1. 1
GOOD HEALTH
OF
WORKING WOMEN
Needs & Concerns :
An Overview

2. 2
Dr. Sharda Jain
Secretary General DGF
Dr. Jyoti Agarwal
Secretary EDGF

3. 3
How many of you
feel Healthy &
Peaceful ?
?
INTERACTIVE SESSION

4. 4Modern Working Woman

5. 5
Life is a Balancing Act.
Striking the right balance is the key

6. 6
Balance in life is big issue !!

7. 7
DGF Survey of
Working Women
(N- 1000)
2005

8. 8
DGF survey -2005
Some hard facts about
working women
• 90% working women agree that striking a
balance is big issue
• 10%say they have achieved a balance
• 50% feel – “life imbalance” reduced their
productivity
• 45% are suffering from stress related
disease

9. 9
• 40% reported poor family relation
• 50% children of working women are
poor achievers
• 50% have health problems
• 65% expect the situation to remain
unchanged.
Winners are never Quitters - Choice is yours
DGF survey -2005
Some hard facts about
working women

10. 10
• TB – 30%
• Anaemia – 65%
• Obesity – 40%
• Backache – 50%
• Cervical Spondylosis - 25%
DGF survey -2005
Some hard facts about
working women

11. 11
• Knowledge of cervical – 5% vaccination
• MTP - Average 2
• Use of contraception 3 %
• Food?? Skipped breakfast – 60%`
NO CHECKUP – 90%
DGF survey -2005DGF survey -2005
Some hard facts about
working women

12. 12
I have my commitment
to my family,
my company and
my life.
I believe
I can balance
for most time.
Sunita Williams
“If it is to be, it is up to me”

13. 13
Value of your
health is only
realised when it
going
out of your
Let us Focus on Your Health
Physical, Emotional, Mental

14. 14
… make life less Complicated

15. 15
Become organised and Focused
For Comprehensive & Convenient
Total Health Plan for yourself

16. 16
Causes of Death of
Indian Women

17. 17
Till 2012
Hard Facts - - Causes of Death’s in
Women in India
• Tuberculosis – number I
• Suicide/ Burns – number II
• Anaemia + Life Style Diseases-
number III
• Pregnancy related – number IV
• Cancer – number V

18. 18
From Jan 2013
Hard Facts - - Causes of
Death’s in Women in India
• Suicide/ Burns – number 1
• Cancer – number II
• Tuberculosis – number III
• Anaemia + Life Style Diseases-
number IV
• Pregnancy related – number V

19. 19
Working Women’s Health Problems
• Self neglect
• Wrong Nutrition
• Total lack of exercise
• Anaemia/TB
• Unsafe abortions/ Female Foeticide
• Use of contraceptives ??
• RTI/ STI/HIV
• Mental Health-Neglected
• Stress & Anxiety
INTERACTIVE SESSION

20. 20
Spectrum of problems in
Working Women
SELF NEGLECT
•NUTRITION
•EXERCISE
•SELF DEVELOPMENT

21. 21
Spectrum of problems in
Working Women
STRESS ++Professional – cut throat competition
Economic – rat race
Family Demands/Relationship
- Immediate
- Extended
Work place nuisances
No time for Society/ Spiritual Health?
No Time – for Self Development

22. 22
● "ECONOMIC
INDEPENDENCE”
● DO APPRECIATE
“PROMOTING
HEALTHY HABBITS IN LIFE
FOR POSITIVE HEALTH”
SILVER LINING

23. 23
SUICIDE / Burns
&
WOMEN
No 1 cause of Death

24. 24
Suicide is the most dreaded
consequence of stress.
INTERACTIVE SESSION

25. 25
Astonishing Facts
• First - leading cause of death
• Every 5th
women who is committing sucide
is an indian
• 2 lakh people committed suicide in India in
2010.
• 60% in women (aged 15-29 years).
.
INTERACTIVE SESSION

26. 26
Causes
• Women are Highly Emotional
• EXTREMELY STRESSED – family,
husband, children, financial, work
• Violence and depression are key
determinants of suicide in women.

