Gender and Health Flashcards
The global understanding of sexual health has evolved over time, including in its relationship to reproductive health.
World Health Organization (WHO)
In 1974 – WHO convention in Geneva
―the integration of the somatic, emotional, intellectual, and social aspects of sexual being, in ways that are positively enriching and that enhance personality, communication, and love
Sexual Health
attention to pleasure and the right to sexual information were fundamental to this definition.
Sexual Health
- “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes
Reproductive Health (ICPD,1994)
ability of people ―to have a satisfying and safe sex life‖ and the capability and freedom to reproduce if and when desired.
Reproductive Health (ICPD,1994)
It also included sexual health
Reproductive Health
the stated purpose of which was the enhancement of life and personal relations, and not merely counselling and care related to reproduction and sexually transmitted diseases
sexual health,
Global health burden
-extensive mortality and morbidity
➢-HIV
➢-STIs
➢-unwanted pregnancies
➢-unsafe abortions
➢-infertility
➢-maternal and genitourinary conditions
➢-gender-based violence
➢-sexual dysfunction
There was also growing awareness about the impact of stigma, discrimination and poor quality of care on people‘s
sexual and reproductive health.
This is a state of physical, emotional, mental and social well-being in relation to sexuality
Sexual Health
it is not merely the absence of disease, dysfunction or infirmity
Sexual Health
requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
Sexual Health
For it to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.
Sexual Health
refers to the biological characteristics that define humans as female or male.
Sex
While these sets of biological characteristics are not mutually exclusive, as there are individuals who possess both, they tend to differentiate humans as males and females.
Sex
For technical purposes in the context of sexuality and sexual health discussions, the above definition is preferred.
Sex
This is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction.
Sexuality
It is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. - not all of them are always experienced or expressed.
Sexuality
Influences: biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors
Sexuality
Sexual rights
the rights to [?] of the person
the rights to [?]
the right to be free from [?]
the right to [?]
the rights to the [?] (including sexual health) and social security
the right to [?] and enter into marriage with the free and full consent of the intending spouses, and to equality In and at the dissolution of marriage
the right to decide the number and [?] of one‘s children
the rights to information, as well as [?]
the rights to [?], and the right to an effective remedy for [?] of fundamental rights.
life, liberty, autonomy and security
equality and non-discrimination
torture or cruel, inhuman or degrading treatment or punishment
privacy
highest attainable standard of health
marry and to found a family
spacing
education
freedom of opinion and expression; violations
protect all people‘s rights to fulfil and express their sexuality and enjoy sexual health, with due regard for the rights of others and within a framework of protection against discrimination.
Sexual rights
Major public health concern contributing significantly to the global burden of adult disease both because of the acute illness and because of long-term outcomes.
STIs
-chronic pain, infertility, adverse outcomes of pregnancy (including stillbirth and low birth weight) and cancers of the reproductive tract (including cervical cancer)
STIs
Most Common and Curable STIs
• Chlamydia • Syphilis • Gonorrhea • Trichomoniasis
Untreated STIs and RTIs are associated with an increased risk of [?] transmission. Effective management of STIs is therefore crucial for controlling the transmission of [?] in some populations (Grosskurth et al., 2000).
HIV
• can cause infection among both men and women
Chlamydia
• cause permanent damage to a woman’s reproductive system.
Chlamydia
• it difficult or impossible to get pregnant later.
Chlamydia
• potentially fatal ectopic pregnancy
Chlamydia
pain or burning while peeing.
Chlamydia
pain during sex.
Chlamydia
lower belly pain.
Chlamydia
abnormal vaginal discharge (may be yellowish and have a strong smell)
Chlamydia
bleeding between periods.
Chlamydia
pus or a watery/milky discharge from the penis.
Chlamydia
swollen or tender testicles.
Chlamydia
pain, discharge and/or bleeding around the anus.
Chlamydia
• The disease starts as a sore that’s often painless and typically appears on the genitals, rectum or mouth.
Syphilis
spreads from person to person through direct contact with these sores.
Syphilis
Stages/Waves of Syphilis
Primary
Secondary
Latent
Late (Tertiary)
infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in women and men.
Gonorrhea
• If you are pregnant and have gonorrhea, you can give the infection to your baby during delivery.
Gonorrhea
Often has no symptoms but can cause serious health problems.
Gonorrhea
Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection.
Gonorrhea
Painful or burning sensation when peeing
Gonorrhea
Increased vaginal discharge
Gonorrhea
Vaginal bleeding between periods.
