The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.
Progress has been made but girls 14 and younger represent 44 million of those who have been cut, and in some regions 50% of all girls aged 11 and younger have been cut.[84] Ending FGC has been considered one of the necessary goals in achieving the targets of the Millennium Development Goals,[83] while the United Nations has declared ending FGC a target of the Sustainable Development Goals, and for February 6 to known as the International Day of Zero Tolerance for Female Genital Mutilation, concentrating on 17 African countries and the 5 million girls between the ages of 15 and 19 that would otherwise be cut by 2030.[84][85]
There remain significant barriers to accessing contraception for many women in both developing and developed regions. These include legislative, administrative, cultural, religious and economic barriers in addition to those dealing with access to and quality of health services. Much of the attention has been focussd on preventing adolescent pregnancy. The Overseas Development Institute (ODI) has identified a number of key barriers, on both the supply and demand side, including internalising socio-cultural values, pressure from family members, and cognitive barriers (lack of knowledge), which need addressing.[67][68] Even in developed regions many women, particularly those who are disadvantaged, may face substantial difficulties in access that may be financial and geographic but may also face religious and political discrimination.[69] Women have also mounted campaigns against potentially dangerous forms of contraception such as defective intrauterine devices (IUD)s, particularly the Dalkon Shield.[70]
Laparoscopy (lap-uh-ROS-kuh-pee): A minor surgery to see inside the abdomen. The doctor does this with a small tool with a light called a laparoscope (LAP-uh-roh-skohp). She or he makes a small cut in the lower abdomen and inserts the laparoscope. With the laparoscope, the doctor can check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.
Sweet chili peppers may not be a winter food, but continue eating them in your burritos, stir-fries, and soups, and you may burn more fat during your outdoor cold-weather runs. These not-hot veggies contain chemicals called capsinoids, which are similar to the capsaicin found in hot peppers. Combine capsinoids with 63-degree or cooler temps, and you increase the amount and activity of brown fat cells—those that burn energy—and give your metabolism an extra boost, according to a study published in the Journal of Clinical Investigation.
Maintaining a healthy weight is important piece of the puzzle to achieve good health. A healthy weight can be determined using the body mass index charts (see web source below). If you find you are overweight or obese, weight loss may be beneficial for you. Before you begin any weight loss efforts, consult with your medical provider and/or consult a registered dietitian to create a weight loss plan. If you are underweight, consult a medical provider to assess your weight status.
Adopting a plant-based diet could help tip the scales in your favor. A five-year study of 71,751 adults published in the Journal of the Academy of Nutrition and Dietetics found that vegetarians tend to be slimmer than meat-eaters even though both groups eat about the same number of calories daily. Researchers say it may be because carnivores consume more fatty acids and fewer weight-loss promoting nutrients, like fiber, than herbivores do. Go green to find out if it works for you.
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Some fat is an important part of your diet; fat is part of every cell. It maintains skin and hair; stores and transports fat-soluble vitamins A, D, E and K; keeps you warm; and protects your internal organs. It even helps your mental processes—not surprising given that fat comprises about 60 percent of your brain. But many women consume too much fat. The American Heart Association (AHA) recommends that you keep your total fat intake between 25 and 35 percent of your total calories.
You don’t have to spend a lot of money, follow a very strict diet, or eat only specific types of food to eat healthy. Healthy eating is not about skipping meals or certain nutrients. Healthy eating is not limited to certain types of food, like organic, gluten-free, or enriched food. It is not limited to certain patterns of eating, such as high protein.
Johnson, Paula A.; Therese Fitzgerald, Therese; Salganicoff, Alina; Wood, Susan F.; Goldstein, Jill M. (3 March 2014). Sex-Specific Medical Research Why Women's Health Can't Wait: A Report of the Mary Horrigan Connors Center for Women's Health & Gender Biology at Brigham and Women's Hospital (PDF). Boston MA: Mary Horrigan Connors Center for Women's Health & Gender Biology.
As the table above shows, some of the best sources of calcium are dairy products. However, dairy products such as whole milk, cheese, and yogurt also tend to contain high levels of saturated fat. The USDA recommends limiting your saturated fat intake to no more than 10% of your daily calories, meaning you can enjoy whole milk dairy in moderation and opt for no- or low-fat dairy products when possible. Just be aware that reduced fat dairy products often contain lots of added sugar, which can have negative effects on both your health and waistline.