27. 27
Suicide – Great Finding
Men - Speaks to nobody
Women - Speaks to FIVE people
at least before taking
extreme step

28. 28
Prevention of suicide –
A three pronged attack
(1) Recognize
(2) Communicate / help
(3) Seek Medical help
Take Home massage
Friend / Mentor / speak out

29. 29
CANCER CERVIX
No 2 killer

30. 30
Human
Suffering
Due To
Cervical
Cancer in India
Is depressing•women who die due to Cervical Cancer in
the world is an Indian
1 out of 4

31. 31
Why is Cervical Cancer
important to you?
> 200 women die every day in India
1 woman every 7 minutes
8 women die every hour
Cervical Cancer is the
commonest cancer in
Indian Women

32. 32
How can you protect yourself?
Awareness
Vaccination Screening
Cervical Cancer
100 % Preventable

33. 33
CERVICAL CANCER IS TOTALLY PREVENTABLE
100%
• VACCINATION BY HPV vaccine
• 100% results before start of sexual activity – less than
16 years
• Catch-up vaccination – 10 – 46 years of age
• Our group feels there is no upper limit in India
Regular ANNUAL CHECK-UP & PAP SMEAR essential in spite
of vaccination 21 – 65 years
Primary prevention

34. 34
Screening Guidline
1. 27% of the world burden of Cervical Cancer is seen in India.
2. Screening is recommended in women of >21yrs 2013
3. No screening required before 21 yrs
4. Screening should stop at 65 yrs and after hysterectomy
“The biggest gain in reducing cervical cancer incidence and mortality
would be achieved by increasing screening rates among women rarely
or never screened. . .
Clinicians, hospitals, health planners, and public health officials should
seek to identify and screen these women.”
ACS, 20002

35. 35
What you should know about
screening: “PAP’s smear”
Simple, quick painless procedure – takes
5 minutes How is it done?
A smooth, sterilized instrument is
gently inserted to see the cervix
A small spatula or brush is swiped
across the cervix to loosen cells
The brush is smeared on a clean
glass slide
The slide is later examined by an
expert to spot abnormal cells
21 to 65 Years
Annual Check-up

36. 36
How to prepare for your pap test
- Not to schedule during periods.
- If you are going to have a pap testing in the next two days
• You should not douche (rinse the vagina with water or
another fluid).
• You should not use a tampon
• You should not use a birth control foam, cream or jelly
• You should not use a medicine or cream in your vagina

37. 37
HPV – VACCINE

38. 38
What you should know about
vaccination
• Vaccination is the only true form of
“prevention” – stops the disease from
happening in the first place
• There are two vaccines available today:
– Quadrivalent (“four type”)
• Protects from 6,11,16,18
• Partial protection from 33, 35, 41
and 7 other types
– Bivalent (“two type”)
• Protects from 16, 18
• Partial protection from 33, 35 and
41

39. 39
We pledge
MERI BETI
MERI DUTY

40. 40
BREAST CANCER

41. 41
13.2% of women13.2% of women born today will be
diagnosed with breast cancerbreast cancer at some
time in their lives.
That means 1 in every 8 women1 in every 8 women
will be diagnosed with breast cancerbreast cancer.
Source: National Cancer Institute

42. 42
Breast Cancer Myth
• Wearing a bra all the time can cause breast cancer. X
 Breast cancer only affects older women X
• Only your mother’s family history of breast cancer can affect your risk. X
• Birth control pills cause breast cancer. X
Source: www.breastcancer.org
Breast Feeding is protective

43. 43
Breast Cancer
• Self Examination
• Ultrasound Breast
• Mammography

44. 44
A CANCER diagnosis doesn’t always
mean an end.
It can be the beginning of learning
how to get the facts, and fight to win.
Regular check – up / proactive approach
Ray of Hope

45. 45
TUBERCULOSIS
&
WOMEN
No 3 Cause of Death

46. 46
All TB Cases are not
chest problem ?
No organ Is spared

47. 47
Latent TB Infection Active TB Disease
Has no symptoms Has symptoms which
you all know Fever,
weight loss, cough ets
Does not feel sick Usually feels sick
Cannot spread TB
bacteria to others
May spread TB bacteria
to others
Latent V/S Active
1 in every 10 (world)
3 in every 10 (India)

