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Cook Islands Women Health a complete detailed study.
– Reported, April 04, 2012
The fertility rate in the Cook Islands decreased quite sharply over the past ten years. There has been:
A decrease in the average number of births that women have in their lifetimes,
A rise in the average age at which women bear children.
Since the early 1990s, the number of births has dropped from around 500 to less than 300 a year. The biggest reduction has been in births to women aged less than 25 (although births to girls under 16 are poorly counted). The main child-bearing age is now 25 to 34 years, but even this age-group has fewer
births than before. Very few women give birth after the age of 40.
This drop in fertility has happened because:
The high migration out of the country over the past decade has mostly been young people. Many Cook Island women aged less than 25 who give birth now do so overseas.Economic change in Cook Islands has affected things like the cost of living, the availability of jobs,and the types of opportunities available to women, all of which influence the decisions people make about bearing children.
There are good family planning services throughout the country, freely available to people of all ages.
Main causes of illness and death
There is a fairly good standard of health in Cook Islands, and little difference by gender in the causes of illness or death. Life expectancy at birth is 74.3 years for women and 68.0 years for men (SPC,2004), on par with many developed countries around the world.
For both women and men over the age of 25, the main causes of death are heart disease and hypertension; cancer, pneumonia and diabetes. Infectious diseases are a minor cause of death or sickness, although there are occasional out-breaks, such as measles and dengue in 1997.
Women account for 57 per cent of hospital admissions. The main causes of womens hospitalisation are childbirth and complications of pregnancy, heart disease, and injuries.
Pregnancy and childbirth
There is a well-developed Maternal and Child health programme. Public health nurses staff the Health Clinics and are involved in monitoring infant, child and maternal health and immunisation. The total fertility rate has fallen to 2.75, meaning that, on average, Cook Island women now have fewer than three
live births in their lifetime. Pregnancy and child-birth have become a fairly low health risk. The maternal mortality rate is very low although in this small population, where even one death can greatly affect the rate, it appears to fluctuate strongly. Around three-quarters of all pregnancy-related hospital admissions are for normal deliveries. Almost all women receive full prenatal care. Most higher-level health services are on Rarotonga, and there inevitably is less access to specialised services in the small communities of the outer islands.
The contraceptive prevalence rate is moderately high, at around 46 to 53 per cent of adult women.Contraceptives are freely available through the government health service to anyone who wants them.Abortion is illegal in Cook Islands and, given social values and the good access to contraceptives,possibly quite rare. Where an abortion is necessary to protect the womans life or the pregnancy was caused by incest or abuse, the hospitals provide counselling and referral to New Zealand, at the womans cost. The Ministry of Health estimates about five terminations are conducted each year but, as people are so mobile, there is no way of knowing how many women go to New Zealand for abortions on their own account .
Lifestyle diseases
Circulatory system and other non-communicable diseases are becoming more prevalent, particularly heart disease, hypertension and diabetes. This is probably related to changing diets and obesity, and affects men and women fairly equally. There are, however, more old women than old men in the population and, as degenerative diseases increase with age, more women with these diseases than men.
Injuries and poisoning
Vehicle accidents are the most common cause of injury for women and men, but poisoning is also a significant cause. Few women or men are hospitalised for assault but these figures are often misleading,for an assault may be recorded as another type of injury, perhaps a fall. Drowning is not common in
Cook Islands.
Obesity and diet
Linked to the rise in diabetes and heart disease are changing food habits and lower levels of activity.There is still a good level of home-produced traditional foods, but also increasing consumption of low quality food, little access to land for food gardening for people who are not land-owners, decreasing interest in home gardening, and visible signs of stress on land and marine resources (National Policy on Women, 1995). A large number of adults, particularly women, are obese.Alcohol and tobacco are quite heavily used in Cook Islands, more by men but also by women. Cook Island residents consume approximately 6 litres of alcohol per capita per year, compared with approximately one litre per year in Samoa and Tonga.
A 1998 survey in Rarotonga found that households spent an average of 1.44 per cent of all expenditure on tobacco and another 1.72 per cent on alcohol. This may not sound like much, but together it was just less than the total household spending on clothing and footwear (3.56 per cent); almost double that spent on church contributions and leisure activities; almost three times that spent on healthy food such as fruit; almost five times that spent on education; and almost six times the average household spending on health care. Of course, spending on tobacco and alcohol is not evenly distributed. Some households spend much less and some much more.
The high and rising consumption of alcohol is linked to its ready availability, especially on Rarotonga.Alcohol is widely advertised and the Sale of Liquor Act is not effectively policed in regard to underage drinking or sales to intoxicated people. Binge drinking is common, especially on the weekends.
Alcohol and tobacco use contribute to motor vehicle deaths and cardiovascular diseases. They also contribute to social problems which affect all sectors of community, including crimes such as burglary,robbery, manslaughter, and rape, and associated family problems. Alcohol use is closely linked to domestic and sexual violence.
Credits: Government of the Cook Islands with assistance from UNICEF
More information at: http://www.unicef.org/pacificislands/CI_Sitan.pdf
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