Gonorrhea
A burning sensation when peeing
Gonorrhea
A white, yellow, or green discharge from the penis
Gonorrhea
Painful or swollen testicles (although this is less common).
Gonorrhea
Rectal infections may either cause no symptoms or cause symptoms in both men and women that may include: Discharge; Anal itching; Soreness; Bleeding; and Painful bowel movements.
Gonorrhea
• Caused by a parasite
Trichomoniasis
• discharge usually has a strong, unpleasant, and sometimes fishy smell
Trichomoniasis
In women, trichomoniasis can cause a foul-smelling vaginal discharge, genital itching and painful urination.
Trichomoniasis
Men have typically have no symptoms.
Trichomoniasis
VULNERABLE POPULATION
Young people
People who engage in transactional sex or commercial sex
People who are sexually abused
People who are at risk of violence within their sexual relationships
―a procedure for terminating an unintended pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards, or both‖ (WHO, 1992).
Unsafe Abortion
Unsafe abortions account for [?] of all maternal deaths worldwide. It is estimated that [?] died from the complications of unsafe abortion in 2003 alone.
13%
66,500 women
Factors influencing the incidence of unintended pregnancies and unsafe abortions
➢access of young women and young men to [?];
➢the legality of [?] to unmarried young people;
➢the legality of [?];
➢ [?] with regard to sex outside marriage;
information on contraception
supplying contraceptives
abortion
sociocultural norms and practices
A number of factors influence the incidence of unintended pregnancies and unsafe abortions in any setting.
➢ [?] and the provision of safe abortion;
➢ the influence of [?] on the ability of girls and women to use contraceptive methods, or to reject sexual relations with men;
➢ the readiness of the [?] to provide safe abortions to the full extent of the law.
unintended pregnancies
gender-power relations
health service
A [?] applied to abortion in general is sought to act across a range of domains, with the intention not only of ensuring that abortion is made safe, but also to reduce the need for abortion in the first place.
sexual health framework
• Some countries who applied a [?] have successfully reduced the incidence of unsafe abortion by legalizing it (Cook et al., 2003; Grimes, 2006).
sexual health framework
reduced the incidence by making their existing legal services safer (Ganatra et al., 200)
• Mongolia and VietNam
• Other countries like [?] have taken steps to reduce the stigma associated with abortion (Ngwena, 2004; Ipas, 2008).
South Africa and Ghana
Concerns related to sexual functioning are universal, but they have culturally specific forms.
Sexual dysfunction
Sexual problems include:
low sexual desire
male erectile dysfunction
an inability to achieve orgasm
Premature ejaculation pain during intercourse
vaginismus
is surprisingly common in all societies in which studies have been conducted in several countries (Egypt, Islamic Republic of Iran, Morocco, Nigeria, and Pakistan)
Erectile dysfunction
the likelihood of men reporting [?] has been found to be associated with various characteristics, most common of which is increasing age (Berradaet al., 2003; Safarinejad, 2003; Seyamet al., 2003; Shaeeret al., 2003).
erectile dysfunction
Most men and women with sexual dysfunction who seek care, tend to look for it within the [?]. This is because [?] servicesaddressing sexual function and dysfunction are relatively uncommon.
private sector
public sector
Studies around the world, including research in Egypt, Nigeria and Pakistan, have found that sexual dysfunction is associated with common mental illnesses, including
depression, and with low quality of-life(QoL) scores.
Violence related to gender and sexuality is both a
violation of human rights and a public health concern.
Sexual and other forms of gender-based violence include
➢rape
➢coerced sex
➢child sexual abuse
➢sexualized forms of domestic violence
➢Intimatepartner violence,
➢FGM
➢“honour”crimes
➢forced prostitution
can be directed at women or men, girls or boys, and any group in a position of vulnerability.
Sexual violence
The most common is violence towards women by men who are known to them, particularly their partners and husbands, but also other family members.
Sexual violence
includes acts of physical aggression, psychological abuse, sexual coercion (including rape), and a range of controlling behaviours(WHO, 2005).
Intimate partner violence
can be an important factor in unwanted pregnancy, in the acquisition of STIs including HIV, and in sexual dysfunction.
Violence
[?], both vaginal and anal, can potentially increase the risk of HIV transmission because of the resulting abrasions and injuries.
Forced sex
Studies show that sexual abuse early in life can lead to increased illhealth in adulthood.
