Women's contribution to global health care under-recognized

The results of a major Commission report on women and health took center stage at the Donna E. Shalala Student Center, as Felicia Knaul, Ph.D., Director of the Miami Institute for the Americas (MIA) at the University of Miami College of Arts & Sciences, presented a discussion of a Lancet study that found women are contributing around $3 trillion to global health care, but nearly half of this labor is unpaid, unrecognized and unaccounted for.

Dean of the College of Arts & Sciences Leonidas Bachas was the host for the special presentation on the study, which was published in The Lancet in June. Dr. Knaul, a co-author of the study while Director of the Harvard Global Equity Initiative, spoke about the findings with the Chair of the Lancet Commission Report on Women and Health, Ana Langer, M.D., professor of the practice of public health at the Harvard T.H. Chan School of Public Health.

The study, a comprehensive and evidence-based analysis of the complex relationships between women and health, presented findings that women's contribution to society is under-recognized across a wide spectrum: economically, socially, politically and culturally.

"The paper was the result of the work of 15 dedicated Commissioners that included academics, policymakers, program implementers and advocates - all of them related to this broad, comprehensive construct of women's health from different perspectives," said Dr. Langer. The purpose of the report, according to Dr. Langer, is to hopefully influence policy agenda on issues related to women and health.

Dr. Langer discussed how women's health is sometimes undertaken in a fragmented way instead of a comprehensive way. "That is what we address in the report when we talk about women's health in a lifecycle. There is evidence to show that women's health at each stage of our lives is influenced by the previous stages, and whatever was done right to protect our health in the earlier stages will definitely put us in a better position to be healthy in later stages."

Regarding women in the role of health care providers, Dr. Langer says women in almost every culture and part of the world are the general health care providers in a household. "That important role they play is not really recognized as it should, and it's definitely not compensated in most places around the world; and women don't get the training or the support they will benefit from in other levels of the health system," she added.

Touching upon valuing women and how to make today's health systems function better, Dr. Knaul explained: "I believe having efficient, responsive, fair and intelligent health systems is very much today the job of women because as it turns out, from the study, health systems are managed...by women, both paid and unpaid." She also revealed that more than 50 percent of graduate students studying to be physicians today are women.

Dr. Knaul addressed another important point from the study on data regarding global gender discrimination. "We know, globally, that women are not paid as much as men when we do the same jobs - sometimes it's a little less, sometimes it's a little more, but it's a constant all around the world that we are fighting to change," she said.

In relation to how women and men, in Mexico specifically, invest their time every week juggling responsibilities in care giving, domestic work and work outside the home, Dr. Knaul presented a pie chart showing how women's time is "eaten away with little left for rest and relaxation," while for men, the pie chart illustrated that half of their time is set aside for relaxation.

"We believe that you need healthy economies and healthy health sectors, and to produce those you need healthy women who can act in ways that allow us to be able to give all that we can give to our health sectors, our societies and our communities," said Dr. Knaul.

In her closing remarks, Dr. Langer presented four categories of recommendations from the study designed to find solutions to the health-related issues women face today: Value Women, Compensate Women, Count Women and Be Accountable to Women. The categories emphasize the need to implement health sector policies, recognize women for their paid and unpaid contributions as health-care providers, and ensure women are accounted for in data collection within the health-care workforce, among other vital points.

The presentation also included opening remarks by UM President Julio Frenk, who was a Commission member on the Lancet study, as well as comments and a panel discussion with esteemed UM faculty members: Dean Nilda (Nena) Peragallo, School of Nursing & Health Studies; Dean Isaac Prilleltensky, School of Education & Human Development; and Professor Merike Blofield, Director of the Women's and Gender Studies Program.