Women's life expectancy is greater than that of men, and they have lower death rates throughout life, regardless of race and geographic region. Historically though, women had higher rates of mortality, primarily from maternal deaths (death in childbirth). In industrialised countries, particularly the most advanced, the gender gap narrowed and was reversed following the industrial revolution. [6] Despite these differences, in many areas of health, women experience earlier and more severe disease, and experience poorer outcomes.[18]
Long-term goals are imperative, but they can make you feel overwhelmed or discouraged at times. Instead of thinking about how many dress sizes smaller you want to be in four months, focus on small everyday victories, suggests Michael Snader, BodyAware specialist and nutritionist at The BodyHoliday, a health and wellness resort in St. Lucia. “For example, today you are going to eat breakfast, fit in a workout, and drink more water,” he says. Stay focused on the present, and your future will be successful. 
Oaks BM, Young RR, Adu-Afarwuah S, Ashorn U, Jackson KH, Lartey A, Maleta K, Okronipa H, Sadalaki J, Baldiviez LM et al. Effects of a lipid-based nutrient supplement during pregnancy and lactation on maternal plasma fatty acid status and lipid profile: results of two randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids  2017;117:28–35.
By contrast, ovarian cancer, the leading cause of reproductive organ cancer deaths, and the fifth commonest cause of cancer deaths in women in the United States, lacks an effective screening programme, and is predominantly a disease of women in industrialised countries. Because it is largely asymptomatic in its earliest stages, more than 50% of women have stage III or higher cancer (spread beyond the ovaries) by the time they are diagnosed, with a consequent poor prognosis.[121][6]
Poor nutrition can manifest itself in many ways. The more obvious symptoms of a nutritional deficiency include dull, dry or shedding hair; red, dry, pale or dull eyes; spoon-shaped, brittle or ridged nails; bleeding gums; swollen, red, cracked lips; flaky skin that doesn't heal quickly; swelling in your legs and feet; wasted, weak muscles; memory loss; and fatigue.

UN Women believe that violence against women "is rooted in gender-based discrimination and social norms and gender stereotypes that perpetuate such violence", and advocate moving from supporting victims to prevention, through addressing root and structural causes. They recommend programmes that start early in life and are directed towards both genders to promote respect and equality, an area often overlooked in public policy. This strategy, which involves broad educational and cultural change, also involves implementing the recommendations of the 57th session of the UN Commission on the Status of Women[146] (2013).[147][148][149] To that end the 2014 UN International Day of the Girl Child was dedicated to ending the cycle of violence.[112] In 2016, the World Health Assembly also adopted a plan of action to combat violence against women, globally.[150]


 Social protection  Health centers (“condition” and delivery platform)    ↑ knowledge about health and nutrition, ↑ HH food consumption, ↑ food expenditures, ↑/NC food share, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control HH resources  ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ self-confidence, ↑ participation in social networks, ↑ control HH resources, ↑ ANC coverage   
For some simple suggestions about eating a healthy, balanced diet, check out the "New American Plate Concept" from the American Institute for Cancer Research. This concept suggests you fill your plate with two-thirds or more of vegetables, fruits, whole grains or beans and only one-third or less of animal protein. This simple principle can guide you toward healthier eating. For more details, visit http://www.aicr.org/site/PageServer?pagename=reduce_diet_new_american_plate.
By contrast, ovarian cancer, the leading cause of reproductive organ cancer deaths, and the fifth commonest cause of cancer deaths in women in the United States, lacks an effective screening programme, and is predominantly a disease of women in industrialised countries. Because it is largely asymptomatic in its earliest stages, more than 50% of women have stage III or higher cancer (spread beyond the ovaries) by the time they are diagnosed, with a consequent poor prognosis.[121][6]
Most traditional fitness plans happen in predictable patterns that usually involve moving in two planes of motion—up and down or forward and backward—ignoring the third plane of motion, lateral. “Move your body in all directions to create the most fit, functional, and athletic physique,” Stokes says. If you're a runner, cyclist, or walker, remember to include movements such as jumping jacks, side shuffles, side lunges, and carioca (the grapevine-like move) in your warm-up or cool-down, she suggests.