48. 48
Don’t ignore ATT treatment
MDR 12%

49. 49
ANAEMIA
IN
WOMEN & GIRLS
4th
Cause
Biggest Cause of Billion & Billion Dollar Loss to Country

50. 50
Expert In
• Group Pic • Infertility
• Recurrent Miscarriage
• Pain In abdomen
• Heavy Menstrual
Bleeding

51. 51
80% working women
50% working men

52. 52
HAEMOGLOBIN CUT OFF LEVELS
FORDETERMINING ANAEMIA AS PER
WHO GUIDELINES ARE AS FOLLOWS:
Infants 6-12 months & children 1-2 years < 11 gm%
Adolescent girls < 12 gm%
Pregnant women < 11 gm%
Lactating women < 12 gm%
Women in reproductive age group < 12 gm%
Adult men < 13 gm%
Mild to moderate anaemia 7 - 10.9 gm
%
Severe anaemia < 7 gm%

53. 53
INDIA HAS LARGEST NO OF
• Anaemic women
• Anaemic girls
• Anaemic children
Anaemic MOTHERS make Anaemic BABIES

54. 54
8 out of 10
Children, adolescent and women are anaemic.
BUT
The silver lining is
50% are only mildly anaemic

55. 55
Anaemia drains all our energy
&
makes us “Lazy Race”

56. 56
Lets Pledge to make
• Anaemia Free India
• Anamia Free School
• Anaemia Free Family
• Anaemia Free Children

57. 57
Get your Hb done today.
Take doctor’s advise
Hb of girls and women should
not be less than 12gm%

58. 58
In India our AIM is 12gm by age 12
In West AIM is for Hb 14 -15gm

59. 59
It is Doable
&
We Can Do it

60. 60
Remember 5 A’s
• Ask what is your Hb
• Ask when was it done last
• Ask what is the normal Hb
• Ask to get it done right away
• Advise : Diet
: Tablet
: Deworming

61. 61
CHINA Role Model
• Once they brought one child norm, they
concentrated on saving this child and making
him/her healthy.
• Their incidence of anaemia in children,
adolescent has markedly decreased.
• They have increased the height of their
children by 4-6 inc.
If they can do it, why can’t we do it.

62. 62
• There are 1 million good teachers in India
Each should work hard to make their class
Student’s :Anaemia Free”.
• women make 20% of the working force – they can
become ambassador for Anaemia free India
• Every parent should take pledge to make their
family “Anaemia Free”
Thank God GOI / state GOVTs. Are woken -up

63. 63
Lifestyle Diseases
Because of Sedentary Lifestyle

64. 64
• Diabetes
• Hypertension
• Obesity
• Coronary Heart disease
• Gout
• Cancer
Lifestyle Diseases in women

65. 65
Hypertension
Adult 1:3
At 25 years 1:4
After 50 years 1:3
Heart
Attack
&
Stroke

66. 66
Diabetes
25 years 10%
50 years 1:5
Women 1:3
If Obese 1:2
If Uncontrolled
It decreases 7-8 years of our life

67. 67
Heart Attack
&
Stroke
No Protection to women
If Commonly in Obesity ,Hypertension & Diabetes
Co - morbidity

68. 68
OBESITY
IN
WOMEN
& GIRLS

69. 69
Obesity
“An Emerging Menace”
Overweight = Underweight
2.1 billion 2.1 billion
First time in human
history !
Aug 2005

70. 70
After 30yrs
1 kg
Per year
Will increase
Unless you
take steps

71. 71
PREGNANCY
&
ABORTION
DEATHS
4th
killer

72. 72
72

73. 73
73
Smita PatilSmita Patil

74. 74
MMR-Indian scenarioMMR-Indian scenario
• 1940 - 20 per 1000 live births1940 - 20 per 1000 live births
• 1960 - 10 per 1000 live births1960 - 10 per 1000 live births
• 1992 - 437 per 100000 live birth1992 - 437 per 100000 live birth
• 1997 - 407 per 100000 live births1997 - 407 per 100000 live births
• 2003 - 301 per 100000 live births2003 - 301 per 100000 live births
• 2006 - 254 per 100000 live births2006 - 254 per 100000 live births
• 2009 -212 per 1,00,000 LB2009 -212 per 1,00,000 LB
SRGSRG
74
SRGISRGI
Expected in 2015 - 135 per lakh LBExpected in 2015 - 135 per lakh LB
MDF – 5 in 2015 is 109 per lakhMDF – 5 in 2015 is 109 per lakh

