19 on Women 9 April 2020

The special role of women as front-line healthcare workers

Sustaining safe and quality care in the SARS-CoV-2 pandemic hinges on the health and mental wellbeing of frontline healthcare workers. Medical staff face exhaustion, difficult triage decisions, separation from families, stigma and the pain of losing patients and colleagues, in addition to their own risks of infection (10).

Special attention needs to be given to the health, psychosocial needs and work environment of frontline female health workers, including midwives, nurses, community health workers, as well as facility support staff. Personal Protective Equipment should be the appropriate size for women. It has been found that masks and covers that were sized using the ‘default man’ size often used in design and production leave women more exposed. It is important to include products such as essential hygiene and sanitation items (8).

Gender-based violence in COVID-19

As the COVID-19 pandemic deepens eco­nomic and social stress coupled with restricted movement and social isolation measures, gender-based violence is increasing exponentially (8).

Source: United Nations Policy Brief. The Impact of COVID-19 on Women 9 April 2020

Securing the mental wellbeing of healthcare workers

Caring for patients with COVID-19 disease causes considerable mental stress, resulting in high levels of anxiety and post-traumatic stress disorders, especially among nurses (11).

A recent systematic review and meta-analyses of 13 cross-sectional studies and a total of 33,062 participants provides early evidence that a high proportion of healthcare professionals experience significant levels of anxiety, depression and insomnia during COVID-19 pandemic. The prevalence rate of anxiety and depression appeared to be higher in females, and nursing staff exhibited higher prevalence estimates both for anxiety and depression compared to doctors. These results may be partially confounded by the fact that nurses are mostly female, but could be also attributed to the fact they may face a greater risk of exposure to COVID-19 patients as they spend more time on wards, provide direct care to patients and are responsible for the collection of sputum for virus detection. Due to their closer contact with patients, nurses may also be more exposed to witnessing patient suffering, death and ethical dilemmas (11).

The impact of COVID-19 on the pregnant mom and unborn child

Although the impact of this pandemic on maternal mental health has not yet been properly evaluated, the importance of considering the pregnant patient and unborn fetus at increased risk has been highlighted (12). The risk may be related to concerns regarding the wellbeing of the unborn child, but also exacerbated by measures, such as quarantine, physical distancing, home isolation, remote consultations with healthcare professionals, and inability to obtain expected level of support and care prenatally as well as during the intrapartum and postnatal periods (12).

Pregnant women may be at risk of having more severe disease, and maternal and neonatal mortalities have been reported (12).

Pregnant women who are infected with SARS appear to have higher morbidity and mortality compared to their non-pregnant counter-parts, though this is based on only a few small studies. Severe disease requiring hospitalization appears to develop, on average, 7 days after symptom onset1(13). Pregnant women also had longer hospital stays, were more likely to require admission to the intensive care unit, and were three times as likely to require mechanical ventilation (1