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GENDER AND HEALTH. Keerti Bhushan Pradhan keerti@aravind.org. The Challenge.
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GENDER AND HEALTH Keerti Bhushan Pradhan keerti@aravind.org
The Challenge “The goal of achieving equality between women and men is based on principles of human rights and social justice. Empowerment of women is more over a prerequisite for achieving people centered development…..The abolition of poverty can not be achieved until men and women have equal access to the resources and services necessary to achieve their individual potential and fulfil their obligations to household, community and, more broadly society……..’’ (UK White Paper on International Development, 1997)
Gender Definitions • Gender refers to the socially defined roles and responsibilities of men, women and boys and girls. Male and female gender roles are learned from families and communities and vary by culture and generation • Gender equality means the absence of discrimination, on the basis of a person’s sex, in opportunities, in the allocation of resources or benefits or in access to services • Gender equity means fairness and justice in the distribution of benefits and responsibilities between women and men and often requires women-specific projects and programmes to end existing inequities
Global Magnitude • 70% of the world’s 1.3 billion people living in poverty are women • Women represent two thirds of the world’s 960 million non-literate people • In most developing countries, boys enrolment in school exceeds that of girls • Approximately two thirds of the 130 million children of school age who do not or can not go to school are girls • Globally, violence against women causes more deaths and disability among women aged 15 to 44 than do cancer, malaria, traffic accidents or war • 2 million girls are at risk each year of female genital mutilation
MMR-Countries • Canada-6 • India-570 • Nigeria-1000 • South Africa-230 (Data from World Health Report,1999) Women suffer a heavier burden of ill-health than men and greater attention must be paid to their health needs
INDIA • 927/1000 MEN (World Bank-1996) • 12 MILLION GIRL BORN(1.5m die before first birth day, 1.5m die before fifth birthday • 70% of Indian women suffer from anaemia • 70-90% suffer from gynecological problems • Mental illness:3:1-4:1 (Women’s health project 1994) • 96% of female workforce in informal sector
Mother’s Education-Impact • A study of 45 developing countries found that the average mortality rate for children under 5 was 144 per 1000 live births when their mothers had no education, 106 per 1000 when they had primary education only, and 68 per 1000 when they had some secondary education. (World Development Report 1998)
Gender in the context of health • Gender Inequality in relation to health Lower status/social value in the household Cultural factors such as lack of female health provider Being excluded from decision making on health actions and expenditure Lower literacy rates and reduced access to information High opportunity costs of women’s labour time –distance, waiting time etc. • Social division of labour (women-informal care provider) • Susceptibility and Treatment to infectious diseases-Malaria & Tb. High • Public health issues like violence, alcoholism, smoking and life style related problems
Gender Equity • Men and Women do not receive less or inferior treatment by virtue of their sex. But Women are less likely to go for the treatment…..Wrong assumption that disease rates are lower among women • Health needs which are specific to each gender receive appropriate resources. For example women and girls have reproductive health needs………
Gender and Health Financing • Are women more disadvantaged by particular modes of payment (or are they better able to manage some modes over others)? • Does cost recovery-particularly the levying of user charges at point of delivery-have an adverse impact on women’s health? • How do different types of cost recovery affect access to services by gender?
Gender and Private Sector • Very little information on the gender aspects of governments working with the private sector • Contracting out services to the private/NGO sector-framework of incentives to address health needs of women and girls
Gender & Decentralization • Effort to include the voice/participation of less powerful both women and poorest households in the process of decentralization in healthcare
WHO Technical Paper 1998 • WHO Technical Paper on gender and health (1998) cites the main criticism of WID policies as being that they continue to define women themselves as the problem, who need welfare and special treatment if improvements in their circumstances are to be made. • The underlying reasons of women are largely unexplored and no explanation is offered for the systematic devaluation of their work or the continuing constraints on their access to resources
Gender-Perspective • Gender equality is an issue of development effectiveness, not just a matter of political correctness or kindness to women. (World Bank 2002)