Good sources of iron include liver, kidneys, red meat, poultry, eggs, peas, legumes, dried fruits and dark, green leafy vegetables. Three ounces of cooked chicken liver contains 7.2 mg of iron; a cup of cooked spinach contains 6.4 mg. Your health care professional will probably recommend iron supplements during pregnancy (probably starting at 30 mg per day).
Having the proper footwear is essential for any workout, and for winter runs, that means sneaks with EVA (ethylene vinyl acetate), says Polly de Mille, an exercise physiologist who oversees New York Road Runner's Learning Series for first-time New York City Marathon runners. “Polyurethane tends to get really stiff and cold in the winter, which could increase your risk of injury.” Another important feature is a waterproof and windproof upper: Look for shoes made with Gortex, or wrap your mesh uppers in duct tape to keep feet dry and warm.

Community health posts and home visits provided a platform to make health care services more accessible (109, 110, 124). Community-based platforms for the delivery of health services included community center and home visits from community health workers, mobile clinics, community support groups, mobile phones, and mass media campaigns (105, 110). Community-based services were effective in reducing maternal mortality and managing HIV (106). However, 1 review found that community-based interventions were only effective in reducing maternal morbidity and not mortality (107, 110). In high-income settings, community-based services were associated with hypertension and diabetes management, and cervical and breast cancer screening (106). We found no references for the use of community-based integrated care to address women's nutrition in low- and middle-income settings. It could be an effective way to reach older women and women of reproductive age who do not regularly engage with health centers. For children, community-based services were effective in improving health outcomes, particularly among the poorest wealth quintiles (13, 110). More research is needed on the potential of community-based services to reduce inequities in delivery of care to women in different settings and across different socioeconomic statuses.
Women and men have approximately equal risk of dying from cancer, which accounts for about a quarter of all deaths, and is the second leading cause of death. However the relative incidence of different cancers varies between women and men. In the United States the three commonest types of cancer of women in 2012 were lung, breast and colorectal cancers. In addition other important cancers in women, in order of importance, are ovarian, uterine (including endometrial and cervical cancers (Gronowski and Schindler, Table III).[6][120] Similar figures were reported in 2016.[121] While cancer death rates rose rapidly during the twentieth century, the increase was less and later in women due to differences in smoking rates. More recently cancer death rates have started to decline as the use of tobacco becomes less common. Between 1991 and 2012, the death rate in women declined by 19% (less than in men). In the early twentieth century death from uterine (uterine body and cervix) cancers was the leading cause of cancer death in women, who had a higher cancer mortality than men. From the 1930s onwards, uterine cancer deaths declined, primarily due to lower death rates from cervical cancer following the availability of the Papanicolaou (Pap) screening test. This resulted in an overall reduction of cancer deaths in women between the 1940s and 1970s, when rising rates of lung cancer led to an overall increase. By the 1950s the decline in uterine cancer left breast cancer as the leading cause of cancer death till it was overtaken by lung cancer in the 1980s. All three cancers (lung, breast, uterus) are now declining in cancer death rates (Siegel et al. Figure 8),[121] but more women die from lung cancer every year than from breast, ovarian, and uterine cancers combined. Overall about 20% of people found to have lung cancer are never smokers, yet amongst nonsmoking women the risk of developing lung cancer is three times greater than amongst men who never smoked.[119]

Women who seek out a women's only club are usually looking for something different. They want the privacy of an all-women environment. They also want the attention they get from women who understand the unique fitness needs of other women and are especially patient and understanding with those who haven't had much experience with fitness in their lives.
Laparoscopy (lap-uh-ROS-kuh-pee): A minor surgery to see inside the abdomen. The doctor does this with a small tool with a light called a laparoscope (LAP-uh-roh-skohp). She or he makes a small cut in the lower abdomen and inserts the laparoscope. With the laparoscope, the doctor can check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.
The effect of education programs on nutrition outcomes is difficult to assess because programs often have poor baseline data or nutrition outcomes are not evaluated (174, 182). Studies that used longitudinal analyses and “natural” experiments (e.g., before and after a national education policy) found that education was associated with reduced fertility (183, 184), and delayed early marriages and pregnancies (184–187). The impact was more significant for higher levels of education (185). However, 1 study in Malawi identified negative associations between education and timing of first birth, although these findings were largely not statistically significant (188). Secondary education for adolescents and women of reproductive age also showed no impact on women's empowerment (184), although it did show an impact on improved literacy and leadership (174). Educational interventions that provided conditional cash transfers (CCTs) and school feeding, as well as other forms of social protection to families of enrolled girls, were associated with greater school enrollment and attendance (189–191), improved test scores (189, 190), reduced gender gaps (192), and reduced hunger (190, 191).

