UNITED NATIONS, New York — Today [April 7] marks the first World Health Day that humanity will celebrate as 8 billion.
The global population's expansion to this landmark number reflects significant progress that has enabled humans, on average, to live longer and healthier lives than ever before. But those two words - "on average" - obscure vast differences in the experiences of people around the globe and their ability to lead healthy lives.
For women and girls, access to health is complicated by gender inequality, which drives harmful norms and practices and global crises such as high rates of unintended pregnancy and preventable maternal mortality. According to UNFPA, nearly half of all pregnancies worldwide are unintended, and a woman dies every two minutes from pregnancy or childbirth.
The World Health Organization defines health as a "state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Below, read about six UNFPA initiatives that move women, girls and members of other marginalized communities closer to this condition and help close gaps to health created by gender inequality, stigma and discrimination.
Traditional birth attendants in Colombia
One of the greatest advancements in women's health in the last century has been the decline of maternal mortality. But once-rapid progress towards ending preventable maternal deaths has stalled in recent years.
In Chocó, a predominantly Afro-Colombian region of Colombia, traditional birth attendants play a crucial role in providing care to pregnant women where health services are limited or major barriers such as cost and distance prevent women from accessing maternal health services. However, traditional birth attendants and their ancestral knowledge have been stigmatized and dismissed by other institutions - despite many women's preference for and reliance on their care.
"There are things that as traditional birth attendants, we know, that doctors do not," Pacha Pasmo told UNFPA in 2020. "And there are things that doctors know that traditional birth attendants do not."
In 2020, UNFPA Colombia saw an opportunity to create a forum for these experts to exchange knowledge. In partnership with local traditional birth attendants and the government of Colombia, the agency launched Partera Vital, an app which traditional birth attendants can use to register the babies they deliver with Colombia's National Department of Statistics, and which they can consult to make decisions on whether a newborn needs hospital care.
"There is not a doctor in every place, but traditional birth attendants are always there," said Ms. Pasmo. "If a traditional birth attendant is trained, it's possible that the lives of the mother and baby are saved."
Mental health support in Iraq
As UNFPA Executive Director Dr. Natalia Kanem once said, "There is no health without mental health." For 28-year-old single mom Rawaa, the two went hand-in-hand at a turbulent time in her life.
Rawaa's husband left her in 2016. With two kids to take care of and feeling lost, Rawaa moved in with her parents. "But I refused to be helpless," she told UNFPA.
While staying with her family, Rawaa began visiting a UNFPA-supported health centre in Mosul, which she'd heard offered mental health services. The centre, one of two to launch in Iraq last year, provides free mental and psychosocial support as well as legal and case management services especially for survivors of gender-based violence. Medical care is also available; Rawaa received treatment for an inflamed kidney in August 2022. Both centres addressed the needs of more than 33,000 women and girls in 2022.
Rawaa approached the centre feeling trapped by a life in tangles. She started going to several therapy sessions a week, and to learn coping mechanisms for the anxiety, fear, and trauma she was experiencing. During one session, Rawaa shared that she had not finished university due to her first pregnancy; the centre helped her re-enroll.
"My life changed significantly," Rawaa told UNFPA. "I encourage other women to seek help and use their voices to raise awareness about mental health."
Challenging harmful gender norms in Georgia
Around the world, gender norms create expectations for how girls "should" act: Timid, pleasant, silent and shy. To counter these stereotypes, UNFPA Georgia supported the production of a new comic book for teens, "Invisible", which follows 14-year-old Nini on a magical journey of self-discovery - and encourages girls to get loud and proud.
Nini begins the story, in the words of her mother's friend, a "quiet, gentle, unproblematic" child. But after the arrival of a strange creature that threatens to wreak havoc on Earth, Nini finds her voice - as well as some previously undetected powers. "Nini is a prototype of many invisible girls, speaking up for all of them," renowned Georgian author Nato Davitashvili wrote of the comic created by Marta Urushadze, Tatia Nadareishvili and Mikheil Tsikhelashvili.
The publication of "Invisible" forms part of a campaign in Georgia encouraging families and society not to treat boys and girls differently. In Georgia, as in other countries, patriarchal values and traditions - including those assigning men and boys the role of provider and breadwinner in families - have led to issues with son preference and the social undervaluing of girls.
