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Empowering women: Participatory approaches in women's health and development projects
Abstract
The authors describe the experience of NGOs (nongovernmental organizations) and community-based organizations in implementing projects aimed at improving women's health. The study included 16 projects, reflecting Australian NGO experiences in Africa, China, Southeast Asia, the Pacific, and South America. They illustrate the value of participatory approaches in determining needs and priorities, and the value of the continued involvement of women in implementation, monitoring, and evaluation. Approaches that succeeded in increasing women's access to and use of health services addressed gender issues, set realistic and achievable objectives, and recognized and enhanced the roles and status of women.
... More evidences on women, community participation and development are now available. However, Manderson and Mark (1997) noted that microfinance project reports of most NGOs, analyses and evaluations of their failures and successes are under-disseminated and that public records lack literatures that describe or evaluate programs and interventions considered to have contributed towards improvement of access and utilization of health care services among women particularly in developing countries and these reports are not published, or made available primarily to donor or funding agencies only. The purpose of this paper is to review peer -reviewed research articles and project reports on how rural women, children and family's health can be improved through integrating income generation and health education & promotion activities for women. ...
... The approach has successfully reduced women's domestic workload and provided household necessities locally to reduce the need to travel to markets and have health committees that work on improving women's health and their family (Rajamma G, 1993). It's widely documented that, in addition to infection burden, women's physical, mental and social well-being is negatively affected by poor sanitation, inadequate water supply, cultural and social factors that limit their accessibility to timely and appropriate health services (Manderson & Mark, 1997). We have to remember that the health of a woman is not only affected by her biological nature but also social and cultural barriers. ...
... Lets consider a project in Zambia for example, a project was implemented that addressed women's need only, creating imbalances and men, became restricted in accessing microloans and other benefits provided, this created resentment among men as a consequence of their inability to access the support for business and agriculture. Exclusion of men, often lead to disagreements that can lead to difficulties in implementation of program activities, consequently resulting into open or implied oppositions, lack of assistance and support to women, and sometimes efforts to diverge the resources to meet men's demand (Manderson & Mark, 1997). Microfinance programs may result into domestic tension between partners and loss of spousal support that is usually necessary (Mayoux, 1998). ...
While increasing number of women enjoys more freedom and power in urban areas, women in rural areas are at a disadvantage in almost all aspects of life when compared to men. Investing in economic empowerment of women particularly in rural areas by supporting them to implement local context based business ideas and basic finance capacity and skills development may reverse these trends, however, when combined with heath education and promotion through trainings focusing on preventive health yields greater impact. This paper is a systematic review of the peer - reviewed research papers and project reports in English language on how rural women, children and family’s health can be improved through integrating income generation and health education & promotion activities. Generally, integrated microfinance, health education and promotion activities has resulted in significant reduction of intimate-partner violence, reduction in HIV/AIDS risk, promotion of mental health and improved women and family health. The findings may guide the process of designing and planning of integrated programs for sustainable women’s income and family health especially in rural areas.
... A higher mortality rate in the middle-aged women compared to men has been also observed in Butajira (Berhane, 2000). It is well recognised that unless women are involved in decision-making processes, through more control over resources and economic independence, and enhanced access to knowledge, their health status cannot be improved (Allman et al., 1992; Manderson & Mark, 1997). However, the on-going societal transition in rural areas may worsen the subordination of the women in a patriarchal society. ...
... While the above complaints are well known, efforts to document the current situation properly and to initiate appropriate interventions are minimal. Poor nutritional status due to food shortage, high fertility levels, heavy work load, poor environmental conditions, socio-cultural and traditional harmful practices , and low access to health and education act in concert to place the health of women in developing countries in jeopardy (Ferguson, 1986; Ardayfio-Schandorf, 1993; Manderson & Mark, 1997; Obermeyer, 1993; Defo, 1997; Aden et al., 1997). In Ethiopia women in reproductive age (15–49 years) make up about 23% of the population. ...
... In the future, the success of abolishing the tradition of nail extraction could be used as an entry point in advocating change with regard to other harmful traditional practices. This study has also shown, like a number of previous studies, that women are over burdened with a heavy workload in the household and on the farm (Ferguson, 1986; Manderson & Mark, 1997). Although significant improvements are reported (water supply and availability of grind mills), women still have very little resting time. ...
There are reports indicating a worsening of women's health in transitional rural societies in sub-Saharan Africa in relation to autonomy, workload, illiteracy, nutrition and disease prevalence. Although these problems are rampant, proper documentation is lacking. The objective of this study was to reflect the health situation of women in rural Ethiopia. Furthermore, the study attempts to address the socio-demographic and cultural factors that have potential influence on the health of women in the context of a low-income setting. A combination of qualitative and quantitative research methods was utilised. In-depth interviews and a cross-sectional survey of randomly selected women were the main methods employed. The Butajira Rural Health Program demographic surveillance database provided the sampling frame. Heavy workload, lack of access to health services, poverty, traditional practices, poor social status and decision-making power, and lack of access to education were among the highly prevalent socio-cultural factors that potentially affect the health of women in Butajira. Though the majority of the women use traditional healers younger women show more tendency to use health services. No improvement of women's status was perceived by the younger generation compared to the older generation. Female genital mutilation is universal with a strong motivation to its maintenance. Nail polish has replaced the rite of nail-extraction before marriage in the younger generation. As the factors influencing the health of women are multiple and complex a holistic approach should be adopted with emphasis on improving access to health care and education, enhancing social status, and mechanisms to alleviate poverty.
... Una revisión de varias propuestas exitosas conducidas por organizaciones comunitarias que trabajan sobre la promoción de la salud de las mujeres en múltiples contextos internacionales, mostró aquéllas prácticas que mejoran el acceso de las mujeres a los servicios, incluyendo las que trabajaban de manera explícita sobre asuntos de género, estableciendo metas alcanzables y mejorando el estatus de las mujeres. 156 Tres ejemplos son: 1) los trabajadores de la salud comunitarios, que en Tanzania recolectaron datos sobre los métodos disponibles de transportación para las mujeres durante emergencias obstétricas y sugirieron estrategias apropiadas con el fin de reducir la tasa de mortalidad materna (que es extremadamente alto, 300 veces mayor que en Europa del Norte). 148 Esto condujo a un proyecto por medio del cual los trabajadores de la aldea aumentaron su conocimiento sobre las señales de peligro, las derivaciones que son apropiadas y la importancia del aumento en el uso de trasporte para llevar a las embarazadas al hospital. ...
