Women's Health

This briefing provides a simplified and abridged summary of over four decades of learning that has taken place within social science approaches to health as well as the development sector, about the relevance of gender in global health. It aims to provide a starting point for researchers, such as biomedical scientists, who are unused to including gender issues in their own work or unfamiliar with social science approaches to gender. In addition to providing a simplified introduction, it provides some links to more detailed resources. This briefing outlines how gender relates to the field of global health in relation to four key dimensions: 1) Non-communicable and infectious diseases, 2) structural aspects of healthcare, 3) research priorities, and 4) women’s health.

Introduction The initial International Conference on Population and Development in 1994 contains the first reference to sexual and reproductive health and reproductive rights (SRHR). It has been considered agreed language on SRHR in future United Nations (UN) documents. However, opposition to SRHR in global forums has increased, including in conjunction with an increase in religious, far-right populist politics. This study provides an empirical analysis of UN documents to discover whether opposition to SRHR has resulted in changes in the language on SRHR between and what these changes are.

Methods This is a qualitative policy analysis in which 14 UN resolutions, 6 outcome documents from the Commission on the Status of Women (CSW) and 522 country and group statements and 5 outcome reports from the Commission on Population and Development were collected from the organisations websites from 2014 to 2019. Framework analysis was used. The text from documents was charted and indexed and themes developed from these.

Results The results demonstrated a disappearance of the language on abortion in the CSW outcome documents from 2017 and a change in the language on comprehensive sexuality education in the CSW as well as the UN General Assembly resolutions from 2018. This change included a removal of ‘sexuality’ to an increased emphasis on the role of families. Furthermore, documents showed an inability of some states to accept any mention of sexual and reproductive health at all, expanding from the usual contestations over abortion.

Conclusion Our findings suggest that the global shift in politics and anti-SRHR actors at UN negotiations and conferences have removed previously agreed on language on SRHR from future UN resolutions and outcome documents. This is a concern for the global realisation of SRHR.

Citation: Afolabi Aanuoluwapo Deborah., et al. "Low Back Pain and its Association with Energy Expenditure and Occupational Activities among Nigerian Physiotherapists". EC Orthopaedics 11.8 (2020). Abstract Objective: The objective of this study was to determine the association between low back pain and occupational activities and energy expenditure among physiotherapists. Methods: Ethical clearance was obtained from institute of Public Health, forty-five (45) physiotherapists were recruited for this study using non-probability sampling technique, and procedure for data collection was explained to participants. A structured self-administered questionnaire on low back pain and occupational activities was then administered to each participant and subsequently pedometer was fixed on the waist and worn during working hours for two days. Data was analyzed using descriptive statistics of mean, standard deviation, frequencies, percentages, Chi square, independent t-test, ANOVA and Spearman rank correlation coefficient. Significance was set at 0.05 α-level. Results: Results obtained showed that 73.3% of physiotherapists with average age of 32.64 ± 5.10 years had history of low back pain. Also, it was observed that there was significant association between all occupational activities studied viz bending or twisting, maintaining a position for a prolonged period of time, performing manual therapy technique, performing repetitive task, transferring of patients, working when physically fatigued and history low back pain. Only awkward position among all the occupational activities was significantly related to energy expenditure. Conclusion: It was concluded that occupational activities rather the energy expenditure was associated with history of low back pain among physiotherapists.

Traditional health management issues are being redefined with diverse mobile technologies, and smartphones and applications have taken the lead. Particularly, increasing numbers of pregnancy applications have entered the market with far-reaching benefits; yet, they fall short to be integrated into daily lives of pregnant women, which implies that mobile health (m-health) technologies should not be merely information providers, decision makers, or problem solvers. In fact, they should go beyond by making pregnant women feel happy and enhancing their wellness holistically. Certain benefits of and trends about m-health use during pregnancy have been exemplified in literature; however, detailed characteristics of them have not been identified.
This dissertation identifies the changes in daily experiences of pregnant women, in general, and characteristics of mobile pregnancy technologies that can enhance their wellness and happiness, in specific, with a user research conducted with pregnant women in three different trimesters. The study involved the usage of a pregnancy application during six weeks, accompanying with multiple in-depth interviews with each pregnant woman. The results have shown that needs and expectations change according to different trimesters and pregnant women types. Correspondingly, positive user experience dimensions with mobile pregnancy technologies and their conceptual relationships, as well as content, interaction, appearance, and function related characteristics and scopes of mobile pregnancy technologies have been revealed paying attention to wellness dimensions during pregnancy. Moreover, feeding from the results of the study and positive psychology literature, design descriptions have been delivered that would focus on the wellness and happiness of different pregnant women.

