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CONTRIBUTIONS OF WOMEN TO HEALTH AND THE HEALTH SECTOR Maternal Newborn Health and Sustainable Development: What Can We Learn from Women and Health?Global Maternal Newborn Health Conference Mexico City, October 19, 2015TRANSCRIPT
Maternal Newborn Health and Sustainable Development: What Can We Learn from Women and Health?
Global Maternal Newborn Health Conference
Mexico City, October 19, 2015
Dr. Felicia Marie KnaulMiami Institute for the Americas and Miller School of Medicine, University of Miami
Fundación Mexicana para la Salud & Tómatelo a Pecho
VALUING THE INVALUABLECONTRIBUTIONS OF WOMEN
TO HEALTH AND THE HEALTH SECTOR
Women produce
the majority of health care
- paid & unpaid
Key Findings & recommendations• Women's contributions to health are valued at $US 3.1 trillion or
almost 5% of GDP. Approximately 50% is unpaid.• Unpaid contributions are unrecognized, unaccounted for, unregulated
& deprofessionalized: a hidden subsidy to health. • The total value of the health sector exceeds what is reported in
official statistics or through national health accounts.• Countries invest more in health than reported: official statistics
ignore the huge unpaid contributions by women & men• Health labor markets need to be reformulated to encompass and
embrace home-based health care & made adaptable to women and men over the life cycle.
• Effective, fair health systems offer equal opportunity & incentives for men to participate in caregiving & health promotion and actively engage in family life and well being.
OutlineWomen in transitionThe framework: measuring myriad
contributions of women to health and the health sector
The economic value of women's contributions to health & the health sector Global & Mexico
Source: Barro & Lee, 2014 (http://www.barrolee.com/data/yrsch.htm).
1950 2010
0
2
4
6
8
10
12
14
Beni
n
Paki
stan
Indi
aTu
rkey
Nic
arag
ua
Chin
aPo
rtug
al
Uru
guay
Peru
Mex
ico
Italy
Pana
ma
Arge
ntina
Sout
h Af
rica
Cuba
Gre
ece
Spai
n
Rom
ania
Fran
ce
Net
herla
nds
Bulg
aria
Pola
ndN
orw
ayH
unga
ry
Ger
man
yU
K
Irela
ndEs
toni
a
Cana
daCz
ech
Repu
blicAv
erag
e Ye
ars
of S
choo
ling
for W
omen
Increased years of schooling for women Ave years of education, Women 15 years+
0
100
200
300
Mex
ico
Bras
il
Vene
zuel
a
Hon
dura
s
Gua
tem
ala
Cost
a Ri
ca
Peru
Colo
mbi
a
Nic
arag
ua
Trin
idad
& T
.El
Sal
vado
r
Para
guay
Ecua
dor
Jam
aica
Pana
ma
Dom
inic
an R
ep.
Cana
da
Guy
ana
Uru
guay
Arge
ntina
Uni
ted
Stat
es
Average
Labor participation of women has Increased & much more than among men
(Latin America, 1960 – 2010)
Men Women
Fuente: Las mujeres latinoamericanas en cifras, FLACSO.
Gro
wth
rat
e o
f e
con
om
ical
ly a
ctiv
ep
op
ula
tio
n i
n t
he
per
iod
Medicine; a global phenomenon
Women as % of all physicians 1980-2012, select countries
Source: OECD Statistics.
Wom
en p
hysi
cian
s as
% o
f to
tal p
hys
icia
ns
0
10
20
30
40
50
60
1980
1985
1990
1995
2000
2005
2010
2012
Australia
CanadaCzech Republic
Denmark
Israel
Portugal
United KingdomUnited States
Yet, recognition and opportunities for progress continue to be limited
PeriodWomen Men
women/total
No. No. %
1901 - 1920 4 101 4%
1921 - 1940 5 99 5%
1941 - 1960 5 113 4%
1961 - 1980 5 176 3%
1981 - 2000 11 286 4%
2001 - 2014 17 147 10%
Women (4.9%)
47
922
Nobel Prizes Awarded to Women 1901 - 2014
OutlineWomen in transition
The framework: measuring myriad contributions of women to health and the health sector
The economic value of women's contributions to health & the health sector Global & Mexico
The many contributions of women to health and the health sector
• Paid work in the health sector• Paid and unpaid contributions to caregiving
& the health sector• Unpaid contributions through volunteerism
Women´s contributions, even if paid, are often undervalued and under-
paid & congregate in low-pay, “feminized” fields.