... Sin embargo, el aumento de la medicina basada en la evidencia y la práctica de la salud pública también basada en la evidencia, ha ofrecido un fuerte contrapeso a aquéllos que desean introducir cambios de comportamiento y organizacionales en la atención a la salud. [152][153][154][155][156][157][158] Por lo tanto, si hay un compromiso para examinar las fuentes iatrogénicas de la morbilidad y mortalidad maternas, la medicina basada en la evidencia es una muy buena herramienta para la promoción de la salud. ...
... The reason for this controversy is that the relation between women's microcredit participation and their exposure to male marital violence has been inconsistent across studies. A few studies have indicated microcredit as a protective factor of MVW (Bates et al. 2004;Hadi 2005;Kim et al. 2007;Manderson and Mark 1997), but other studies have stated that women's microcredit participation is as a risk factor of MVW (Bhuiya et al. 2003;Koenig et al. 2003;Naved and Persson 2005;Schuler et al. 1998). ...
... Many studies have assessed the relationship between microcredit and marital violence (Bhuiya et al. 2003;Frazier and Tix 2004;Hadi 2005;Kim et al. 2007;Koenig et al. 2003;Manderson and Mark 1997;Naved and Persson 2005;Schuler et al. 1998). Our previous study also revealed a significant association between the husbands' gender ideology and the wives' microcredit participation (Karim and Law 2013). ...
Evidence on the relation between women’s microcredit participation and their exposure to marital violence has been inconsistent across studies. This study examined how women’s various levels of microcredit participation are associated with marital violence against women (MVW), while also taking into account the husbands’ gender ideology. The study included 243 wife-abusive men in rural Bangladesh. Multiple regressions were performed to predict the frequency of MVW in the preceding year. Of the married women, 52.3% were microcredit participants, 11.1% of whom were active participants and 41.2% nominal participants. The study showed that women’s active microcredit participation was negatively associated with MVW, and nominal participation was positively associated with MVW among the husbands who held a more conservative gender ideology. The findings suggest that women-focused microcredit interventions should also take into account men’s gender ideologies.
Link to the article: http://link.springer.com/article/10.1007/s10896-015-9763-1?wt_mc=alerts.TOCjournals
... Subsequently, NGOs have adopted gender mainstreaming as their strategy for systematically integrating gender considerations into organizational policies, strategies, plans and projects. In addition, staff of NGOs have gender norms, attitudes and practices of their own (Manderson & Mark, 1997; Tiessen, 2007; Wallace, 1998). NGOs are generally regarded as a better actor to address inequality and injustice at small scales than government. ...
... Gender has been institutionalized within NGOs via the gender norms, attitudes and practices of their staff and systematically incorporated into the policies, strategies and procedures that shape their development work and functions (Manderson & Mark, 1997; Tiessen, 2007; Wallace, 1998).Researchers and practitioners have conducted research and surveys on gender mainstreaming using NGO samples in different countries. For example, Oxfam GB in the South America has a focal gender point staff and considers gender work as a concern or responsibility for all staff, rather than just a few specialists. ...
... Gradually, in the 1980s and 1990s evidence came forward that community engagement and participation provides more sustainable water supply and sanitation (e.g. Stanton et al. 1987;Manderson and Mark 1997;Hadi 2000). ...
... Under this programme there is tremendous scope for public-private partnership. The mobilization especially of women has been found to be of primary importance (Manderson and Mark 1997;Rao et al. 1997). On the whole community participation has yielded useful results in the rural areas as per a summing up by Ghosh (2006). ...
Water-borne and poor sanitation related diseases still account for much of the morbidity and mortality in India. Out of the 300 million urban dwellers in India, 22.6% reside in slums. This paper aims to examine the sanitation conditions of slums in the city of Mumbai. About 6.9 million slum dwellers are residing in almost 2000 slum pockets in Mumbai, which constitutes 54% of the population of the city. Most of the slum households depend on inadequate public toilet facilities of very poor quality. Efforts and investments in sanitation have failed to alleviate the situation, as the local population has not been involved. Only recently a demand-driven approach has been applied largely inspired by experiences in rural sanitation programmes. Still supply-driven initiatives by short-term political interests are, to some extent, eroding the resources available for sanitation. However, experiences from the last decade locally and globally, reveal that the demand-driven model is a way forward.
... It has been used as an "intervention" to address a myriad of community health problems throughout the world, yet there is no universally acceptable definition of community participation (Meleis, 1992;Rifkin, 1996). To participate means to act in common or to share in common with others (Webster, 1986), but participation has been often operationalized as being involved in the community, being active in the community, and/ or being represented in project decision making (Caudill, 1999;Eng & Parker, 1994;Kahssay & Oakley, 1999;Lazzari, Ford, & Haughey, 1996;Manderson & Mark, 1997). ...
... Community participation has been perceived as both a process and an outcome (Meleis, 1992). As an outcome, participation in health and research projects is assumed to develop community members' capacity to assess and address common problems (Caudill, 1999) that, in turn, will empower communities for self care (Manderson & Mark, 1997) and create community competence through developing community members' skills to work collectively (Eng & Parker, 1994). There is, however, little research that has explored the process of participation or the experience of participation from the perspective of community participants. ...
Community participation is embedded in primary health care and is key to improving the health and well-being of communities. The concept has not, however, been well studied particularly from the perspective of community members who participate. This article describes findings from qualitative interviews with five Afghan refugee women to explore their experience and the meaning of community participation. From data analysis, two themes emerged: Becoming active encompasses their stories of home, flight, resettlement, learning, and coming together; and being active reflects what they are doing and why they are doing it. Nascent themes and questions that need further elucidation are also discussed.
... Ces interventions sont mises en oeuvre à tous les niveaux du système ; individuel, familial (Naidu et al, 2012), organisationnel (Samb et Ridde, 2012), communautaire (Hildebrandt, 1996 ;Kironde et Kahirimbanyi, 2002), économique (Lorenzo et al, 2007) et législatif (Meier et al, 2012). Les publics ciblés par les interventions communautaires visant l'empowerment sont principalement des populations précaires, vulnérables (El Ansari, 2005) tels que les femmes (Manderson et Mark, 1997), les indigents ou les orphelins (Wallis et al, 2010). Cependant, ce type d'interventions peut également agir sur des publics intermédiaires, tels que les membres d'une famille d'un enfant atteint d'une maladie comme le paludisme par exemple, afin qu'ils puissent le prendre en changer et gérer sa maladie (Franckel et Lalou, 2009). ...