75. 75
Risk of Motherhood
• Developed World- 1:2800
• India - 1:175

76. 76
Say ‘No’ to Home Delivery

77. 77
SAFE Abortion
Medical
Surgical
Say ‘No’ to Quacks

78. 78
POPULATION
EXPLOSION
Basis of all problems in India

79. 79
CONTRACEPTION
EVERY PREGNANCY SHOULD BE WANTED

80. 80
Choice of Contraception
Choice Failure Rate
No contraceptive
Pregnancy rate is 80/hwy
Oral contraceptive Less than 1/hwy
IUCD Less than 1 to 3/hwy
Condoms and other barrier
methods
More than 20 pregnancies/hwy
Permanent methods like female sterilization and male
vasectomy are also advocated if family is complete

81. 81
EMERGENCY PILL

82. 82
Emergency Contraception
(i-pill, Unwanted 72, Pill 72)
• Only for emergency.
• Not for regular use.
• Should not be taken more than twice in a month.
• Repeated intake can lead to menstrual
irregularity.
• Can cause nausea and vomiting.
• If not used correctly, can fail to prevent
conception.
• To be taken within 72 hours of intercourse.

83. 83
Common Problems
In Women

84. 84
HEAVY
MENSTRUAL
PERIODS

85. 85
More than 1 in 5
30s & 40s suffer from
HEAVY PERIODS
(Unmanageable)

86. 86
•20-40 yrs – 10 / lakh
•40-50 yrs - 36 / lakh
Risk of Endometrial Carcinoma

87. 87
Ultrasonography
TVS – Gold std.

88. 88
Office
Endometrial
sampling

89. 89
Treatment

90. Current TreatmentCurrent Treatment
Recommended for HMBRecommended for HMB
Drug therapyDrug therapy
HysterectomyHysterectomy
20%-30% after
35 years
Global Endo.
Ablation/
Mirena

91. 91
Mirena (LNG IUS)
(5 yrs)
is a
Magic Stick
Effective in 70-80%

92. 92
10 minutes Treatment of DUB
Uterine Balloon Therapy
Very effective (90%+)

93. 93KJ Carlson, NEJM 328:856,
1993
HYSTERECTOMY
as Treatment
Should be last resort

94. 94
DISCHARGE
IN
WOMEN & GIRLS

95. 95
Vaginal discharge (VD) is one of the
commonest complaint in women
It can bother all age groups
VAGINAL
DISCHARGE

96. 96
RISK FACTORS
• Multiple sexual partners
• S.T.I.s
• Early exposure to sexual activity
• Bad hygienic habits
Chronic asymptomatic infections can
persist for several decades

97. 97
Why treating Vulvo-vaginitis is so important?
IF LEFT UNTREATED, CAN LEAD TO MORE
SERIOUS CONDITIONS
• PID
• Endometritis
• INFERTILITY
• spread of AIDS

98. 98
PerinealPerineal HHygieneygiene
Cleaning HabitsCleaning Habits

99. 99
Golden Rule
• ““Front to Back”Front to Back”
• after urination or bowel movement, aafter urination or bowel movement, a
woman should wash area from front towoman should wash area from front to
back & pat dry.back & pat dry.
• This prevents bacteria from movingThis prevents bacteria from moving
from rectal area to vagina.from rectal area to vagina.

100. 100
Perineal HygienePerineal Hygiene
During MenstruationDuring Menstruation
Sanitary napkins should ideally beSanitary napkins should ideally be
made of cotton lining.made of cotton lining.
Avoid the nylon-lined ones or thoseAvoid the nylon-lined ones or those
that are heavily deodorized.that are heavily deodorized.
Change your napkins as often asChange your napkins as often as
required.required.
Keep the vulval area clean & dry.Keep the vulval area clean & dry.