While the rates of the leading causes of death, cardiovascular disease, cancer and lung disease, are similar in women and men, women have different experiences. Lung cancer has overtaken all other types of cancer as the leading cause of cancer death in women, followed by breast cancer, colorectal, ovarian, uterine and cervical cancers. While smoking is the major cause of lung cancer, amongst nonsmoking women the risk of developing cancer is three times greater than amongst nonsmoking men. Despite this, breast cancer remains the commonest cancer in women in developed countries, and is one of the more important chronic diseases of women, while cervical cancer remains one of the commonest cancers in developing countries, associated with human papilloma virus (HPV), an important sexually transmitted disease. HPV vaccine together with screening offers the promise of controlling these diseases. Other important health issues for women include cardiovascular disease, depression, dementia, osteoporosis and anemia. A major impediment to advancing women's health has been their underrepresentation in research studies, an inequity being addressed in the United States and other western nations by the establishment of centers of excellence in women's health research and large scale clinical trials such as the Women's Health Initiative.
 Social protection  Health centers (“condition” and delivery platform)    ↑ knowledge about health and nutrition, ↑ HH food consumption, ↑ food expenditures, ↑/NC food share, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ participation in social networks, ↑ self-confidence, ↑ control HH resources  ↑ knowledge about health and nutrition, ↑ HH food security, ↑ food expenditures, ↑/NC food share, ↑ HH food consumption, ↑ dietary diversity, ↑ HH intake of fruits, vegetables, and ASF, ↑/NC intake of fats and sweets, ↑ self-confidence, ↑ participation in social networks, ↑ control HH resources, ↑ ANC coverage   
Don’t fear the fats! Healthy fats provide the structural component to many cell membranes which are essential for cellular development and carrying various messages (hormones) through our body quickly. Protein is also responsible for hormone production, so it’s important for women to get foods that will provide you with healthy fats and protein. Women’s cycles can also deplete your body of B vitamins, iron, zinc, and magnesium so you should be aware of your whole food intake and possibly choose to supplement (see above for more if it’s right for you).
Women need more of this mineral because they lose an average of 15 to 20 milligrams of iron each month during menstruation. Without enough iron, iron deficiency anemia can develop and cause symptoms that include fatigue and headaches. After menopause, body iron generally increases. Therefore, iron deficiency in women older than 50 years of age may indicate blood loss from another source and should be checked by a physician.
The increasing focus on Women's Rights in the United States during the 1980s focused attention on the fact that many drugs being prescribed for women had never actually been tested in women of child-bearing potential, and that there was a relative paucity of basic research into women's health. In response to this the National Institutes of Health (NIH) created the Office of Research on Women's Health (ORWH)[154] in 1990 to address these inequities. In 1993 the National Institutes of Health Revitalisation Act officially reversed US policy by requiring NIH funded phase III clinical trials to include women.[119] This resulted in an increase in women recruited into research studies. The next phase was the specific funding of large scale epidemiology studies and clinical trials focussing on women's health such as the Women's Health Initiative (1991), the largest disease prevention study conducted in the US. Its role was to study the major causes of death, disability and frailty in older women.[155] Despite this apparent progress, women remain underepresented. In 2006 women accounted for less than 25% of clinical trials published in 2004,[156] A follow up study by the same authors five years later found little evidence of improvement.[157] Another study found between 10–47% of women in heart disease clinical trials, despite the prevalence of heart disease in women.[158] Lung cancer is the leading cause of cancer death amongst women, but while the number of women enrolled in lung cancer studies is increasing, they are still far less likely to be enrolled than men.[119]

Calcium: For adult women aged 19-50, the USDA recommended daily allowance is 1,000 mg/day. For women over 50, the recommended daily allowance is 1,200 mg/day. Good sources of calcium include dairy products, leafy green vegetables, certain fish, grains, tofu, cabbage, and summer squash. Your body cannot take in more than 500 mg at any one time and there’s no benefit to exceeding the recommended daily amount.


