I will start with a disclaimer. During my career in health care, I have come across men, women, and children who do not understand the nature of their illnesses even after medical consultation and diagnosis. Lack of understanding means that patients are likely to default from care, have poor medication adherence, often with unwarranted consequences. This inconsistency in health knowledge is the motivation for Bridging Health Gap. Therefore, every article published on this platform is purely for public health literacy and should not replace consultation with your health care provider nor self-medication. Every tip provided in our discussion is for health education, health promotion, and disease prevention.
Recently, I went to our local hospital for a routine checkup. As I waited in the queue for my turn, I decided to do some mathematics. I counted the numbers of men and women sited eagerly waiting to be called in. In total, I counted 47 ladies and nine men. Some women were sick, others had brought young children, and a few others had come for antenatal care. The difference in attendance for men and women was uncanny and set the ground for discussion from the previous article on health-seeking habits. To bridge the health gap, we shall look at women’s health-seeking habits, health profiles that increase risks of diseases, factors that facilitators access to care, barriers, and policy considerations.
Health Profile of women
- Women suffer a disproportionate high burden of Non-Communicable diseases (NCDs). NCDs are the leading cause of death among women. Top on the list is cardiovascular (heart disease), stroke, cancers, diabetes, and respiratory tract infections. These diseases cumulatively cause two out of every three deaths among women. It is important to note that these diseases are preventable and can be managed effectively with early diagnosis.
- Globally, efforts on women’s health are focused more on reproductive maternal health while NCDs are lower in priority.
- Women mostly outlive men by 6 to 8 years. Longevity increases the risk of chronic illnesses like cancers, diabetes, hypertension, stroke, and heart disease. These illnesses among the elderly are a source of grieve and pain due to complications and disabilities. Moreover, most health insurances have a caveat on age that leaves the majority to fend for themselves.
- Among the communicable diseases, the greatest challenge facing women is the high prevalence of the Human Immunodeficiency Virus (HIV). Women account for over half of all people living with HIV/AIDs, globally.
- The majority of women lack formal education limiting the acquisition of health knowledge on the origin of diseases, their symptoms, and how to prevent the onset of diseases. Inadequate health literacy affects the understanding of health messages, interpretation, and action. Furthermore, poor health literacy affects their ability to navigate the health care system and gainfully participate in their care, that of their children, and families.
- Where most women are unemployed or work in informal sectors, lack of medical insurance results to out-of-pocket spending that is often expensive and unattainable. Evidence indicates that women delay seeking care for as many as three days. This delay can exacerbate a disease increasing health care costs, complications, and lost productivity.
Factors that promote women’s health-seeking habits
Despite the many factors that affect the women’s health profile, their health-seeking behavior is outstanding compared to other sub-groups. A few gender-specific characteristics are responsible for the apparent observation;
- The level of a women’s autonomy in the household influences her health-seeking habits. This autonomy provides the freedom required for decision-making. Factors that increase her independence in decision-making include education, the number of resources under her control, and support received from spouse and family in general. Economic empowerment is crucial for decision-making. Women with low autonomy in decision-making delay health-seeking and suffer more health burdens.
- Adequate knowledge of health. Women can interpret symptoms of diseases and their effect on health. Usually, slow and progressive illnesses receive little attention compared to rapidly developing symptoms.
- Family social network. A supportive family network that responds to a woman’s health needs increases their health-seeking behavior. A supportive spouse who makes financial and emotional support to the woman when ill leads to prompt health care consultation, an early diagnosis, and the likelihood of early recuperation without complications. Poorly managed illnesses increase the cost of care and long-term disabilities.
- A responsive health care system that is aware of women’s health needs provides confidence. Female gender-specific health needs can encourage or discourage health-seeking behavior. When women feel that their health needs are a priority, they are prompt in health-seeking.
- Perceived severity of the illness. Having the capacity to comprehend the seriousness of a disease is a motivation to seek health services. Often, severe illness receives more attention than insidious illness of long duration, and fewer symptoms.
- Affordable medical insurance. Having medical insurance is an incentive to seek health care. It lessens the cost of health care and reduces the burden of out-of-pocket payments.
- When health systems are accessible, the physical distance to the health facility is short, and there is available transport, women are able to seek health interventions promptly.
Factors that limit women’s health-seeking habits
However, unlike other sub-groups, women face unique barriers to accessing health care. In most countries, women occupy a low social status, suffer more ill-health, and many social conditions that limit optimal health-seeking habits. For example;
- Due to low education levels, women lack knowledge and awareness of health conditions limiting promptness in health-seeking. A woman can be ill for some time without seeking proper medical care. It is very complex when the woman is the head of the family and the sole breadwinner. Getting time for detailed health care may not be the top priority among the many competing needs.
- Cost of accessing care. Cost of care includes the direct cost of seeking care and the cost of lost opportunity. Sickness presents exceptional challenge to most women, lack of money to pay for health services and loss of day earning are too compelling enough not to seek health care.
- Distance to the health facility is equally challenging. Although many governments have increased access to health care, distance to health facilities remains a factor to many women in rural areas. Lack of transport to the health facility can be a deterrent to care.
- Women as homemakers, the care of children and other vulnerable family members constitute their work. During illness, the woman may delay seeking care because of competing roles until her health is debilitated.
- Women will continue attending to work and children even when they are suffering. Compared to other sub-groups, women are unlikely to play the “sick role”. Women are constantly working, suppressing the sickness until such a time that they cannot cope.
- By their social status, many women do not access medical insurance and social protection. Work in the informal sector is a low-paying job that leaves many women with few disposable resources to caution during an illness.
- Some social-cultural norms affect a woman’s autonomy in decision-making and control of family resources. Lack of freedom to make decisions depletes their ability and depend on others to decide on their health. In set-ups where women do not travel alone, the lack of a chaperon can delay how fast she can access health care.
- Perceived poor attitude of health care providers. Complain about the negative attitude of health workers towards patients is not new. Women may perceive discrimination and stigma, especially when seeking care for reproductive-related illness. This perception of discriminatory can deter prompt health-seeking and prolong the time taken to seek treatment. The delay worsens the disease with irreversible consequences.
- The Health system should prioritize female gender health education to create awareness of common diseases, predisposing factors, vulnerability, and characteristics to prompt health-seeking.
- Social protection. Due to low livelihood, women lack social capital gained from secure employment. Thus, policies that caution women from out-of-pocket spending can have an impact on health-seeking habits.
- Promote female empowerment for self-advocacy through education. Globally, women face challenges related to caring, implementing women supportive structures at the family, community, and national level to reduce the burden bestowed upon women. National policies and programs that support women’s empowerment and socio-economical resource accumulation can increase their self-worth and independence.