Gender-related differences in the impact of tropical diseases on women: what do we know?

Abstract

This paper explores the importance of gender differences in the impact of tropical diseases on women. Malaria and schistosomiasis are used as examples but most of the observations also apply to other diseases endemic to developing countries. The distinction between sex and gender is discussed and evidence of sex and gender differences in the determinants and consequences of malaria and schistosomiasis, particularly their economic, social and personal dimensions, is reviewed. Issues on which research and intervention studies are needed are identified.

PIP: We have limited knowledge about nonreproductive aspects of women's health in developing countries. We need to learn about these aspects t identify effective interventions to improve their health. Improved knowledge and effective interventions will allow women to actively participate in disease prevention and obtaining health care for their families and the larger society. This review of gender differences uses schistosomiasis and malaria as examples of the determinants and consequences of tropical diseases. Women, particularly poor women, basically do not know the signs and symptoms of the diseases and that these diseases risk their health. They do not realize that, when they are infected, they pose a threat to their children. Women tend to be at a greater risk of schistosomiasis than men because they have more contact with water. Since women in India spend the early evening hours around cooking fires and men sit outside, women are at a lower risk of malaria than men. In some countries, women cannot seek medical treatment for schistosomiasis or participate in morbidity surveys without the consent and/or the presence of their husbands. Health providers tend not to believe women's experience of symptoms, so the women question their own perceptions and knowledge base. When women take care of ill family members, their work days become longer, the work load becomes heavier, and they defer some chores. When women have a tropical disease, a female relative or neighbor cares for her but then is unable to complete her own duties. These effects, as well as the conflict between expected roles and physical limitations, exacerbate their stress and feelings of inadequacy. Women with schistosomiasis report their illness later than do men. Clinicians need to provide women accurate information through better communication techniques while considering their perception of illness. Improvement in provider-patient relations has the potential to empower women to be actively involved in disease prevention.