The gender dimensions of Reproductive Health. By: Marguerite Monnet, WBI/HD July, 2001 1

1. The gender dimensions of Reproductive Health. By: Marguerite Monnet, WBI/HDJuly, 20011

2. Questions for discussion • Think of proverbs describing the relationship between women and men in your society • What are the messages/views behind these proverbs • What implications do these views have for reproductive health • Identify gender-responsive strategies to improve health outcomes at the national, health sector, community and household levels

3. Proverbs : • Quoted in a specific social and cultural context; • Short pithy sayings embodying an admitted truth or common belief at a given time; • Evaluative, validative, and conservative function in a given society;

4. Continued: • Powerful and therefore to be taken seriously; • Part of a people’s cultural heritage; • Confirm societal norms and values.

5. Proverbs on proverbs: • A hundred proverbs, a hundred truths”. Spain • “An old proverb will never break”. Russia • “Proverbs are the cream of language”. Afar • “Proverbs are the horses of speech”. Nigeria

6. Proverbs on women and men: • Mother as the only category of women favorably portrayed: • “A wife should be like one’s mother”. Swahili. • Mother often seems to prefer sons to daughters: • “No matter how beautiful and talented a girl is, a boy is always more valuable” . China. • Women are more unfaithful than virtuous.

7. Continued: • Men are warned not to fall for their charms and evil intentions: • “Like the scorpions, woman is a relative of the devil: when she sees a poor wretch, she wiggles her behind and moves away”. India. • The silent submissive type is highly recommended: • Virtuous is a girl who suffers and dies without a sound”. India.

8. Continued: • Women ought to be less clever and should be kept inferior to men. • “Never marry a a woman with bigger foot than your own”. Malawi • Women confined into the domestic sphere, and men to the public roles; • The exercise of power by women is often seen as illegitimate. • .

9. Proverbs do not have to be true: • No longer reflect certain women’s reality today; • Still continue to represent deep-rooted views, values, ideas on women’s roles, position/status, and (im)possibilities; • Internalized images, collectives memories and traditions.

10. With regard to gender in proverbs: • Who is quoting? • Whose views are represented? • Whose power is perpetuated, at the expense of whom?

11. It’s a gender issue: • Gender is described the socially constructed roles, activities, and responsibilities assigned to women and men in a given culture, location, or time. These social structures and attributes influence how women and men perceive themselves and each other. Examining gender roles and the relationship between men and women helps to understand underlying gender attitudes.

12. Sex /Gender: • Gender differs from sex which describes biological and genetic differences between men and women. • Gender functions at the household, community, and national levels and thus is embedded in a society’s social, cultural, economic, and political systems.

13. What are the implications of gender disparities for Reproductive Health?

14. If men and women are not equal, then : • Women are less educated, less employed and then poorer than men • Women may be nurses and men doctors; • Doctor may decide to not inform woman, but tell her husband instead; • Doctor may take decisions with her husband regarding her RH.

15. If men cannot trust/control women, then: • They shouldn’t enjoy their sexuality; • Men may treat them badly (Violence; rape…) • Men and the society must control women’s sexuality.

16. If the women’s place is in the home, then: • They must take care of everybody who is sick at home; • They are overworked even during their pregnancy; • They may have limited mobility even for attending health care center.

17. If women are seen as “minors” and are incapable to take decisions, then: • They should not make decisions or have issues concerning their RH; • National Policies regarding RH should have no relevance to them; • They have no voice where laws are discussed regarding their RH.

18. If women are not worth investing in, they are less educated, and then: • They have little access to information and services related to their RH; • They may take wrong decisions; • They are economically dependent on men and may be not able to invest on RH.

19. Is it any wonder that... • Developing countries still face severe morbidity and mortality, abortion related mortality, and higher HIV prevalence among women than men.

20. What have we learned? • Well equipped facilities and technical competencies are not enough; • Gender disparities at the household and community levels increase the risks factors; • Decisions made at the HH. level concerning HH. assets allocation of resources/ distribution of roles may result in gender disparities in health;

21. Continued: • A gender perspective has to be an integral part of the RH approach to population activities; • There is a need to empower women to make them able to have control on their sexual and reproductive health.

22. Some areas for strategic action planning: • Improve understanding about the linkages between cultural values, sexuality & RH; • Promote comprehensive sexuality education in school programs, RH services, & in communities; • Incorporate gender socialization issues, human rights, & RH into RH programs;

23. Continued: • Promote gender sensitive community empowerment programs; • Re-orient top down IEC strategies & support behavior-change interventions; • Promote gender sensitive laws and policies.

24. Some successful interventions that address gender issues and RH: • In Kenya: traditional coming –of-age ceremonies & FGM replaced by Alternative Rites of Passage; • In Ghana: analyzing Human rights laws led to better understanding the concept of rape, and improve the services of health workers; • In Senegal: Women’s groups from Malicounda resolved to stop FGM, to affect other villages, & encourage the Gov. to pass a law against FGM.