... The program is based on an outreach model developed by the World Health Organization, which has proven successful in its public health campaigns. The Organization utilized a similar train-the-trainer model while conducting AIDS education outreach (Ahluwalia, Schmid, Kouletio, & Kanenda, 2003;Manderson & Mark, 1997). ...
... However, evidence on the impact of women's microcredit participation (MCP) on their exposure to marital violence has been inconsistent. A few studies have indicated that women's microcredit participation has a protective effect on marital violence since it improves women's socioeconomic status, reduces structural (income) inequality between husband and wife, and raises women's self-esteem (e.g., Hadi, 2005; J. C. Kim, et al., 2007;Manderson & Mark, 1997). Contrarily, other studies have stated women's microcredit participation as a risk factor of male marital violence behaviors since women's increased socioeconomic status can threaten men's traditional patriarchal family authority (Bhuiya, Sharmin, & Hanifi, 2003;Koenig, Ahmed, Hossain, & Mozumder, 2003;Naved & Persson, 2005;Schuler, et al., 1998). ...
.Male marital violence against women is a widespread public health and human rights problem in rural Bangladesh. Recently it has also become an issue that concerns microcredit based women-focused poverty reduction intervention. The reason is that the relationship between women’s microcredit participation and their exposure to marital violence has been inconsistent. Some studies indicated microcredit intervention as a risk factor of marital violence, while other studies suggested it to be a protective factor.
Women’s microcredit participation can allow them to have an income of their own, which may improve their socioeconomic status. However, the influence of microcredit participation on marital violence may also be associated with factors related to men. Regarding the typical patriarchal family authority-structure in rural Bangladesh, women’s microcredit participation can itself be also influenced by their husband’s gendered attitudes/ideologies. Previous studies unveiled that a significant proportion of the loans given to women were actually controlled by their husbands. However, previous studies hardly addressed how women’s microcredit participation was practiced according to their husband’s gendered ideology, and thereby how this was associated with marital violence.
Within the current study, three conceptual models are proposed. The first model examines how their husbands’ gendered ideology influences women’s microcredit participation, their status within the household, and then their vulnerability to marital violence. The second model assesses how women’s changing status influences household male dominance, and then marital violence. And the third one, an integrative model, examines how household male dominance influences masculine gender role stress (related to subordination to women), and then marital violence.
The study adopts a cross-sectional design. Data was collected from 342 randomly selected married men in five villages of northwest Bangladesh. A questionnaire survey with face-to-face interview was conducted. A path analysis was performed to test the hypothesized models. Multivariate regression analysis was utilized to predict the frequency of marital violence over a one-year recall period.
From the findings, it appears that husband’s gender ideology has indirect effects on marital violence, mediated through three different channels: women’s active microcredit participation (loan control and use) leading to their changing status as household co-breadwinner, household male dominance, and masculine gender role stress. Women’s active microcredit participation leading to their cobreadwinner status appears to be a direct protective factor, while household male dominance and masculine gender role stress appear to be direct risk factors of marital violence. Husband’s liberal ideology was positively associated with both women’s active microcredit participation and their co-breadwinner status, while it was negatively associated with household male dominance and masculine gender role stress. However, women’s nominal microcredit participation (loan control/use by husband) was neither associated with their improved status nor with their exposure to marital violence.
The present study addresses a preventive measure of marital violence in rural
Bangladesh from women-focused development interventions, and is suggested to be effective in theory and practice. It is suggested that women-focused development interventions should also address people’s traditional gendered ideologies/attitudes and should create a mechanism for engendering women’s socioeconomic roles and rights.
Full Text URL: http://hub.hku.hk/handle/10722/143224
... In order to build capacity at the individual and community levels, social development programmes focus on health care issues. Social development programmes promote and sustain reproductive health by transferring health benefits from one generation to another (Manderson and Mark, 1997). At the population level, improvement in reproductive health increases women's participation in the processes and benefits of social development. ...
The purpose of this study is to identify interrelationships between social development and reproductive health in developing countries. Growth in social development is expected to improve reproductive health over time. In addition, improvements in social development are anticipated from increases in reproductive health. Economic development is seen as a prime force influencing growth processes in both social development and reproductive health. While confirmatory factor analysis methods are used to develop a measure of reproductive health, latent growth curve and latent score difference modelling methods are used to estimate the reciprocal nature of the relationship between social development and reproductive health. It is found that social development has a positive effect on reproductive health. Reproductive health gains over time were accompanied by strong and significant advances in social development levels. At high levels of social development, the rate of reproductive health changes declined. Social workers have for long depended on social development strategies to improve reproductive health in developing countries. The role of reproductive health in improving social development was either neglected or perceived as unimportant. The empirical evidence from this study suggests that strategies for programmes and policies for improving social development and reproductive health may be undertaken simultaneously.
... Only advice for commercial sex workers at the National STD Center and a few governmental medical clinics are carried out by the Cambodian gov-ernment 5). In other developing countries, many of the social support activities are carried out by non-governmental organisations (NGOs) [24][25][26]. In Cambodia, especially, it is important to introduce and support non-governmental organisations. ...
Objective: This study surveyed the sexual behaviour of commercial sex workers and their clients in an attempt to identify factors of transmission of STDs (including HIV/AIDS) and to control their epidemics in Cambodia and South-East Asia.
Design: Cross-sectional study.
Setting: Trained questioners asked items of the questionnaires to each objective subject in December 1996. Data were analysed to show the descriptive status by risk group of each person.
Participants: 200 direct commercial sex workers, 220 indirect commercial sex workers, and 211 clients in Phnom Penh.
Results: Prostitution was widely accepted by both young males and females, and this was an easy way for young girls to obtain money. Although commercial sex workers and clients were knowledgeable about prevention methods against STDs, they seldom used condoms. Some commercial sex workers had been infected with STDs many times, and many of them incompletely treated the diseases by themselves. Social support from governmental and non- governmental organisation was poor.
