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Women health presentation

  1. 1. Woman's health (violence, menopause ,Brest Cancer, and Reproductive health) Physical examination and history taking. Registered midwife Areej Faeq Abu-sharar Major /Head of Midwifery Department at Royall medical services Faculty of nursing
  2. 2. The lecture objectives  At the end of this lecture the students will be:  Identify the meaning of women health .  Define the violence, causes, risk factors.  Define the menopause period, signs and symptoms and risk factors.  Define the breast cancer, signs and symptoms and risk factors.  Explain the nursing role(physical assessment) among these topics.  Explain health promotion strategies.
  3. 3. Women's health  refers to the health of women, which differs from that of men in many unique ways. Women's health is an example of population health, where health is defined by the World Health Organization as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Often treated as simply women's reproductive health.
  4. 4. Woman's health Key facts According to WHO  Worldwide, women live an average four years longer than men.  In 2011, women's life expectancy at birth was more than 80 years in 46 countries, but only 58 years in the WHO African Region.  Girls are far more likely than boys to suffer sexual abuse.  Road traffic injuries are the leading cause of death among adolescent girls in high- and upper-middle-income countries.  Almost all (99%) of the approximate 287 000 maternal deaths every year occur in developing countries.  Globally, cardiovascular disease, often thought to be a "male" problem, is the number one killer of women.  Breast cancer is the leading cancer killer among women aged 20–59 years worldwide.
  5. 5. Infancy and childhood (0-9 years)  Both death rates and the causes of death are similar for boys and girls during infancy and childhood.  Prematurity, birth asphyxia and infections are the main causes of death during the first month of life, which is the time of life when the risk of death is the highest.  Pneumonia, prematurity, birth asphyxia and diarrhoea are the main causes of death during the first five years of life. Malnutrition is a major contributing factor in 45% of deaths in children aged less than 5 years
  6. 6. Adolescent girls (10-19 years)  Mental health and injuries: • Self-inflicted injuries, road traffic injuries and drowning are among the main causes of death worldwide in adolescent girls. • Depressive disorders and – in adolescents aged 15-19 years, schizophrenia – are leading causes of ill health.  HIV/AIDS • In 2011, about 820 000 women and men aged 15-24 were newly infected with HIV in low- and middle-income countries; more than 60% of them were women. • Globally, adolescent girls and young women (15-24 years) are twice as likely to be at risk of HIV infection compared to boys and young men in the same age group. This higher risk of HIV is associated with unsafe and often unwanted and forced sexual activity.
  7. 7. Adolescent girls (10-19 years) /Adolescent pregnancy  Early childbearing increases risks for both mothers and their new-borns.  progress has been made in reducing the birth rate among adolescents.  more than 15 million of the 135 million live births worldwide are among girls aged 15-19 years.  Pregnant adolescents are more likely than adults to have unsafe abortions.  An estimated three million unsafe abortions occur globally every year among girls aged 15-19 years.  Unsafe abortions contribute substantially to lasting health problems and maternal deaths.  Complications from pregnancy and childbirth are an important cause of death among girls aged 15–19 in low- and middle-income countries.
  8. 8. Adolescent girls (10-19 years) Con,  Substance use • Adolescent girls are increasingly using tobacco and alcohol, which risks compromising their health, particularly in later life. • In some places girls are using tobacco and alcohol nearly as much as boys • in the WHO Region of the Americas, 23% of boys and 21% of girls aged 13-15 reported that they used tobacco in the previous month.  Nutrition • In 21 out of 41 countries with data, more than one third of girls aged 15-19 years are anaemic. • Anaemia, most commonly iron-deficiency anaemia, increases the risk of haemorrhage and sepsis during childbirth. • Anaema causes cognitive and physical deficits in young children and reduces productivity in adults. Women and girls are most vulnerable to anaemia due to insufficient iron in their diets, menstrual blood loss and periods of rapid growth
  9. 9. Maternal health  Maternal deaths are the second biggest killer of women of reproductive age.  Every year, approximately 287 000 women die due to complications in pregnancy and childbirth, 99% of them are in developing countries.  Despite the increase in contraceptive use over the past 30 years, many women in all regions still do not have access to modern contraceptive methods.  For example, in sub-Saharan Africa, one in four women who wish to delay or stop childbearing does not use any family planning method
  10. 10. Tuberculosis  Tuberculosis is often linked to HIV infection and is among the five leading causes of death, in low-income countries, among women of reproductive age and among adult women aged 20–59 years.