101. 101
Perineal HygienePerineal Hygiene
During MenstruationDuring Menstruation
Say No to whisper also
• Talcum Powder
• Deodorants
• Antiperspirants
• Antiseptic
• Douching

102. 102HIV IN INDIA

103. 103
HIV/AIDS
“ 50% HIV positive are
women in India”.
• Young people between the ages of
10-25 years make up 50% of all new
HIV infections
(Source : India responds to HIV/AIDS, UNAIDS,1999)

104. 104
Awareness of RTI/STI in India
YOUTH
65%
35%
YES NO
ADOLESCENT
32%
68%
YES NO
OTHERS
37%
63%
YES NO
Source: RHS-2003

105. 105
Menopause
• Life Style Changes
• Positive Thinking
• Weight Check

106. 106
Post
Menopausal
Bleeding
Don’t Ignore /Seek Gynaecologists Help

107. 107
OSTEOPOROSIS
World Health Organization
The W.H.O. puts osteoporosis in the group
Of the world’s 10 most frequent diseases.

108. 108
Calcium supplementation is useful
but not sufficient to treat individuals
with osteoporosis.

109. 109
• Despite the introduction of new
drugs for OSTEOPOROSIS….
• The common approach does
not give satisfactory results

110. One in 2 women and 1 in 4 men age 50 and
older will suffer from an osteoporosis-
related fracture in their lifetime.
Nearly 53% of peri and post-menopausal
women suffer from osteoporosis-
2011, PGI Chandigarh.

111. Treatment

PREMENOPAUSAL WOMEN and men younger
than 50 years without risk factors for
osteoporosis should receive a total of 1000 mg of
calcium daily.

Postmenopausal should receive a
total of 1200-1500 mg of calcium
daily.

112. 112
Vitamin – D Deficiency
AN EPIDEMIC
Adults younger than 50 years of age should
receive 400-800 IU of VITAMIN D 3 daily. All
adults older than 50 years should receive
800-1000 IU of vitamin D 3 daily.

113. 113
ANNUAL HEALTH
CHECK UP IS
MUST

114. 114
It is never too late
to have
Preventive Health Checkups
(Tests/Frequency )
• Family History
• Risk Factor
once a year - <40
>40 Twice a year ……if no problem

115. 115
Check Up
•Weight & BMI
•Blood Pressure
•Papsmear
•TVS
•Mammography
•Haemoglobin status
•Diabetic Status – FBS /HBA1C

116. 116
Well Women Check up
1st
– 8th
March
1st – 8th Dec.
DELHI GYNAECOLOGIST FORUM
&
WOW India
Is holding Free camps at Checkup Gynaecologist’s
clinic sat 100 sites in Delhi
Pap Smear, Ultrasound , Mammography
BMD- DEXA, Colposcopy- Highly Subsidized
Don’t Miss Golden Opportunity
Every Year we hold camps at 100 sites twice a year

117. 117
Adult Vaccination
•T-Dap
•HPV
•Flu
•Pneumonia

118. 118
Better be safe
then feel
sorry
Health Insurance
Is Must

119. 119
CLOSE
RELATIONSHIPS

120. 120
To encourage our children –
Positive Self Esteem
Knowledge = 12% / 88% Human management)
• Tell then – “We love then”
• Treat them with kindness & Respect
• Discipline - Must, but be gentle
• Listen /Teach then decision making
• Praise (when due) – v/s criticism
• Responsibility/trust
• “Thanks” - ‘Count the blessing’

121. 121Ringmaster approach will not do !!

122. 122
Why don’t you listen to me ??

123. 123
What are my limits ??

124. 124
My wonderful moments ….

125. 125
“Be the change that you wish to
see in the world.”
M.K.Gandhi
Social Responsibility

126. 126
Give Back to
the country
MUDDO !!
se judo

127. 127
FEMALE FOETICIDE

128. 128
ZERO TOLERANCE FOR
SEXUAL HARASSMENT

129. 129
Domestic
Violence

130. 130

131. 131
It is better to light
a candle than
to curse the
Darkness!
(A Chinese proverb)

132. 132