Conclusions: It is very important to support both commercial sex workers in practicing preventive methods against STDs and also visiting physicians when they notice symptoms of STDs. It is strongly recommended that not only governmental but also non-governmental organisations should be more active in this area. J Epidemiol, 1999 ; 9 : 175-182
... Karlan and Morduch (2010) state in a recently published and broad review of microfinance that the evidence so far indicates that finance interventions alone may not be as powerful as 'finance coupled with other interventions such as training and healthcare. A small but growing number of studies that integrate microfinance with other nonfinancial services seems to support the argument that MFI financial services have positive impacts beyond the direct financial benefit, such as women's empowerment and decision making agency (Manderson and Mark 1997;Kim et al. 2007), nutritional status of children (Dunford and MkNelly, 2002) and health outcomes, including use of contraceptives, higher child-survival rates, reduced family violence and increased use of health services (Mohindra 2008 There is no doubt that microfinance has increased both in research and practice, in spite of this emphasis, current research did not provide sufficient justification for the link between microfinance health services and entrepreneurs' productivity in developing countries. Besides, the empirical evidence emerging from various studies on the overall effect of microfinance have so far yielded mixed results that are inconclusive and contradictory. ...
This paper investigates the effects of microfinance bank health related services on micro and small enterprise owners' productivity. Productivity is measured as output value over resource input value. The paper employed panel data and multiple regression analysis to analyze a survey of 502 randomly selected entrepreneurs whose enterprise are finance by microfinance banks in Nigeria. We find strong evidence that microfinance bank health related programmes have positive correlation with productivity of micro and small entrepreneurs in Nigeria. Participation in health related services such as health education and health finance are found to have positive impact on entrepreneurs' productivity, while microfinance bank linkages with health services provider and entrepreneurs access to health product through microfinance bank are microfinance banks health related services that are yet to be developed well developed by the microfinance banks . The paper recommends that a well structured health seminar and training programmes should be embedded in all Microfinance programme to further enhance productivity of entrepreneurs in Nigeria and partner with Insurance Companies in the country to provide quality health insurance services affordable to MFBs' client. This will guarantee the clients' access the health services when the need arise. Abstract -This paper investigates the effects of microfinance bank health related services on micro and small enterprise owners' productivity. Productivity is measured as output value over resource input value. The paper employed panel data and multiple regression analysis to analyze a survey of 502 randomly selected entrepreneurs whose enterprise are finance by microfinance banks in Nigeria. We find strong evidence that microfinance bank health related programmes have positive correlation with productivity of micro and small entrepreneurs in Nigeria. Participation in health related services such as health education and health finance are found to have positive impact on entrepreneurs' productivity, while microfinance bank linkages with health services provider and entrepreneurs access to health product through microfinance bank are microfinance banks health related services that are yet to be developed well developed by the microfinance banks . The paper recommends that a well structured health seminar and training programmes should be embedded in all Microfinance programme to further enhance productivity of entrepreneurs in Nigeria and partner with Insurance Companies in the country to provide quality health insurance services affordable to MFBs' client. This will guarantee the clients' access the health services when the need arise.
... 24,25 Public health intervention strategies increasingly aim to empower women and transform gender structures and power dynamics that inhibit women's autonomy and harm their health. [26][27][28] Health promotion programs, as well as grassroots women's movements, are empowering women to seek health care, 29 be treated as equals in the health care system, 30 have control over their own bodies, 31 earn their own money, 27 improve their educational status, 32 secure their land and inheritance rights, 33,34 increase their access to HIV testing and contraceptives, [35][36][37] and improve their decision-making power in romantic and sexual relationships. 38 While a focus on gender equality since the Cairo conference motivated an emphasis on global heath programs targeting women and girls, research on women's health and empowerment also identified narrow and constraining masculine norms as an important barrier to women's and girls' health and well-being. ...
Research shows that constraining aspects of male gender norms negatively influence both women's and men's health. Messaging that draws on norms of masculinity in health programming has been shown to improve both women's and men's health, but some types of public health messaging (e.g., Man Up Monday, a media campaign to prevent the spread of sexually transmitted infections) can reify harmful aspects of hegemonic masculinity that programs are working to change. We critically assess the deployment of hegemonic male norms in the Man Up Monday campaign. We draw on ethical paradigms in public health to challenge programs that reinforce harmful aspects of gender norms and suggest the use of gender-transformative interventions that challenge constraining masculine norms and have been shown to have a positive effect on health behaviors.
... A purposeful, deductive approach was used in this research, where the information gathered was used to draw specific conclusions regarding the tasks for which interventions should be developed, and the interventions that should be selected for further research. Similar approaches have been successfully used in other women's health and development projects in Africa [20,21]. The PI worked with the local project team and the focus group facilitator to interpret the focus group data both during and immediately after the discussions. ...
This paper describes the qualitative, community-based participatory approach used to identify culturally-acceptable and sustainable interventions to improve the occupational health, safety, and productivity of smallholder women vegetable farmers in The Gambia (West Africa).
This approach was used to conduct: 1) analysis of the tasks and methods traditionally used in vegetable production, and 2) selection of interventions.
The most arduous garden tasks that were amenable to interventions were identified, and the interventions were selected through a participatory process for further evaluation.
Factors contributing to the successful implementation of the participatory approach used in this study included the following: 1) ensuring that cultural norms were respected and observed; 2) working closely with the existing garden leadership structure; and 3) research team members working with the subjects for an extended period of time to gain first-hand understanding of the selected tasks and to build credibility with the subjects.
... Karlan and Morduch (2010) state in a recently published and broad review of microfinance that the evidence so far indicates that finance interventions alone may not be as powerful as 'finance coupled with other interventions—training and healthcare'. A small but growing number of studies that integrate microfinance with other non-financial services seem to support the argument that MFI financial services have positive impacts beyond the direct financial benefit, such as women's empowerment and decisionmaking agency (Manderson and Mark 1997; Kim et al. 2007), nutritional status of children (Dunford and MkNelly 2002) and health outcomes, including use of contraceptives, higher child-survival rates, reduced family violence and increased use of health services (Mohindra 2008). Nonetheless, most MFIs have naturally chosen to focus where their competencies are strongest, on microenterprise credit. ...
Introduction:
Single solutions continue to be inadequate in confronting the prevalent problems of poverty, ill health and insufficient health system capacity worldwide. The poor need access to an integrated set of financial and health services to have income security and better health. Over 3500 microfinance institutions (MFIs) provide microcredit and financial services to more than 155 million households worldwide. Conservative estimates indicate that at least 34 million of these households are very poor by the definition in the Millennium Development Goals, representing around 170 million people, many in remote areas beyond the reach of health agencies, both private and governmental. A small but increasing number of MFIs offer health-related services, such as education, clinical care, community health workers, health-financing and linkages to public and private health providers.