UNFPA Georgia runs a diverse range of initiatives aimed at addressing these challenges: Puppet shows, equality corners in schools and libraries, youth engagement programmes and more. "Invisible" is just one of many promoting the idea that girls should be valued not for the way they're expected to act, but for who they are - hidden powers and all.
Family planning advice for young people in Liberia
Many young people dream of one day becoming parents. But for millions of adolescent girls, "one day" has already happened.
Across the developing world, almost one third of women aged 20 to 24 are mothers, having become pregnant during adolescence. Motherhood at this life stage can have dire consequences; one of the top causes of death for girls aged 15-19 worldwide is complications from pregnancy and childbirth. Access to education and opportunity can also be severely constrained.
In Liberia, just under one third of young women aged 15-19 are pregnant with their first child, or have already given birth. Christiana is one; she gave birth in December 2022.
"I am not in school now," she told UNFPA. "I had to drop out as my parents asked me [to leave] their house when they realized I was pregnant."
Christiana lives in Greenville in Liberia's southeast region, where the government has targeted efforts to provide young people with age-appropriate sexual and reproductive health information and services since 2017. Since the launch of this programming with UNFPA's support, adolescent pregnancies across five counties in southeastern Liberia have reduced by almost half.
Christiana found out about the sexual and reproductive education programming through a friend, and began attending community meetings on life skills and family planning. "The lessons I learned encouraged me to begin taking contraceptives and join the group as a peer educator," she told UNFPA.
Christiana plans to return to school in September.
Bringing down HIV infection rates, and stigma, in Timor-Leste
For some members of marginalized communities, including the more than 38 million people around the world living with HIV in 2021 and those at increased risk of infection, stigma represents a major barrier to health.
"I do not feel safe when accessing health services in public facilities," João*, who lives in Díli, Timor-Leste, told UNFPA. "I am happy that I can now access HIV self-testing kits for free and know my status discreetly."
The self-test kits are part of a new UNFPA-backed initiative launched by the Timor-Leste Ministry of Health and non-profit Associação Comunidade Progresso (KP) to support those at heightened risk of HIV infection - including men who have sex with men, sex workers, transgender people, people who inject drugs and incarcerated people - with the services, information and care they need to protect themselves and their communities.
The initiative will also serve as a pilot programme for the roll-out of Pre-exposure prophylaxis (PrEP) to target populations in Díli. When used as directed, PrEP cuts down the risk of HIV infection by about 99 per cent.
"I have used PrEP to protect myself since February 9," Maria*, a sex worker, told UNFPA. "I am now sure about my safety and the safety of my partners."
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* Names have been changed.
Equal access to sexual and reproductive health care in Zambia
Not everyone has equal access to health care, including sexual and reproductive health care. While the availability of contraceptives around the world has increased in recent years, UNFPA estimates that 257 million women who want to avoid or delay pregnancy are not using safe, modern methods.
In Zambia, 15 per cent of women aged 15-49 had an unmet need for family planning last year. To fill this gap, the government of Zambia launched an initiative in October 2017 that mobilized 180 community-based family planning distributors in Central Province, Zambia, to provide women and girls, especially in hard-to-reach areas, with contraceptives and care.
Jacqueline Kalunga is one of these community-based distributors. After attending a training on family planning caregiving in Kabwe, the capital Central Province, Jacqueline began supplying her community with contraceptives. This made life easier for clients such as mother-of-two Karin.
"When I had my first child, I started family planning. I would struggle going all the way to the hospital to get my contraceptive injection because I couldn't get it here; it was expensive," Karin told UNFPA. Now, it's become easy because of Jacqueline, who comes to inject us right in our homes."
Jacqueline has more than 300 clients and counting - men and women both. She offers them a critical service: Bringing sexual and reproductive health care closer to home.
Rights and choices for all
These and countless other interventions enable UNFPA to save lives and support the rights and health of millions of women and girls around the world. As UNFPA Executive Director Dr. Natalia Kanem urged on this World Health Day, "Investing in sexual and reproductive health is an essential investment in sustainable development and in delivering a world where every woman, girl and young person can live up to their full potential."
