From many perspectives women in South Asia find themselves in subordinate positions to men and are socially, culturally, and economically dependent on them.3
Women are largely excluded from making decisions, have limited access to and control over resources, are restricted in their mobility, and are often under threat of violence from male relatives.4
Sons are perceived to have economic, social, or religious utility; daughters are often felt to be an economic liability because of the dowry system.5
We believe that individual and societal beliefs about and attitudes towards appropriate gender specific roles, and the choices of individuals and households on the basis of these factors, mean that women are disadvantaged with regard to health and health care. There are some instances in which gender differences hurt men's health—for example, men are more likely to be involved in road crashes or occupational accidents as they are more likely to be outside the home or in a workplace than women. However, most of the evidence shows that gender inequalities have led to a systematic devaluing and neglect of women's health.
The life advantage for girls and women that characterises the health statistics of industrialised countries is blurred in South Asia
Gender discrimination at each stage of the female life cycle contributes to health disparity, sex selective abortions, neglect of girl children, reproductive mortality, and poor access to health care for girls and women
The violation of fundamental human rights, and especially reproductive rights of women, plays an important part in perpetuating gender inequity
Policy makers, programme managers, health professionals, and human rights workers in South Asia need to be aware of and responsive to the detrimental health effects that gender plays throughout the life cycle
Established gender norms and values contribute to the loss of the “female advantage” in South Asia. In contrast to industrialised countries, healthy life expectancy is equal or shorter in women than in men in nearly all these countries. The probability of surviving the first five years of life for girls is equal to or smaller than that for boys (). The single exception is Sri Lanka, which has indicators that reflect both improved overall health status of the population and a paucity of evidence of female disadvantage. India, Bangladesh, and Pakistan constitute almost 97% of the population in South Asia, and our comments will focus on these countries.
Table 1 Life expectancy indicators for South Asian countries2