Women who are socially marginalized are more likely to die at younger ages than women who are not.[21] Women who have substance abuse disorders, who are homeless, who are sex workers, and/or who are imprisoned have significantly shorter lives than other women.[21] At any given age, women in these overlapping, stigmatized groups are approximately 10 to 13 times more likely to die than typical women of the same age.[21]
Women who are socially marginalized are more likely to die at younger ages than women who are not.[21] Women who have substance abuse disorders, who are homeless, who are sex workers, and/or who are imprisoned have significantly shorter lives than other women.[21] At any given age, women in these overlapping, stigmatized groups are approximately 10 to 13 times more likely to die than typical women of the same age.[21]
If you thought texting changed your love life, imagine what it could do for your waistline. When people received motivational text messages promoting exercise and healthy behaviors twice a week (i.e., “Keep in the fridge a Ziploc with washed and precut vegetables 4 quick snack. Add 1 string cheese 4 proteins”), they lost an average of about 3 percent of their body weight in 12 weeks. Participants in the Virginia Commonwealth University study also showed an improvement in eating behaviors, exercise, and nutrition self-efficacy, and reported that the texts helped them adopt these new habits. Find health-minded friends and message each other reminders, or program your phone to send yourself healthy eating tips.

  Community centers  ↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity  ↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity  ↑/NC knowledge about hygiene and sanitation, ↑/NC hand-washing, ↑ water quality, NC waste disposal, ↓ diarrheal morbidity  ↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity 
Low-fat diets also can help you lose weight.16 But the amount of weight lost is usually small. You can lose weight and lower your risk for heart disease and stroke if you follow an overall healthy pattern of eating that includes more fruits, vegetables, whole grains and beans that are high in fiber, nuts, low-fat dairy and fish, in addition to staying away from trans fat and saturated fat.

Many WASH interventions targeted mothers and their caregiving behaviors for children. However, these interventions were applied to entire households and not individual household members. Larger community-based hygiene and sanitation initiatives broadly reached more people in the community (131). However, certain populations such as the elderly and young children might have limited access to public infrastructure, such as public latrines, particularly if there are physical and economic barriers to accessing them (136).
“The more colorful the vegetables — and fruits — the more nutrients you’re going to get in your diet,” says Hincman. And green leafy veggies, like turnip, collard and mustard greens, kale, Chinese cabbage, and spinach, all rich sources of vitamins and minerals, are a great place to start. Many are also a good source of iron, important for women’s health, especially after menopause. One serving of cooked leafy greens — a half a cup — is not a lot, considering that just around two and one half cups of veggies, or five servings in total, is all you need each day.
Something else to remember: an estimated 90 to 95 percent of dieters who lose weight regain all or part of it within five years, and the consequences can be even worse than simply being overweight. Those who exercise regularly as part of a weight loss diet and maintenance program are more likely to keep the weight off. Also note that an overly restrictive diet can lead to more overeating, a natural reaction to food deprivation.
Folate or vitamin B9 (also known as folic acid when used in fortified foods or taken as a supplement) is another nutrient that many women don’t get enough of in their diets. Folate can greatly reduce the chance of neurological birth defects when taken before conception and during the first few weeks of pregnancy. Folate can also lower a woman’s risk for heart disease and certain types of cancer, so even if you’re not planning on getting pregnant (and many pregnancies are unplanned), it’s an essential nutrient for every woman of childbearing age. In later life, folate can help your body manufacture estrogen during menopause.