  11. 11. Injuries  Both self-inflicted injuries and road injuries figure among the top 10 causes of death among adult women (20-59 years) globally.  In the WHO South-East Asia Region, burns are among the top 10 leading causes of death among women aged 15–44.  Women suffer significantly more fire-related injuries and deaths than men, due to cooking accidents or as the result of intimate partner and family violence.
  12. 12. Cervical cancer  Cervical cancer is the second most common type of cancer in women worldwide, with all cases linked to a sexually transmitted genital infection with the human papillomavirus (HPV).  Due to poor access to screening and treatment services, more than 90% of deaths occur in women living in low- and middle- income countries.
  13. 13. Violence  Violence against women is widespread around the world.  Recent figures indicate that 35% of women worldwide have experienced either intimate partner violence or non-partner sexual violence in their lifetime.  On average, 30% of women who have been in a relationship experienced some form of physical or sexual violence by their partner.  Globally, as many as 38% of murders of women are committed by an intimate partner.  Women who have been physically or sexually abused have higher rates of mental ill-health, unintended pregnancies, abortions and miscarriages than non-abused women.
  14. 14. Violence  Women exposed to partner violence are twice as likely to be depressed.  almost twice as likely to have alcohol use disorders, and 1.5 times more likely to have HIV or another sexually transmitted infection.  42% of them have experienced injuries as a result.  Increasingly in many conflicts, sexual violence is also used as a tactic of war.
  15. 15. Depression and suicide  Women are more susceptible to depression and anxiety than men.  Depression is the leading cause of disease burden for women in both high-income and low- and middle-income countries.  Depression following childbirth, affects 20% of mothers in low- and lower-middle- income countries, which is even higher than previous reports from high-income countries.  Every year, an estimated 800 000 people die from suicide globally, the majority being men.  However, there are exceptions, for instance in China where the suicide rate in rural areas is higher among women than men.  Attempted suicide, which exceeds suicide by up to 20 times, is generally more frequent among women than men and causes an unrecognized burden of disability.  At the same time, attempted suicide is an important risk factor for death from suicide and shows the need for appropriate health services for this group.
  16. 16. Disabilities  Disability – which affects 15% of the world’s population – is more common among women than men.  Women with disabilities have poorer health outcomes, lower education achievements, less economic participation and higher rates of poverty than women without disabilities.  Adult women with disabilities are at least 1.5 times more likely to be a victim of violence than those without a disability.
  17. 17. Chronic obstructive pulmonary disease (COPD)  Tobacco use and the burning of solid fuels for cooking are the primary risk factors for chronic obstructive pulmonary disease – a life-threatening lung disease – in women.  One third of all of the COPD deaths and disease burden in women is caused by exposure to indoor smoke from cooking with open fires or inefficient stoves.
  18. 18. Older women (60 years and over)  Globally, men slightly outnumber women .  Women tend to live longer than men, they represent a higher proportion  Older adults: 54% of people 60 years of age and older are women.  Proportion that rises to almost 60% at age 75 and older, and to 70% at age 90 and older.
  19. 19. No communicable diseases  No communicable diseases, particularly cardiovascular diseases and cancers, are the biggest causes of death among older women. regardless of the level of economic development of the country in which they live.  Cardiovascular diseases account for 46% of older women’s deaths globally,  14% of deaths are caused by cancers – mainly cancers of the lung, breast, colon and stomach.  Chronic respiratory conditions, mainly COPD, cause another 9% of older women’s deaths.  Many of the health problems faced by women in older age are the result of exposure to risk factors in adolescence and adulthood, such as smoking, sedentary lifestyles and unhealthy diets.
  20. 20. Disability Other health problems experienced by older women that:  decrease physical and cognitive functioning include poor vision (including cataracts), hearing loss, arthritis, depression and dementia.  In many countries women are less likely to receive treatment or supportive aids than men. Older women experience more disability than men, reflecting broader determinants of health such as:  inequities in norms and policies that disadvantage women.  changing household structures.  higher rates of unpaid or informal sector work. These factors combine to increase vulnerabilities, and reduce access to needed and effective health services.