Forced sex
This is partly because of increased sexual risk-taking, such as having early first sex, multiple partners, and participating in sex work of various kinds (Klein & Chao, 1995)
Forced sex
can be an obstacle to achieving sexual health in more indirect ways. (e.g.Male dominance-female has reduced autonomy)
violence
“physical disabilities can affect sexual functioning andhave anegative impact on sexual wellbeing”
Interpersonal relationships
Self-esteem
Body image
neurological disabilities such as spinal cord injury, stroke,multiple sclerosis, traumatic brain injury and cerebral palsy.
Physical disabilities
The sexual needs andexpressions of people with these disorders are often ignored, because there is aperception that they are not –or should not be –sexually active.
Physical disabilities
also have a negative impact on sexual health
chronicillnesses
Other [?], including arthritis, cardiovascular disease, diabetesand depression, aswell as certain medications (such as those used for treating high blood pressure)are also implicated in sexual health problems
chronicillnesses
might include the creation of policies to increase the social acceptability of sexual expression by people with a disabilityor chronic illness.
Sexual health framework
It might also address the provision of information and education regarding certain side-effects of medicinesused by people with chronic disease.
Sexual health framework
SEXUAL HEALTH FRAMEWORK (DOMAINS, BARRIERS, AND PROMOTIONS)
- Laws, policies, and human rights
- Education
- Sociocultural
- Economic
- Health
• Work to change political structures that do not recognize sexual health concerns, or HIV-and sexualityrelated stigma.
- Laws, Policies, and Human Rights
• Work for the repeal of discriminatory laws and policies, and to establish mechanisms to redress violations of human rights.
- Laws, Policies, and Human Rights
• Work to review laws and policies as they affect sexual and reproductive health.
- Laws, Policies, and Human Rights
• Work to review the application of human rights standards to sexual and reproductive health.
- Laws, Policies, and Human Rights
Work to create political support for sexual health issues and interventions
- Laws, Policies, and Human Rights
Promote dialogue about sexual health at all political levels from grass roots to national leadership, including religious and community leaders
- Laws, Policies, and Human Rights
Publicize the efforts of leaders who work to promote sexual health
- Laws, Policies, and Human Rights
Develop a strong evidence base to identify best practices in relation to sexual health, and promote commitment to them
- Laws, Policies, and Human Rights
Promote and implement supportive rights-based national legislation, policy frameworks and institutional policies
- Laws, Policies, and Human Rights
Promote awareness of rights (e.g.through work with media) Use international human rights standards in advocacy (e.g. in challenging FGM)
- Laws, Policies, and Human Rights
Incorporate promotion of rights, diversity and gender equality into teacher-training curricula.
- Education
Increase access to comprehensive, choicebasedsexualityeducation in schools.
- Education
Promote sexuality education for the most vulnerable, including young people who do not attend school
- Education
Promote equality within sexual partnerships and challenge and condemn violence.
- Education
Promote community-based work on gender equality, building on positive social norms.
- Education
Recognize and remove barriers to general and sexuality education.
- Education
Recognize the role of genderbased power in sexual relationships as a determinant of sexual health outcomes Identify cultural practices that contribute to sexual ill-health.
- Sociocultural
Promote equality and responsibility in relationships
- Sociocultural
Challenge discrimination based on sexual and gender diversity
- Sociocultural
Recognize the positive role that men can play in improving women‘s health
- Sociocultural
Promote cultural practices that improve sexual health (e.g.early discussions of sexuality and sexual health)
- Sociocultural
Engage influential community leaders (e.g. religious leaders) in debate to promote awareness of public health imperatives of addressing sexual health issues.
- Sociocultural
Build partnerships to implement culturally sensitive programmesaimed at preventing violence against women, sexual violence, intimate partner violence, and FGM.
- Sociocultural
Recognize and emphasize the links between economic marginalization and sexual ill-health.
- Economic
Promote economic empowerment and alternative livelihood strategies for vulnerable groups (e.g.women, sex workers, young people, migrants, and LGBT who leave home)
- Economic
Promoteeconomic development that favours economic improvement and opportunity for women and girls
- Economic
Support research on the links between sexual health and poverty.
- Economic
Eliminate barriers to service provision
- Health
Ensureadequate resources for sexual health services
- Health
Increase access to sexual health services and resources, especially for the most vulnerable.
- Health
Improve quality of sexual health care by implementing nonstigmatizing, rights-based approaches to service provision.
- Health
Encourage religious leaders to challenge HIVand AIDS relatedstigma and social and gender issues that are harmful to health within communities
- Health
Enhance communication between providers and clients (e.g. by promoting counselling within sexual health services) .
- Health
Promote greater integration of sexual health services.
- Health
Reach out to men in more positive ways.
- Health
