POPULATION: Economic Reforms Hurt Women’s Health

By Farhan Haq Reprint | | Print |

UNITED NATIONS, Mar 26 1999 (IPS) - Structural adjustment policies have hurt efforts by governments to improve women’s health and family planning services worldwide, according to a new study by the Women’s Environment and Development Organisation (WEDO).

In a survey released to evaluate progress five years after the International Conference on Population and Development (ICPD), held in Cairo, WEDO argued that many neoliberal economic policies have cut back on measures to improve women’s health. These included decentralisation of health care management and the imposition of user fees

The report – called ‘Risks, Rights and Reforms’ – found that in 50 countries surveyed, 70 percent of respondents reported that the imposition of user fees had made many reproductive health services unaffordable for the poor.

“In the majority of countries, we found that economic transition and reform measures are eroding women’s access to basic health care services,” argued Bharati Sadasivam and Pamela Ransom, two WEDO directors who researched and edited the report.

Cost-recovery measures were particularly damaging, the report said, noting an Oxfam study which noted that the 1994 imposition of a 10-Zimbabwe-dollar charge for antenatal care in Zimbabwe led to an 18-percent drop in out-patient care.

The Zimbabwe data suugested that “people were delaying health care until absolutely necessary.”

Similarly, the report said, “in Uganda and parts of Tanzania, poor women can no longer afford the costs of pre- and post-natal care and resort to traditional midwives.”

Cost recovery was not the only problem with structural reforms.

The study cited responses from 54 percent of the countries surveyed that argued that “privatisation trends have weighted the odds against access to health services by the poor, women in particular, the elderly and minority populations”.

Several countries, notably Tanzania and Kenya, reported the departure of top medical personnel to southern Africa. Sri Lanka, Tanzania and Egypt all reported shifts of qualified medical staff from public to private practise.

Meanwhile, the removal of price controls on pharmaceuticals has led to soaring medical costs, including increases by 300 percent or more in Egypt, the report said. Spiraling health costs were cited as “a growing barrier to health care” in Algeria, China, India, Morocco and the Philippines.

WEDO said that some countries – notably the nations in the “transitional” post-Soviet bloc – had been subjected to market forces which discourage contraception but encourage abortion.

“Women resort to abortion in large numbers (in Bulgaria and Ukraine) even though it must now be paid for, and despite the fact that abortion is a major cause of secondary infertility,” the report said.

“Activists say this is because government budgets provide no funds for public education on the damage caused by repeated abortions and most women cannot afford contraceptives at market rates – 15 to 40 percent of average monthly income in Bulgaria,” it added.

The recent Asian economic crisis had also placed new burdens on women – even in more prosperous nations.

“In Japan, female students are having a hard time seeking jobs, while female full-time employees are relegated to the status of part-timers, or in some cases asked to leave the workplace for no justifiable reasons,” said Hiroko Hara of Japan’s Network for Women and Health.

“The male employers often do this at the time of maternity or child leaves.”

In addition to economic problems, the report also found major environmental risks to women’s health, from water pollution in Uzbekistan – linked to birth defects and complications in pregnancy – to exposure to pesticides in central Sudan, deemed to be a factor in 22 percent of hospital stillbirths.

Despite mainstream medical wisdom which recommends the feeding of breast milk to infants, the survey cited findings in Guatemala that pesticide residues in breast milk were about 250 times the allowable amount in cow’s milk.

The report also stated that many Chinese children ingested DDT from breast milk at levels 10 times the internationally-accepted maximums.