Review of evidence:
Multiple studies indicate the effectiveness of microfinance and its impact on poverty. A small but growing number of studies also attempt to show that MFIs are capable of contributing to health improvement by increasing knowledge that leads to behavioural changes, and by enhancing access to health services through addressing financial, geographic and other barriers. While these studies are of uneven quality, they indicate positive health benefits in diverse areas such as maternal and child health, malaria and other infectious disease, and domestic violence. While more rigorous research is needed to inform policy and guide programme implementation to integrate microfinance and health interventions that can reliably enhance the well-being of the poor, there is useful evidence to support the design and delivery of integrated programmes now.
Conclusion:
Worldwide, current public health programmes and health systems are proving to be inadequate to meet population needs. The microfinance sector offers an underutilized opportunity for delivery of health-related services to many hard-to-reach populations.
... In it, men and women, in particular, graduated from mere recipients of well-intended but inadequate interventions to agents actively involved in disease prevention and training of village health workers. 7 For example, women were instrumental in the success of fighting childhood diarrhea with oral rehydration therapy 8 and exclusive breastfeeding. 9 Similarly, the field of epidemiology needs an expansion beyond its traditional paradigms. ...
Participatory research involving communities, especially women, is increasingly recognized as a valuable and scientifically sound approach to improve the relevance of a study, the accuracy of data collection and interpretation, the adherence to study procedures, and the likelihood of adopting any resulting intervention. This approach has interdisciplinary roots dating back more than half a century. Although widely used in community-based conservation and development projects worldwide, international public health research has yet to fully embrace this inclusive approach, which requires the sharing of power with research participants and a more involved relationship building process with communities. In return, the gap between publication and public action can be narrowed because ownership of the research process by an empowered community can lay the foundation for an accelerated implementation of interventions tailored to community needs and based on research results. This article draws on the professional experiences of the authors as well as published examples of international participatory health research with women. Factors critical for the success of participatory research are discussed, including attention to initial planning, early community involvement, conceptual clarity, defined community benefits, and joint interpretation of results, as well as translation to action. It includes common challenges and strategies to overcome them, such as conflict resolution and data ownership.
... The ethnographic details of this work, rather than its use in interventions, are most widely published. In contrast, there is relatively little which demonstrates this use, partly because the interventions are frequently government or NGO initiatives, where programme reports are internal documents and accountability is to funding agencies rather than a scientific public (Manderson & Mark 1997). While anthropological input in terms of community perceptions of illness, including local taxonomies and aetiology, have value in developing health educational material to support interventions, a more sophisticated understanding of cultural and social dimensions of illness and disease draws attention to the structural barriers to change and to the difficulties of introducing and sustaining interventions. ...
This paper focuses on two roles of anthropology in the control of infectious disease. The first is in identifying and describing concerns and understandings of disease, including local knowledge of cause and treatment relevant to disease control. The second is in translating these local concerns into appropriate health interventions, for example, by providing information to be incorporated in education and communication strategies for disease control. Problems arise in control programmes with competing knowledge and value systems. Anthropology's role conventionally has been in the translation of local concepts of illness and treatment, and the adaptation of biomedical knowledge to fit local aetiologies. Medical anthropology plays an important role in examining the local context of disease diagnosis, treatment and prevention, and the structural as well as conceptual barriers to improved health status. National (and international) public health goals which respect local priorities are uncommon, and generic health goals rarely coincide with specific country and community needs. The success of interventions and control programmes is moderated by local priorities and conditions, and sustainable interventions need to acknowledge and address country-specific social, economic and political circumstances.
... Maintaining community life has often been seen as women's work. Governmental agencies use community participation as a means of shifting community work to the shoulders of women, thereby extending their limited funds (Manderson & Mark, 1996;McElmurry and Keeney, 1999;Pillsbury, 2000;Zakus, 1998). All of these expectations increase the burden on women and limit the recognition of their work load without increasing their access to the bene ts accrued from their work (Avotri & Walters, 1999;Gomez, 2000). ...
Gender equity and equality in health and human development are key national and international goals. To achieve these goals, the androcentric definition of work needs to be addressed. The current definition is driven by the globalized capitalistic model, which equates "work" with generating income or the production of goods. Indeed, employment in the formal labor force has become the de facto definition of work. Women's work, unpaid and reflecting the gendered role of caring for others, does not fit the economic mold and is, therefore, devalued. The health and social welfare sectors rely heavily on the unremunerated work of women to reduce their budgets, ignoring the unequal burden of care shouldered by women worldwide. Research on women's health has also been hampered by the dichotomous nature of work as employment. Changing the definition of work to value explicitly women's work could significantly impact social, health, and research policies.
Social participation is an important means for governments to develop responsive health policies and programmes, which are more likely to be implemented by a broad stakeholder group. It is at the heart of the inclusive governance needed for countries to stake their individual paths towards Universal Health Coverage while ensuring that no one is left behind.
As simple as it may seem in theory, it is a complex undertaking in practice, one which policy-makers struggle with. The Handbook on Social Participation for UHC is thus designed to provide practical guidance, anchored in conceptual clarifications, on strengthening meaningful government engagement with the population, communities, and civil society for national health policy-making. It draws on best practices and lessons learned to support government institutions in setting up, fine-tuning, improving, and institutionalizing new or existing participatory health governance mechanisms.
The handbook follows through the different tasks which policy-makers must reflect on and undertake when bringing in people’s voice into health policy-making. Examples include creating an enabling environment for participation, ensuring good representation, strengthening capacities, increasing policy-uptake of participatory process results, and sustaining participatory engagement over time. A fundamental premise of the handbook rests on the idea that policy-makers can leverage format and design elements of a participatory process to address power dynamics amongst participants, thereby fostering more meaningful contributions to the process.