 Micronutrient supplementation  Health clinics  ↓ anemia and Fe-deficiency anemia, ↑ Hgb, ↓ soil-transmitted helminth infection, ↑ cognitive function  ↓ anemia and Fe-deficiency anemia, ↑ Hgb, ↑ serum ferritin, ↓ soil-transmitted helminth infection  ↓/NC anemia, ↑/NC MN status (Hgb, folate, zinc, retinol), ↑ MN status [ferritin, B-12, 25(OH)D], ↓/NC gestational hypertension and pre-eclampsia, NC gestational diabetes, ↓/NC hyperthyroidism, ↓/NC night blindness, ↓ bone mineral content, ↑ weight gain (among underweight women), ↓ maternal mortality, ↓/NC placental malaria, NC parasitemia, NC maternal infection, ↓/NC depression and perceived stress   


In 2000, the United Nations created Millennium Development Goal (MDG) 5[43] to improve maternal health.[44] Target 5A sought to reduce maternal mortality by three quarters from 1990 to 2015, using two indicators, 5.1 the MMR and 5.2 the proportion of deliveries attended by skilled health personnel (physician, nurse or midwife). Early reports indicated MDG 5 had made the least progress of all MDGs.[45][46] By the target date of 2015 the MMR had only declined by 45%, from 380 to 210, most of which occurred after 2000. However this improvement occurred across all regions, but the highest MMRs were still in Africa and Asia, although South Asia witnessed the largest fall, from 530 to 190 (64%). The smallest decline was seen in the developed countries, from 26 to 16 (37%). In terms of assisted births, this proportion had risen globally from 59 to 71%. Although the numbers were similar for both developed and developing regions, there were wide variations in the latter from 52% in South Asia to 100% in East Asia. The risks of dying in pregnancy in developing countries remains fourteen times higher than in developed countries, but in Sub-Saharan Africa, where the MMR is highest, the risk is 175 times higher.[39] In setting the MDG targets, skilled assisted birth was considered a key strategy, but also an indicator of access to care and closely reflect mortality rates. There are also marked differences within regions with a 31% lower rate in rural areas of developing countries (56 vs. 87%), yet there is no difference in East Asia but a 52% difference in Central Africa (32 vs. 84%).[37] With the completion of the MDG campaign in 2015, new targets are being set for 2030 under the Sustainable Development Goals campaign.[47][48] Maternal health is placed under Goal 3, Health, with the target being to reduce the global maternal mortality ratio to less than 70.[49] Amongst tools being developed to meet these targets is the WHO Safe Childbirth Checklist.[50]
For this comprehensive narrative review, we evaluated both nutrition-specific and nutrition-sensitive interventions. Nutrition-specific approaches are those that address the immediate determinants of nutrition (e.g., food and nutrient intake, diet-related practices and behaviors, disease, etc.), whereas nutrition-sensitive approaches are those that address the underlying determinants of nutrition (e.g., food security, access to resources, safe and hygienic environments, adequate health services, etc.) (5, 12). We evaluated the following nutrition-specific interventions described by Bhutta et al. (13, 14): nutrition counseling and education, micronutrient supplementation and fortification, protein and energy supplementation, and lipid-based supplementation. We also included the following nutrition-sensitive approaches described by Ruel and Alderman (5) and Bhutta et al. (14): health care; family planning; water, sanitation, and hygiene (WASH); empowerment; income-generation; education; and social protection. For each intervention, we 1) described the scale and coverage of the intervention, when available; 2) summarized the evidence of effectiveness for women's health and nutrition outcomes; and 3) described and evaluated the target population and delivery platforms, as described in the published articles and as summarized in Table 1. The delivery of interventions included the physical platforms, as well as the adherence and the implementation challenges of the different interventions.
Globally, women's access to health care remains a challenge, both in developing and developed countries. In the United States, before the Affordable Health Care Act came into effect, 25% of women of child-bearing age lacked health insurance.[176] In the absence of adequate insurance, women are likely to avoid important steps to self care such as routine physical examination, screening and prevention testing, and prenatal care. The situation is aggravated by the fact that women living below the poverty line are at greater risk of unplanned pregnancy, unplanned delivery and elective abortion. Added to the financial burden in this group are poor educational achievement, lack of transportation, inflexible work schedules and difficulty obtaining child care, all of which function to create barriers to accessing health care. These problems are much worse in developing countries. Under 50% of childbirths in these countries are assisted by healthcare providers (e.g. midwives, nurses, doctors) which accounts for higher rates of maternal death, up to 1:1,000 live births. This is despite the WHO setting standards, such as a minimum of four antenatal visits.[177] A lack of healthcare providers, facilities, and resources such as formularies all contribute to high levels of morbidity amongst women from avoidable conditions such as obstetrical fistulae, sexually transmitted diseases and cervical cancer.[6]
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