Expanding Concern for Women's Health in Developing Countries. The Case of the Eastern Mediterranean Region.
Background: Women's health is still largely associated with the notion of reproduction in developing countries despite a more varied disease burden, including noncommunicable conditions resulting from consequences of changing epidemiologic and demographic patterns on women's health. Methods: The World Health Organization (WHO) Global Burden of Disease data base is used to derive for the Eastern Mediterranean Region (EMR) cause-specific rates of death and of disability-adjusted life-years (DALYs) by age for adult women, and percent of total deaths and total DALYs for women in the reproductive ages, as related to maternal conditions and to three selected noncommunicable conditions, namely, cardiovascular disease, cancer, and neuropsychiatry conditions. Inequalities by country income category are examined. Results: Maternal health conditions still form a substantial component of the disease burden, with an increasing burden of cardiovascular disease and cancer starting in the late reproductive years and beyond. The burden of neuropsychiatric conditions is also high during the reproductive years, reflecting possibly the stress of multiple roles of women as well as stress of war and conflict that permeate the EMR. Women in low- to middle-income countries suffer more from maternal health conditions and less from neuropsychiatry conditions than women in high-income countries. Conclusion: The wider disease burden of women should be addressed making use of available reproductive health services taking special account of interactions between reproductive and noncommunicable conditions for better health of women during and beyond reproduction. Better measures of the burden of illness should be developed. There is a special need for improved health information systems in the EMR.