Microfinance institutions (MFIs) offer targeted opportunities for the poor to generate additional income with a range of financial services including credit, insurance, savings accounts and money transfers. Aside from reducing poverty, microfinance can potentially improve health because it is the poor who are usually more constrained from health investments due to limited budgets. Furthermore, microfinancing specifically targets women, who are more likely to spend additional income on children’s well-being. Finally, several MFIs have also begun to offer health-related services, such as health education, health-care financing, clinical care, training community health workers, health micro-insurance and linkages to public and private health providers. Using a new data set, this article conducts the first multi-country study of the effect of microfinance on child mortality, the heath outcome, which is most sensitive to the effects of absolute deprivation. Our findings confirm that an increase in the proportion of MFI clients in a country is significantly associated with lower under-five and infant mortality rates. We conclude that if MFIs’ educational and health services have indeed caused improvements in health outcomes at the community level, then it may be important for governments to complement these activities with similar campaigns, particularly in remote areas where MFI penetration is low.
Social service agencies need the knowledge that can be gained through research, and universities are equipped to conduct research. It seems like a natural partnership. Yet, university research conducted in agencies often fails to satisfy the interests of either party. In seeking successful frameworks for meaningful applied research in community settings, universities and agencies must form an intentional relationship that integrates the capacities of the differently oriented partners. This article describes a partnership framework in which both community agency staff and university researchers discarded the usual disunified approach to addressing service questions and committed to an embedded, interactive, investigative model in which all participants merged their specific skills to gain mutually fulfilling outcomes.
Health policies, in the context of development, have typically been formulated with little regard for women's actual and specific life experiences and health problems. Although recent international forums have addressed this issue, contributing to the rise of gender sensitive health policies, efforts towards increasing women's participation remain necessary. Also, barriers to the implementation of such policies and/or programmes must be overcome. Participatory research methods have the potential to seize local realities and contribute concretely to policy knowledge. Through our research in rural Gujarat, we discuss the essential elements of effective partnerships and the barriers to women's participation within participatory research projects. Based on these lessons, we offer recommendations for future, participatory studies.
Background:
Breast cancer has a low cure rate in low-income and middle-income countries because patients often present with late-stage disease that has metastasised to other organs. We assessed whether the implementation of a cancer awareness and breast examination programme that uses local, volunteer women could increase the early detection of breast cancer in a rural area of sub-Saharan Africa.
Methods:
We did this pilot study in two counties in Gezira State, Sudan. We chose Keremet (56 villages) as the experimental county and Abugota (79 villages) as the control county. Female volunteers from villages in Keremet were trained in the detection of breast abnormalities. When trained, volunteers visited households in their village and screened women aged 18 years or older for breast abnormalities, referring women with suspected breast cancer for medical diagnosis and, if necessary, treatment at the district hospital. We also ran a cancer awareness programme for both men and women in study villages. Villages in the control population received no intervention. This study is ongoing.
Findings:
Between Jan 1, 2010, and Oct 10, 2012, 10 309 (70%) of 14 788 women in Keremet were screened. 138 women were identified as having breast abnormalities and were referred to the district hospital for diagnosis and treatment. 20 of these women did not report to the hospital. Of the 118 women who did report, 101 were diagnosed with benign lesions, eight with carcinoma in situ, and nine had malignant disease. After treatment, 12 of the 17 women with either carcinoma in situ or malignant disease (four had early breast cancer and eight had ductal carcinoma in situ) were disease-free and had a good prognosis. In the control villages, only four women reported to the centre: one was found to have a benign lesion while three were diagnosed with advanced disease.
Interpretation:
Our findings show that a screening programme using local volunteers can increase the detection of breast cancer in asymptomatic women in low-income rural communities. These findings can inform policy-makers' decisions in the design of cancer control programmes in Sudan and other similar areas in sub-Saharan Africa.
Funding:
Sudan National Cancer Institute.
Objective
A train-the-trainer intervention was evaluated in which village leaders in Malawi, Africa, taught other villagers how to improve their health.
Design
Health knowledge and reported health practices were compared before and after the educational intervention in 15 villages in Chimutu, Malawi, Africa.
Setting
Surveys were completed by trained data gatherers in the village setting.
Patients/Participants
All men and women of childbearing age who were present in the village when data collection occurred were asked to participate. There were 187 participants in the preintervention survey and 175 participants in the postintervention survey.
Intervention
Seventy-six village women were trained, using low literacy techniques, to provide content on health promotion and risk reduction in pregnancy. Over 20,000 persons have received at least one health teaching session from the village trainers.
Results
The intervention resulted in reported changes in prenatal and postpartum care and in more births occurring in the hospital or clinic. Some positive nutritional changes were reported, although few changes in beliefs about use of herbal medicines or about the use of witchcraft were reported.
Conclusions
A train-the-trainer approach is a sustainable intervention that appears to have positive benefits on the health of village women living in Malawi, Africa.
To explore the effect of demographic characteristics on the outcomes of cataract surgery in terms of visual acuity and patient satisfaction, and gender role in the uptake of postoperative care.
Comprehensive ocular examinations were performed on 478 subjects (558 eyes) over the age of 50 years who underwent surgery for age-related cataract at the largest eye hospital in Iran. Demographic characteristics were obtained and surgical records were reviewed.
Male subjects had significantly better outcomes in terms of uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) (mean difference 0.12 and 0.13 logMAR; p = 0.004 and p < 0.001, respectively). Women were significantly less satisfied than men (73.2% vs. 83.6%; p = 0.011). Postoperative UCVA and BSCVA were better in patients with higher levels of education (both p < 0.001). Age had an inverse association with UCVA (p = 0.004) and BSCVA (p < 0.001). Women were twice as likely to need capsulotomy (p = 0.002). Men's uptake of postoperative refractive care was 4-fold that of women's (31% vs. 7%). In multivariable analyses, age, sex, education, presence of ocular comorbidity and need for capsulotomy, spectacle prescription and other care were associated with postoperative UCVA (all p < 0.05; adjusted R(2) = 0.256).
Female patients were shown to be at a clear disadvantage in cataract surgery; outcomes of the procedure and postoperative care were both poorer. Older age, lower level of education, ocular comorbidity and unmet postoperative need were also associated with a poorer outcome.
In this historical review, Ignaz Semmelweis's study of handwashing to prevent puerperal fever is described and used as a benchmark from which to identify salient issues that are informative to today's women’s health activists working for Safe Motherhood. The epidemiology of contemporary excess maternal mortality is reviewed. Using the conceptual framework of social epidemiology, the paper addresses four issues that were problematic in Semmelweis’ era. New tools in public health are presented that can help to solve critical, still challenging problems to reduce excess maternal mortality, nosocomial infections, and puerperal fever at childbirth: 1) progress in behavioral methods to promote health behavior change, 2) the introduction of participatory action research, 3) the diffusion of evidence-based public health practice and 4) understanding how politics and health interact and present challenges when trying to meet public health goals. Social exclusion and marginality are still key issues in determining who has access to safe motherhood and who risks her life in maternity. Applied social epidemiology allows practitioners to make effective use of the already accumulated evidence and translate it into effective public health practice to promote safe motherhood around the world.
