For women living in poverty, access to reproductive care and family planning can literally mean the difference between life and death.
According to the World Health Organization, the second cause of death for adolescent girls aged 15-19 around the world is complications from pregnancy and childbirth — killing over 800 women every day.
But a new study from the United Nations Population Fund (UNFPA) shows that the world’s poorest women are also the most likely to lack reproductive care and family planning access.
The study, “World’s Apart: Reproductive rights and health in an age of inequality,” makes the case that inequality should not simply be measured in economic terms, but also in terms of access to this critical care.
In fact, economic inequality and gender inequality are very closely tied, according to the report.
“Neither explains the totality of inequality in the world today, but both are essential pieces that demand much more action,” the authors of the report wrote. “Without such action, many women and girls will remain caught in a vicious cycle of poverty, diminished capabilities, unfulfilled human rights and unrealized potential — especially in developing countries, where gaps are widest.”
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The authors noted that while there is no single policy that would improve access to healthcare for women around the world, governments must take into account economic policy, legal systems, financial regulations, and the social safety net.
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Here are five major takeaways from the report:
1/ The gender gap is growing in nearly half of countries.
Out of 142 countries covered in the World Economic Forum’s global gender gap index, 68 saw an increase in gender inequality between 2015 and 2016, including countries from both the developing world and wealthier, “first world” nations. Not only are countries failing to improve opportunities, but many are taking a steps backwards in the fight against inequality.
The report’s authors noted that when countries fail to address gender inequalities it can exacerbate pre-existing economic inequalities, creating a negatively reinforcing cycle of poverty, the cost of which is “compounded for societies and economies as a whole.”
2/ Poor women in West and Central Africa have the least access to skilled birth care.
The UNFPA report found that in 14 of 20 countries in West and Central Africa, women in the top fifth of wealth are more than twice as likely as women in the bottom fifth to have access to skilled birth care, which is a critical buffer against maternal and child deaths during childbirth.
Among the countries with the lowest care are Cameroon, Guinea, Niger, and Nigeria, where more than 80% of women give birth on their own.
3/ Richer women, on average, receive more checkups before pregnancy.
In order to ensure a healthy childbirth, women are recommended to have at least four checkups before giving birth. Among the world’s 35 poorest countries, less than 40% of the poorest women in those countries accomplish this, versus nearly 80% of the richest women in them.
4/ Latin American countries are the best at providing contraceptives to rich and poor.
In terms of access to contraceptives, the gap between the poorest and richest people in Latin America is only 6%, making the region far and away the most equal in this regard.
The biggest gap in access to contraceptives? West and Central Africa.
5/ In at least four countries, poorer women are actually more likely to have access to contraceptives.
Several countries are leading the way in expanding access to contraceptives to the poorest members of society.
In Bangladesh, Bhutan, Cambodia, and Thailand, poorer women are more likely than richer women to have access to contraceptives, the report found.
“In these and several other countries, concerted efforts to expand family planning coverage have led to almost universal access to modern contraception, and near-equitable rates of contraceptive prevalence across the wealth spectrum—among the richest and poorest households,” the authors wrote.