As part of a theme issue on “Women’s health beyond reproduction – a new agenda,” the current issue of the Bulletin of the World Health Organization features an interview with Ana Langer, Director of the Maternal Health Task Force and Coordinator of the Women and Health Initiative at the Harvard School of Public Health. The interview highlights some of the ways that maternal health connects with broader health concerns, including chronic diseases and conditions. For example, Dr. Langer points out that obstetric fistula, which occurs as a result of complications in childbirth, can have life-long effects, along with chronic illnesses, such as cervical cancer and obesity, which are linked with reproductive and maternal health, and also have far-reaching effects and implications. The interview also touches on issues such as the under-representation of women in clinical trials, a critical challenge for efforts to address the full range of health challenges that women face, particularly when they live in low and middle income countries.
In response to these challenges, Dr. Langer calls for a comprehensive agenda to meet women’s health needs:
Governments and donors should continue their efforts to reduce maternal mortality, considering that MDG 5 is lagging farther behind than any other goal, and to curb HIV infection, which is now a feminized epidemic mainly affecting young women. But they should not wait until these problems are solved to embrace the emerging epidemic of chronic diseases. That, from my perspective, is short-sighted and a false dichotomy. We can address women’s health comprehensively by using some existing service delivery platforms for the “old” problems to start addressing the “new” chronic diseases epidemic. For instance, HIV services, which have been established in many places to treat chronically ill men and women, could be scaled up and used to screen for other chronic diseases. Maternal health services and family planning clinics, which exist in most countries, should also be used to raise awareness, screen for and provide counselling on chronic diseases. Many organizations and individuals are trying to help in that transition but it will take time. It is a change of perspective that the world is not embracing very easily.