Design has turned towards positive psychology, noticing its potential beyond overcoming problems and tracing possibilities to enhance quality of life. As a newly blossoming domain, design for well-being faces with challenges like correct translation of well-being concept and advancing a shared language. Calls are made for empirical research to test, discuss and expand on already introduced materials. This paper exemplifies a use case of an existing framework, the Design Well-Being Matrix, and builds on it by demonstrating alternate use opportunities considering designers’ needs from user research deliverables. The case involves the utilisation of the framework as an analysis, synthesis, and communication tool in a research on characteristics of digital health technologies that aim at enhancing the well-being of pregnant women.

Ouvrage conçu et coordonné par Jean COHEN, Patrick MADELENAT et Rachel LEVY-TOLEDANO.
Contribution du GYT Institute et de 20 experts en gynécologie, obstétrique et santé publique.

Réflexion sur l'avenir de la gynécologie et sur la prise en charge des femmes en France en 2020.
Etat des lieux en 2000 - Perspectives en 2020.
L'offre de soins en gynécologie sera-t-elle en adéquation avec les besoins des femmes ? Nous avons alors décidé de mener cette réflexion en nous basant sur des chiffres et des situations réels et en comparant notre système de santé à celui d'autres pays européens.

Worldwide, almost 630,000 women died from breast cancer last year. North American women face a lifetime risk for breast cancer of one in eight, with nearly 500 new breast cancer diagnoses each week in Canada. The overall global incidence of breast cancer continues to rise. Five to ten % of cases are related to genetics, family history, lifestyle and behaviour, all factoring into overall incidence. Fewer than 50% of breast cancers can be explained by the known or traditionally suspected risk factors. The complexity of the varied contexts, which produce disparate degrees of risk, should be incorporated into prevention strategies. Increased attention to environmental and occupational risk factors represents a significant site where primary prevention interventions could be effective. This qualitative study examines how women who work in an environment with an identified risk of breast cancer construct understandings and narratives of their risks and how women perceive and exercise agency in the acceptance, avoidance or negotiation of those risks. Personal narratives were gathered through in-depth individual interviews from 25 women who are current or former employees of the Ambassador Bridge in Windsor, Ontario, Canada. The research draws on Kleinman's ecological approach, where the subject location is key to the framework for understanding health information within its socio-cultural context. Kleinman's approach is further developed in this study by incorporating feminist standpoint theory and a socio-ecological framework. The theoretical approach constructed by incorporating these multiple perspectives frames women's subjective understandings as situated in their socio-cultural contexts and allows understanding subject location and, importantly, agency—or control over breast cancer risks—as seen through the subject in her location. The narratives reveal how women construct their understanding of breast cancer risks, particularly concerning environmental factors, based on personal knowledge, occupational experience, and through the lens of gender. The exploration uncovers and analyzes how women's subject location influences understandings, interpretations and use of knowledge about perceived risks for breast cancer in a risk-bearing environment and their related ideas about agency directed at risk mitigation. Policy, regulation, and risk mitigation strategies are enhanced by understanding how women make meaning in their knowledge of breast cancer risks and how they perceive the possibilities and barriers to agency to mitigate risks. The way women understand breast cancer risk is dynamic, contextualized, multisectoral, and relational and offers insights into understanding spaces. As seen from women’s standpoint, breast cancer risk is not solely a biomedical phenomenon residing in the body, determined by genetics or lifestyle choices, but is experienced by women in a nested set of social, cultural and political relationships. Increased understanding and collaborative partnerships between medical science and social science would improve breast cancer prevention strategies, particularly where risks are related to involuntary, environmental exposures. The findings contribute to efforts to address environmental health risks at the Ambassador Bridge and other workplaces and communities.