  21. 21. Life-Cycle Approach to Reproductive Health
  22. 22. Domestic Violence, Causes, Risk factors and Assessment  Domestic And Family Violence is an abuse of power ,mainly (but not only) by men against women in a relationship or after separation. It occurs when one partner attempts to physically and/or psychologically dominate and control the other.
  23. 23. Type of Domestic Violence?  Physical abuse: Kicking, slapping, hitting, punching, pushing, pulling, choking and property damage.  Emotional abuse: Jealously , anger, intimidation, controlling, neglect, humiliation, threats, isolation and verbal abuse.  Social Abuse: Being stopped from meeting or seeing friends or family, not allowed to leave the home.  Sexual abuse: Forcing sexual acts, rape and having sex without wanting to.  Economic Abuse: Controlling access to money and other resources, forced to live without money.
  24. 24. Global Database on Violence against Women in Jordan 2011 Prevalence Data on Different Forms of Violence against Women:  Lifetime Physical and/or Sexual Intimate Partner Violence :24 %  Physical and/or Sexual Intimate Partner Violence : 14 %  Lifetime Non-Partner Sexual Violence :8 %
  25. 25. Menopause Definition According to International Menopause Society Menopause (natural menopause) – the term natural menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Natural menopause is recognized to have occurred after 12 consecutive months of amenorrhea, for which there is no other obvious pathological or physiological cause. Menopause occurs with the final menstrual period (FMP) which is known with certainty only in retrospect a year or more after the event. [Source: WHO]  World Menopause Awareness Day – 18th October 2016
  26. 26. Menopausal Symptoms
  27. 27. Brest Cancer According to the latest issued statistics (2011 National Cancer Registry Report):  Cancer is the second leading cause of death in Jordan after heart disease.  The total of new cancer cases registered in Jordan in 2011 was 6,971. of them, 4,675 were Jordanian and 2,296 were non-Jordanian.  In 2011, the number of new cancer cases among Jordanians decreased by 246 cases, compared to 4,921 cases in 2010.  The top three most common cancers among males in Jordan are: colo- rectal (colon) cancer, lung cancer and U Bladder.  The top three most common cancers among females in Jordan are: breast cancer, colo-rectal (colon) cancer and thyroid.
  28. 28. Definition of Breast Cancer, Signs and Symptoms and Risk Factors What is breast cancer? Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancerous) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs almost entirely in women, but men can get it, too.
  29. 29. Breast Mammogram & X -Ray Non Malignant Malignant
  30. 30. Health Promotion  Family Planning and Reproductive Life Plan  Weight Status  Physical Activity  Nutrient Intake  Folate  Substance or Alcohol use  Sexually Transmitted Infections (STDs)  Depression
  31. 31. Health screening Screening test 18–39 Ages 40–49 Ages 50–64 Ages 65 and older Bone mineral density test (osteoporosis screening) if she is at risk of osteoporosis. Get this test at least once at age 65 or older. Breast cancer screening (mammogram) One each two years One each two years Once every years Cervical cancer screening (Pap test one Time One each 5 years One each two ears One every years
  32. 32. Rferences  Physical Activity Guidelines Advisory Committee. Physical  Activity Guidelines Advisory Committee Report, 2008. Washington, DC: U.S.  Department of Health and Human Services, 2008.  U.S. Department of Agriculture and U.S. Department of Health and Human  Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010.  Centers for Disease Control. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR 1992;41(No. RR-14);001  - 42k  - 45k   Department of Statistics (2015). Jordan in Numbers 2015, Amman, Jordan  Government of Jordan (2015). Jordan Position Paper on the Beijing +20 review and appraisal process. Amman, Jordan.  Jordanian National Commission for Women. Jordan’s Fifth National Periodic Report to the CEDAW Committee – Summary. Amman, Jordan  Al Nsour, M. Al Kayyali, G. & Naffa, S. (2013). Overweight and obesity among Jordanian women and their social determinants. EMHJ, 19(12), 1014-1019  WHO (2007). Cross cutting gender issues in women’s health in the Eastern Mediterranean Region. Cairo, Egypt  Department of Statistics (2012). DHS, Amman, Jordan  The Demographic Opportunity in Jordan, A Policy Document. HPC Oct. 2009
  33. 33. T h a n k y o u Any Question ?