Quality healthcare for women

Dr Sujit Chatterjee, CEO, Dr LH Hiranandani Hospital, elaborates on the need to focus on women’s health to ensure that she maintains her pivotal position in the society

Sir Winston Leonard Spencer-Churchill said “We make a living by what to get but we make a life by what we can give”.

This is a mindset of a mother who will give her all to make a life for her family.

We feel our society is based on equity, justice, social sensitivity and a culture of services in which we are all self reliant. Our society will stand to crumble if the woman (or a mother) is removed from the equation. It is only natural then that we need to focus on the women’s health to ensure that she maintains her pivotal position in society. If this asset is not strengthened in all its dimensions then the future of our country will not be vibrant socially, culturally or economically in the next decade.

India is on the world map of rocket technology in sending 103 satellites into the orbit by a single rocket, having solid fuel technology, a first-of-its-kind a world record. However, the team behind this initiative was a dedicated team of women scientists and technologists and the experts who worked on micro details to ensure a successful launch. The question really to be asked is what has this to do with women’s health? For those reading this article, I request you to imagine each of the many lady scientists who were the core to the project success being absent from critical meetings on account of health. The programme may have failed.

Health disorders of woman has undergone a change. There is a shift from the communicable to the non-communicable disorders. The metros are witnessing manifold rise in women who have high blood pressure, major undiagnosed cardiac disorders, undiagnosed hypothyroidism, Vitamin D deficiency, osteoporosis, diabetes, psychological disorders and obesity. While in the rural set up, it still is a communicable disease disorder and disorders related to child birth but with modernisation gradually seeping in hinterland there is a shift in the disease burden from the communicable to non communicable.

In the early decades, the woman’s role was basically to be at home, manage children and generally be the pivot and the person to absorb the emotional, physical, social and spiritual well being of the family. As era passed and the women has decided to step out and be recognised as a entity, she has only subjected herself to an additional pressure of work environment without relinquishing her role as a pivot for her family’s health. This has added a burden on her which she has gracefully taken in her stride. This does not mean that she does not feel the pressures that are manifold on her today as opposed to what her mother or grandmother may have faced. A study conducted at Dr LH Hiranandani Hospital indicated that women do have concerns about their health and the concerns related to some common disorders. In order of importance, their concerns start with anaemia, thyroid disorders, stress of travelling, diabetes and nutrition. It is very evident that it is a common disorder which is getting reflected as the concern that the working woman has today. All these disorders are mainly related to lifestyle and the pressures that can be contributory to under performance or inability to perform because of the underlying ailments. All of them are treatable and an early diagnosis helps.

Also, there are various issues that could create work life imbalance such as planning a family. It seems that a career- oriented woman would prefer to start her family once well established at work. However, this may take time and hence the inclination to start a family may come at the mid to late 30s as opposed to yesteryear where woman generally conceived in mid 20s to late 20s. The fact that pregnancy (a normal physiological process) is postponed by a decade does not slow down the natural changes which occurred in women with age. There is a decrease in fertility but with assisted reproductive techniques, delayed pregnancies are quite common. That again puts the patient in a ‘risk category,’ as physiological changes of pregnancy are better tolerated in the mid 20s than in the late 30s. There is also a rising incidence of lifestyle disorders for women in metros such as anxiety, panic attacks, depression and its related co- morbidities. The sheer physical exertion of travelling to and from work can also take a toll on health of the working women. Then there is a need to manage the family and also get ready for the next day’s travel. Apart from the physical wear and tear, there is also mental pressure not only for travel but also at work. These can translate into issues which start cropping at house that might result not only in marital discord but panic attacks in women which can manifest in various ways and mimic acute disorders or result in depression which if not corrected may result in suicidal tendencies.  This is quite tragic.

For malignancy (cancer) while the incidence may not have increased in totality, however, breast cancer as an individual disease is more prevalent in metros and has overtaken the incidence of cervical cancer which erstwhile was the leading cancer amongst women in our country. Again there is a role of lifestyle disorder such as diet which is rich in saturated fats, delayed pregnancy, lack of breast feeding, excessive ingestion of junk food have led to this transition. Also screening processes, vaccines, contraception by way of barrier contraception have contributed in good measure to the decrease in cervical cancer in the metros. Cervical cancer is now labelled as a preventive disease and breast cancer awareness has resulted in early reporting of breast lumps and as contributed to better outcomes but an apparent increase in incidence.  Most doctors and hospitals are aware of such transformation and are fairly well geared up to attend to disorders which are commonly seen by afflicting ladies.

There has to be a reduction in maternal mortality and infant mortality rates by improving emergency services in the rural areas. This becomes the state issue, which needs to be addressed on a war footing.

Education while playing a role is not the most important factor in awareness and reduction in maternal and peri natal mortality rates. It is the availability of well equipped primary health centres that can give good ante natal care and also undertake emergency procedures as and when required will drastically reduce the maternal mortality and give very good peri natal outcomes.

India is poised to become the youngest nation in the world in the year 2020. But a healthy nation is what is the need of the hour. There are lot of initiatives that are being talked about as ‘Arogya Bharat’ by the year 2025. This will never happen if we do not wake up and improve quality of healthcare for a woman which translates to be the pivot in India’s march to become a super power.