This paper explores the intersections within bodily materialism and future textiles by inquiring into embodied practices and materiality in care. By placing the body as a site of research, it centres around concepts of bodily care and the body as an ecosystem, one that is always in flux and considers the fluidity of bodies and bodily fluids, such as urine, discharge, breath and sweat, as fluids with potential to design with. It looks at how bodies are acted upon by outside forces, and explore more-than-human relations as co-creators in co-habiting the space of the body and that around it. To illustrate this, the paper introduces a series of design research artefacts that take a variety of approaches to exploring the materiality of care in the everyday. First, an eTextile toolkit that aims to create bodily awareness through hands-on engagement with textile crafting technology, then a biotextile harvesting toolkit that involves the raw material of the intimate body that explores DIYbio in the context of the home, and lastly a set of wearable living material-based explorations that recognize biomimicry and symbiotic relationships in designing for chronic stress. In embracing notions of bodily materialism, this paper explores the bodily abject i.e. fluids and the more-than-human as crucial to engendering new modes of knowing in intimate and personal care through textile-based materials. The paper engages critically with textile design research and practice by placing material that embraces care as ambivalent at the forefront and thus challenging traditional approaches to health and care and, importantly, the design of future textiles.

Although puberty occurs to both male and female bodies, celebrating a girl’s ‘transition to womanhood’ is considered to be a grand affair in many societies and comes with its own set of rituals. Such celebration as a ritualistic event, projects a hetero-normative and patriarchal view of womanhood. Assam has its own peculiar ways of rituals and customs to celebrate a girl’s puberty or her menarche through the Tuloni Biya. The essay takes a critical look at this particular ritual.

FRENCH NEW EDITION OF OUR BODIES, OURSELVES

co-authored with : Mathilde Blézat, Naïké Desquesnes, Nina Faure, Nathy Fofana, Hélène De Gunzbourg, Marie Hermann, Nana Kinsky, Yéléna Perret

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FRENCH DESCRIPTION
Le collectif Notre corps, nous-mêmes s’est formé en 2016 dans le but de réactualiser le livre du même nom paru en 1977. Notre corps, nous-mêmes est un manuel de santé féministe, forgé à partir de nos expériences et des paroles de plus de 400 femmes cisgenres, et de quelques personnes trans et non-binaires, qui ont accepté de nous confier leurs vécus, leurs analyses, leurs ressources ou stratégies pour se défendre, s’émanciper et se réapproprier leur corps.

Ce manuel pourra accompagner les femmes dans les différentes expériences de leur vie (règles, sexualités, accouchements, ménopause, prise de conscience de son corps, choix de vie, travail...) et les aider à se défendre contre les injonctions et les violences patriarcales dans la sphère intime, institutionnelle ou publique.

Abstract: Often, people are able to recall a message on a particular topic for a long period of time. These memorable messages have the ability to influence behavior when they are recalled from memory long after initial exposure. Knowing the topics and sources of the messages that are remembered about breast cancer can improve the efficacy of future breast cancer outreach. To this end, 359 women completed an online survey about memorable breast cancer messages. Most women (60%) recalled a memorable message, described it, identified its source, and noted whether it had resulted in prevention or detection behaviors. Four categories of message topics emerged: early detection (37.3%), awareness (30.9%), treatment (25.8%), and prevention (6%). Furthermore, five categories of sources of these memorable messages were found: media (35.5%), friends (22.2%), family (21.6%), medical professionals (15.2%), and others (5.5%). The media were a major source of all four topics of messages, although family members, friends, and the medical community were major sources for particular message topics as well. Memorable messages originating from medical professionals were substantially more likely to motivate detection behaviors than prevention behaviors. This research demonstrates that message topic and source both play roles in determining message recall as well as in determining how memorable messages impacted behavior.

