The invisible women

Burnet Institute

07 March, 2015

In the West we often hear women saying, as they get older, that they become invisible. Certainly it is true that older women have been largely invisible when it comes to health policy in developing countries.

Infant feeding and child health promotion advice and materials are aimed at mothers, and, increasingly, fathers – but older women don’t usually appear in the pictures or in the text.

Yet it is older women who give advice about pregnancy, childbirth and breastfeeding, and with more women working outside the home, it is older women who are caring for small children.

Family sizes are now small in most Asian populations, but older women had many babies, and at a time when there were few maternal health services. They may suffer from weakened pelvic floors, with urinary incontinence and prolapse common.

After a lifetime of working in the fields and carrying heavy loads of wood and water, they suffer from lower back pain and arthritis, with reduced mobility. Cooking for their families for decades means that they have breathed in the smoke from the cooking fire resulting in a chronic cough, lung disease and cataracts.

They are also at greater risk of diabetes, high blood pressure, and heart disease, and their complications. A high proportion has loss of hearing and vision.

Many older women in poor families put their children and grandchildren first. They give them their own food, and are often reluctant to spend money on themselves, even to travel for health care or to buy medicines.

Older women in hilly, high country areas have especially difficult living conditions, and are often damp and cold. They become chilled more readily than younger adults, reducing their immunity to infections.

Older women are also at greater risk of falls and fractures. They may have to climb up and down slippery paths and steps to reach a toilet or the well for washing. Lack of balance, vision and hearing increases the risk of being hit by a vehicle when walking on the road.

Older women are very likely to be widowed. Most live with their adult children and may have little privacy. Very few have an income or any pension, so they depend on their children.

They often have a heavy burden of domestic tasks, which may prevent them meeting their friends; social isolation is common. Emotional and physical abuse of older women is a hidden and shameful problem, but it does occur.

In our Better Vision Healthy Ageing Program in the hill country in Sri Lanka, we are piloting a range of strategies to learn lessons for policy and practice to improve the health and well being of elders.

Elders’ Clubs have many benefits. They reduce social isolation and give elders a collective voice. Older women support each other, visit other members when they are ill, travel together for health care to reduce costs, and undertake income-generating activities together.

The clubs enable health promotion through trained peer educators. Screening for vision problems is easier when club members gather in one place. Some of the elders have been trained as Eye Health Promoters and undertake the screening and referral of their peers very effectively.

Older women, and older men, should be taken into account in all health and development initiatives.

On International Women’s Day 2015, let’s redouble our efforts to ensure they become more visible, for their own sake and for the sake of their families and communities.

You can find out more about the program here.


Health Issue

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Burnet Institute

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