Although women's health conditions have improved over time and in almost all countries of the world, differences persist between men and women (and for groups, within each gender) that often hide avoidable, related inequities. the different social position, access to resources, social rules.
Furthermore, the different role assumed by women in society and their increasing contribution to the world of work has often led them to adopt behaviors and lifestyles that can affect their health. This year the Cnesps-Iss has decided to dedicate the International Women's Day(March 8) – celebrated all over the world to commemorate both the social, political and economic achievements of women, and the discrimination and violence to which they are still subjected – to a series of reflections on their role in prevention and health promotion and on the existence of inequalities.
This day must not be an isolated moment but act as a driving force to remember the progress achieved in various areas (economic, political and social) and to encourage the “continuity” of interventions to achieve future objectives.
Objective woman: the active offer to develop skills
In the broad world of prevention and health promotion, when defining intervention strategies, it is important to try to identify priorities: in which population groups and at what moments in life you can have the highest return on investment (human be it economic or social)?
In this perspective, there is no doubt that women are one of the priority targets since their natural social role (fulcrum of family relationships), their living important experiences of change in the course of life (such as the period of pregnancy) and the ‘being generally more attentive to their health than men, makes them privileged subjects, able to accept, favor and “radiate” to other healthy choices and lifestyles.
The women's movement in the early 1970s anticipated the “vision” of the Ottawa Charter, affirming with extraordinary force the right to speak and self-determination with the proposition of the “gender” point of view. The Ottawa Charter (presented in November 1986 by the WHO, read the translation in Italian , pdf 177 kb) proposes a dynamic definition of health, inscribed in the social context as a common good: health as the ability to control one's own state by of people and communities for autonomous choices.
In this context, the idea of consulting services with multidisciplinary skills for health promotion, radically innovative services in the traditional scenario and the legislation of those years was born(law 405/75 and law 194/78) reflects this powerful thrust. Epidemiological research systematically confirms how much investment in promoting women's skills pays, as well as how fertile their potential is.
The objective maternal and child project, launched in 2000, is underlying this “vision” of public health aiming to activate autonomous and conscious decision-making processes, according to a non-directive but horizontal approach.
Promoting health implies the adoption of operational strategies with measurable objectives concerning the population as a whole, with the epidemiological cornerstone of knowing the social articulations of the population itself and the corresponding risk articulations (in the awareness that the social ones are the “causes behind the causes “determining the state of health).
The epidemiological hinge consequently implies the operative hinge of the active offer(in the knowledge that the most difficult to reach are generally affected by social deprivation and, therefore, at higher risk).
In order to promote an individual and community rethinking of everyday life and historical memory, and to develop new awareness and skills, it is in fact essential to use a communication process that synergistically exploits all the potential operating channels (from institutional ones to those already operating within community) with methods tailored to the specific characteristics of the people and population groups to be involved.
In general, the social model of health corresponds to a welfare model based on participation and empowerment , as an alternative to the traditional, dominant, paternalistic managerial model.
In public health, bringing out potential skills, enhancing them, promoting them, supporting them and protecting them is the keystone for the promotion of health, of women and of the whole community, understood according to the Ottawa Charter.
Promotion of reproductive health
Promoting reproductive health and evaluating the effectiveness of the care pathways offered during the birth process is an index of the quality of a country's health care.
Numerous initiatives have been launched in the field of reproductive health aimed not only at preventing adverse events, but also at reducing the excess of medicalization, at involving women in the choice of care pathways and at promoting their appropriateness.
The birth path: a great opportunity to promote health
Health promotion interventions involving women of reproductive age allow to maximize results with limited use of resources. Thanks to the centrality of the role of women in the family, these interventions promote the protection of women's health, but also of the family and of the community in a broader sense.
Considering the opportunity offered by repeated contacts between mother and socio-health personnel involved in assisting the birth process, it is strategic to plan health promotion interventions dedicated to issues of interest to women. How can we not see in the birth path a great opportunity to carry out prevention and health promotion interventions?
The persistence of inequalities
A specific focus on the health of women (and of all citizens) must be maintained for monitoring the inequalities that continue to be observed, based on the area of residence, socio-economic conditions, migrant status, even in the territory Italian. Often these conditions of vulnerability interact to exacerbate women's chances of accessing care opportunities and thus benefiting from their greater health potential.
An example of these difficulties and “missed opportunities” is found among immigrant women in our country who, however, also demonstrate that when they are enabled to express their abilities, they achieve results similar to those observed in Italians.
- Health of migrant women and children : in recent years it has been possible to observe, both internationally and locally, the strengthening of the process of feminization of migratory flows which has led to a progressive increase in the female component of the foreign population. An evident relapse of the consistent foreign female presence, which is also characterized by the young age, can be observed on the birth rate.
- Faced with this situation, attention is increasingly being paid to the protection of maternity among immigrants who give birth in Italy. Read the in-depth analysis on ” Health of migrant women and children ” by the Women's Health and Developmental Department, Cnesps-Iss:
- The use of drugs in the immigrant female population : 56% of immigrant women and 64% of Italians received at least one prescription during the year. Differences in prevalence of use decrease for women between the ages of 25 and 44. Furthermore, except in children under the age of 15, immigrant women consume more drugs than immigrant men.
- In terms of the impact of NHS pharmaceutical expenditure, immigrant women had a per capita expenditure of 74 euros against 101 for Italians. These are some of the data that emerge from a survey on pharmaceutical prescription in the immigrant population in which the Cnesps-Iss also participated. Read the in-depth article on “ The use of drugs in the immigrant female population”Edited by the Department of Pharmacoepidemiology, Cnesps-Iss.