In this paper I describe maternal and child health needs in Zimbabwe, as well as existing health care delivery services designed to meet these needs. The information presented is based on a project sponsored by Earthwatch (a worldwide volunteer organization) that addressed the needs of women and infants, as well as the author's contribution to this effort. Because of a long-standing drought, many women and children in Zimbabwe are malnourished. Poor nutrition affects the woman herself, pregnancy outcomes, and the developing child, and has far-reaching repercussions. The major problems that contribute to maternal child morbidity and mortality include nutritional deficiencies, lack of safe water, and family planning needs. Earlier surveys conducted on maternal nutrition consistently showed iron deficiency, goiters, underweight, and inadequate nutrient intake to be quite prevalent. On the basis of previous assessments, this project focused on educating community health workers on ways to assist families with nutritional deficiencies, family planning, and hygiene needs.
A train-the-trainer intervention was evaluated in which village leaders in Malawi, Africa, taught other villagers how to improve their health.
Health knowledge and reported health practices were compared before and after the educational intervention in 15 villages in Chimutu, Malawi, Africa.
Surveys were completed by trained data gatherers in the village setting.
All men and women of childbearing age who were present in the village when data collection occurred were asked to participate. There were 187 participants in the preintervention survey and 175 participants in the postintervention survey.
Seventy-six village women were trained, using low literacy techniques, to provide content on health promotion and risk reduction in pregnancy. Over 20,000 persons have received at least one health teaching session from the village trainers.
The intervention resulted in reported changes in prenatal and postpartum care and in more births occurring in the hospital or clinic. Some positive nutritional changes were reported, although few changes in beliefs about use of herbal medicines or about the use of witchcraft were reported.
A train-the-trainer approach is a sustainable intervention that appears to have positive benefits on the health of village women living in Malawi, Africa.
This paper aims to assess the contribution of the micro-credit programme in raising health knowledge among poor women in rural Bangladesh. Data were collected from the 1998 sample survey of 500 mothers aged 15-49 years who had at least one child aged <5 years. Findings revealed that the socio-demographic factors such as the age of the woman, land ownership of the family and occupation of husband had no association with the prevalence of maternal knowledge. The knowledge was much greater among credit forum participants than non-participants, although exposure to the media and the education of women had also played a significant role in raising the level of knowledge. Multivariate analysis suggested that the duration of credit programme participation and exposure to the media were significantly more likely to raise the health knowledge among women when the influence of demographic and socio-economic factors were controlled. The paper concludes that the micro-credit programme can be an effective tool in promoting health among poor women in Bangladesh.
Previous studies note a positive relationship between female-headed households (FHHs) and poverty in urban and rural areas of Botswana. To explore this further, data were collected from 7 FHHs through participant observation and open-ended interviews. A secondary analysis of data described the quality of life (QOL) of members of the households according to one's ability to meet basic human needs (food, water, shelter, safety, and health). FHHs ranged in age from 40-91 years, with family size ranging from 1-11 members. Monthly income for 6 of the 7 families was 30 dollars (U.S.) per month or less. Physical living environments were overcrowded, with poorly maintained latrines and unsafe refuse disposal. Family illnesses included hypertension, cataracts, mental illness, knee pain, ringworm, leg sores, and tonsillitis. Health risk behaviours included unprotected sex, alcohol abuse, and breastfeeding among potentially HIV positive mothers. Although Botswana claims rapidly rising levels of national income after independence, the QOL of FHHs remains poor. We suggest that, to alleviate poverty, governments in developing African countries should explore strategies that effectively target families headed by women.
A train-the-trainer intervention, based on the World Health Organization's Safe Motherhood Initiative, was successful in changing some health beliefs and health practices among village men and women of childbearing age in a remote area of Uganda. Specifically, more villagers reported attending postpartum care and beginning prenatal care earlier in pregnancy. Some beliefs were not changed (eg, belief in bewitchment), but some beliefs (eg, use of herbal medicines during labor) were not as widely held as a result of this cost-effective and easily sustainable program.
During the past two decades, the term "women in development' has become common currency both inside and outside academic settings. But while "women in development,' or "WID,' is understood to mean the integration of women into global processes of economic, political, and social growth and change, there often is confusion about the meanings of two more recent acronyms, "WAD' (women and development) and "GAD' (gender and development). This paper begins with an examination of meanings and assumptions embedded in "WID', "WAD', and "GAD' and then looks at the extent to which differing views of the relationship between gender and development have influenced research, policymaking, and international agency thinking since the mid-1960s. It is suggested that each term has been associated with a varying set of underlying assumptions and has led to the formulation of different strategies for the participation of women in development processes. -from Author
Conducted 11 focus groups with a total of 78 19–45 yr old women (primarily Latinas and Black) from high HIV seroprevalence neighborhoods. Results suggest that HIV interventions for women must consist of sex education, including anatomy and physiology. Sexual negotiation skills must be taught and HIV prevention messages must address many women's desire for pregnancy. Development of new HIV prevention strategies must focus on methods under women's control that are outside of negotiation with a male sex partner. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The premise of this paper is that services and information can only contribute to improving health to the extent that people are aware of them, are able to make use of them, and choose to do so. Many service-related factors, as well as social, economic and cultural aspects of people's lives, can interfere with the use of health services or the implementation of health practices. The specific issue with which this article is concerned, however, is the possible negative effect of time constraints on women's capacity to use health services or to engage in other health related activities. It attempts to disaggregate health services and practices along a number of dimensions, with the goal of identifying those health related activities that may be particularly vulnerable to non-utilization because of conflicting demands on women's time.
This paper reviews twenty years progress in the study of gender in Third World development and the extent to which gender has been incorporated within mainstream development theory and practice. Special reference is made to the role geography has played in this arena. It is argued that while gender as a theoretical framework for explaining women's differential but continued subordination should be reaching maturity, there has been little attempt to formulate cohesive models which integrate micro-and macro-level concepts and which could provide a firm base for future theory-building. More important, studies of gender in the Third World development have seldom addressed the question of development policy or put forward practical solutions for the integration of gender issues in development planning. As a case study of gender in development planning the paper examines the Australian Government's women in development (WID) policy, the ways in which it was informed, and the extent to which it has been implemented.