Discrimination
Data: 32 countries• Employment and time use survey data for
Canada, Spain, Turkey, Mexico and Peru• Published reports of results of Time Use
Surveys for 27 countries• Represents 52% of the global population
Low income, 4%Lower middle income, 91% Upper middle income, 17%High income, 33%
Counting strategies and estimations (14)
DF=Gender discrimination factorNet/Gross: Social Security and taxes
“standard” valuation
What could not be measured• Unpaid contributions to disease
prevention and health promotion in in home-based activities that are only partially health-related
• Innovation and ideas• Investment of women´s earning in health
directly or through taxation• Increased economic growth due to
increased health – dynamic contributions
OutlineWomen in transitionThe framework: measuring myriad
contributions of women to health and the health sector
The economic value of women's contributions to health & the health sector Global & Mexico
PAID: 51.2%
UNPAID: 48.8%
TOTAL:US$ 3.1 TRILLION4.8% Global GDP
• Exceeds total US+UK health budget•2.9 times Mexican economy
• 20% of the US economy•Each and every woman contributes
$1,200 to health annually
Total value of women's contributions to the health sector:
Paid
Unpaid
Lower bound
Wages reported in the survey
Upper bound 2.43% 2.85%
6420
Proportion of global GDP (%)
Global Contributions of Women to the Health Sector: Upper & Lower Bound Estimates
% GDP & trillions of $US
$1.56$1.49 2.35% 2.47%
2.27% 2.17%
1.1%
2.4%T$1.5
3.1%
2.5%
2.5%T$1.6
4.0%
Paid
UnpaidBased on Country
Minimum Wage
Wages reported in the survey
Wages adjusted by social benefits package and sex
Global Contributions of Women to the Health Sector
% GDP & trillions of $US, by method of wage valuation
6420
Proportion of global GDP (%)
8
T$3.1
$T4.5
$T2.8
Estimated Value of Women's Paid and Unpaid Contributions to the Health Sector
Canada, Spain, Turkey, Mexico, PeruDetailed calculations using household surveys and several wage scenarios
Wag
es r
epor
ted
in th
e su
rvey
Adj
uste
d by
soc
ial
Ben
efits
pac
kage
an
d se
x di
ffere
nces
Proportion of GDP (%)
0.4
1.3
1.6
0.4
1.8
4.2
0.71.6
0.20.3Peru
MexicoTurkey
SpainCanada
0.92.1
2.9
0.9
3.1
6.2
12.2
0.5 0.5Peru
MexicoTurkey
SpainCanada
0 2 4 6 8 10
Paid
Unpaid
Mexico: Value of work in the health sector
Women & men 2010, by wage valuation method, $US Billion
VoluntaryPaidUnpaid
1.6% G
DP
1.0
% G
DP
Women: B$13.6
Men: B$8.80.032
0.026
8.1
10.9
5.8
7.85.0
3.8 What are the men doing?
Mexico: Unpaid work dedicated to health activities in the home, w/ health promotion
Women, 15 years and older, average hours / week
2.3
Unpaid time devoted to health care
Joint health promotion with other activities – assuming 25% of
time-value is health
3.4% GDP
1.1% GDP
2.3 hours
7.2 hours (of 29)
What about girls
<15?
4.6% GDP
=
$ 47 b
Mexico: the workweek
Men and women, based on a 168 hour week
Source: Own estimates based on INEGI 2012 and CEPAL..
MEN WOMENCare giving
Domestic work
Work outside of the home
41
41 42
209
56
R & R12
hours/day
Rest & r?
6
hours/da
y
r?
Women's Contributions to Health and the Economy - the choice:
Do we aspire to a Virtuous or a Vicious Cycle?
Unhealthy children learn less and adults are less
productive
Less money to invest in
health and human
development
Inequality of opportunities
More poverty
Unhealthy, poor, disenfranchised women produce less health care
Unhealthy women invest time ineffectively in an attempt to prevent disease and loss of life
Less health for
men, women
and children
Suboptimal development
of human capital
Healthy women invest time
effectively in producing health and preventing
disease
More health is produced for men,
women and children
Children learn better and adults
are more productive
More health and education mean more economic
growth
More economic growth means more money to invest in health
and human development
More equal opportunitie
s
Healthy and more education
women women produce more
health care
Virtuous Cycle Vicious Cycle
Poor health and less education means reduced
economic growth
Maternal Newborn Health and Sustainable Development: What Can We Learn from Women and Health?
Global Maternal Newborn Health Conference in Mexico City from October 19, 2015
Dr. Felicia Marie KnaulMiami Institute for the Americas and Miller School of Medicine, University of Miami
Fundación Mexicana para la Salud & Tómatelo a Pecho
VALUING THE INVALUABLECONTRIBUTIONS OF WOMEN
TO HEALTH AND THE HEALTH SECTOR