Early menopause (EM) or premature ovarian insufficiency (POI) can disrupt gendered and age‐related expectations associated with perceived ‘normative’ biographies for young adult women, with implications for subjectivity and relationships. While previous qualitative research has concentrated on the impacts of EM/POI on biography and sense of self, in this article, we examine the enmeshment of personal relationships with the formation of early menopausal subjectivities. Drawing on research exploring concepts of ‘biographical disruption’ and personal relationships, and theoretical work on social norms and subject formation, we present findings from a narrative thematic analysis of 25 interviews with women diagnosed with spontaneous or medically induced EM/POI. We identify three main narrative ‘types’ of subjective and relational experience in response to the ‘disruption’ of EM/POI: interlude and continuity; disruption and adaptation; and disruption and ambivalence. Women’s accounts of their experience of EM/POI indicate that the formation of early menopausal selves is mediated by the extent to which women and those around them identify with gendered norms related to reproduction and age. Consistent with theoretical perspectives that consider the self as relationally produced, we argue that the subjective and relational dimensions of EM/POI are intertwined and must be understood in tandem.

Many diseases are caused by our culture, and are reinforced by habit, custom, and unspoken social pressures. To prevent these lifestyle, or culturogenic diseases, we need to radically change our way of life. And it usually takes some cultural crisis to make this type of fundamental change possible.

One disease which is largely culture-caused is breast cancer. The primary cultural factor causing this disease is the excessive wearing of tight bras daily. While this is an inconvenient truth for a bra-using culture which has been ignoring the harmful impacts of bras on breast health, dozens of studies internationally now confirm that bras are a leading cause of breast cancer.

This means that, in order to end the breast cancer pandemic, we need to end the harmful use of bras. However, given the entrenchment of bras in modern culture, it would take an unprecedented cultural shift to allow women the opportunity to end their habit of using bras.

Enter COVID-19.

Alliance of International Doctors (AID), Esenler Maternity and Child Health Hospital (EMCHH) implemented an educational project on pregnancy and maternal health targeting pregnant Syrian women in Esenler District of Istanbul. The Project aims were increasing health literacy, service utilization and social integration among the pregnant Syrian women. The Project carried out with twelve groups for twelve months. Each group had twelve or fifteen women trained for six hours within a month and reached to a hundred seventy women between October 2017 and October 2018. The Motherhood school was practiced in EMCHH. 124 women of participants filled in-person satisfaction surveys. Data was obtained from 77 women about their delivery experiences through phone surveys. 80 postnatal home visits were conducted by medical voluntary teams who observed general health of mothers and babies along with the mothers' knowledge and practices. According to the results, 23.4 % of the participants were under eighteen years old and 8.9 % were above thirty-five years old. 18.8 % had four or more pregnancies. Of the 124 survey participants, 118 visited EMCHH for antenatal care, 123 reported high satisfaction and benefits with the trainings and 122 reported satisfaction with its scope. High awareness and practice of breastfeeding, vaccination were observed during postnatal visits.

Childbirth is part of our women’s lives and it is one of the most transforming. It happens through the same love canal where we experience sexual pleasure, our yoni, and it is indeed a continuation of women’s sexual life in its full orgasmic potential. Today we have the science that proves the importance of modulated voice for the wellbeing of women, children, men, couples, communities and human species in general. The melodious maternal voice has a special effect on humans, as it is in the roots of our linguistic and social behaviour. Yet singing during childbirth has still to be properly addressed as a beneficial and powerful practice used by women and by traditional as well as medically trained midwives and ob-gyns inside maternity assistance nowadays. Until recent times women used to sing and dance during important moments of their social and individual lives, including childbirth. You don’t have to be a professional singer to sing while you’re having your baby. Spontaneous singing is part of our human nature and culture. Making peace with our own ancestors is the first step to remember and set our voice free in order to regain our dignity as childbearing women and mothers.
Cit.
Skoko, E., 2017, Singing Birth. From Your Voice to Your Yoni, Rose M.J., Ross L., Hartmann J. (ed). The Music of Motherhood: History, Healing, and Activism, 105-120, Demeter Press, ISBN: 9781772581348.