Gender planning is specifically applied to primary health care. A theoretical discussion of issues which focus on greater 'mainstream' participation of women in health and development programmes is viewed as a process of empowerment. The theoretical discussion is integrated with a methodology for planning and evaluating gender-focused health programmes. Planning and evaluation are linked in a single feed-back relationship. Relevance of all investigations is discussed and specific methods suggested.
Incluye bibliografía e índice
This paper is concerned with access to health care for women in developing countries, with specific reference to Latin American and Caribbean countries. It reviews the available literature on the concept of access as it relates to other variables such as accountability, affordability and acceptability of health services, taking into consideration the effects of the generalized socio-economic crisis that has affected most countries during the last decade, as well as equity objectives. Various approaches to defining variables affecting access to health care appear in the literature reviewed. While some of them indicate that ability to pay for services act as a major determinant of access to health care, others point to behavioral issues related to motivation, health seeking behavior or perception of illness as a deterrent to women in the low socioeconomic strata, while others indicate that sociocultural issues, such as values, education, religion or demographic variables related to age, influence access to health care. The paper concludes with some comments on policies and strategies for securing access to health and healthcare, indicating the need to move away from traditional solutions including framing gender-based health differences in status and access adequately, promoting and strengthening social participation of women in policy making.
Women in developing countries are frequently confronted with a myriad of socio-cultural factors which negatively impinge upon physical well-being and accessibility to appropriate health care services. Institutional, economic, and educational barriers effect and lowers their standard of living when compared to their male counterparts. Women must become agents of change to improve their situation. Factors such as access to income, legal rights, social status, and education may prove far more important in determining women's access to health care than technology distribution and governmental strategies.
Women are increasingly at risk for AIDS. At the root of this risk is women's relative lack of control over their bodies and their lives. Those women with least control, generally poor women of color, are at greatest risk in both developed and developing countries. To date, AIDS prevention programs have ignored most women, focusing almost exclusively on women in the sex industry and, more recently, prenatal women. We urgently need prevention programs for women that view women as more than "mothers and whores" and recognize that AIDS poses a real risk to many of us; programs that are sensitive to the complex realities of women's lives and offer realistic alternatives that will allow women to protect themselves from HIV infection.
This article presents a synthesis of five country studies of the sustainability of U.S. government-funded health projects in Central America and Africa. The studies reviewed health projects with a comparative framework to determine which project activities had continued after the donor funding ceased. This review found that health projects in Africa were less firmly sustained than those in Central America. The studies then evaluated context factors and project characteristics that were related to the sustainability of the projects. The weak economic and political context of the African cases was found to inhibit sustainability in those countries, suggesting that broader development issues be addressed before donors expect significant sustainability of health projects in Africa. Even in Central America it was found that the strength of the institution implementing the project was an important variable for sustainability, suggesting that donor attention also be shifted toward strengthening institutional development in order to assure sustainability. In addition to context factors, several project characteristics were related to sustainability in most cases and suggest sustainability guidelines for project design and implementation. The article concludes that projects should be designed and managed so as to: (1) demonstrate effectiveness in reaching clearly defined goals and objectives; (2) integrate their activities fully into established administrative structures; (3) gain significant levels of funding from national sources (budgetary and cost-recovery) during the life of the project; (4) negotiate project design with a mutually respectful process of give and take: and (5) include a strong training component.
Increasing demographic and epidemiological evidence shows that maternal health problems are widespread and are linked to social, cultural, and economic factors, in particular, to women's status in society. Thus, there is an urgent need to expand existing knowledge about these influences on reproductive health and to empower women to gain control over them. To this end, there is a need for a comprehensive, interdisciplinary approach with an emphasis on social science research and training. The Ford Foundation, after an extensive review of its work in population and development, embarked on a new, ten-year, comprehensive reproductive health program for the 1990s. This paper describes one component of that program, a partnership with the All China Women's Federation to sponsor a series of reproductive health research activities. It examines the development and evaluates the positive and negative outcomes of the project, which commenced in 1991, from the perspective of a consultant involved in the process. So far, the project has generated interest in reproductive health in at least twenty-one Chinese provinces and has fostered a real partnership between the sponsoring and the collaborating agency. Based on the immediate outcomes of a research competition designed to identify research projects and investigators, of participant evaluation of the methodology training course, and of the strategies aimed at building capabilities and strengthening institutions in order to ensure future success, I conclude that the Ford Foundation's reproductive health initiative in China is a worthwhile and sustainable project.
An important contribution social science research makes to understanding the experiences of disabled individuals in the U.S. is to illuminate the influence of stigma and deviance on those experiences. Because perceptions of negative difference (deviance) and their evocation of adverse responses (stigma) have been and continue to be widespread, it is these with which alternate perceptions and responses vie in the construction of disability's symbolic and practical meanings. While some research demonstrates a regrettable imposition of stigma/deviance into the lives and minds of disabled people, some of it shows disabled people resisting stigma/deviance imputations; and some of it suggests that such imputations are losing force as new ways of thinking about the meaning of disability gain sway.
Nearly 80% of Thailand's population live in the rural sector. To date, these villages have been subject to top-down dissemination of HIV/AIDS education information via the mass media and bureaucratic networks. This report details an ethnographic enquiry into the impact education campaigns are having in one village in Northeast Thailand. It is found that AIDS information is primarily integrated with local conceptions of sexual behaviour and commercial sex. By the early 1990s, heterosexual behaviour is a major mode of HIV transmission in Thailand. Local and international media discourse focuses on the commercial sex industry in describing the spread of the virus. However, the lack of detailed research of sexual practices in Thailand makes accurate projections of HIV transmission difficult and allows unsubstantiated claims to be made concerning typical Thai sexual behaviour. This paper explores the local context in which these practices are found and discusses the meanings villages attached to HIV/AIDS information. Knowledge levels and behaviour change are assessed and it is argued that community based imperatives are essential for effective future campaigning.
This paper explores the importance of gender differences in the impact of tropical diseases on women. Malaria and schistosomiasis are used as examples but most of the observations also apply to other diseases endemic to developing countries. The distinction between sex and gender is discussed and evidence of sex and gender differences in the determinants and consequences of malaria and schistosomiasis, particularly their economic, social and personal dimensions, is reviewed. Issues on which research and intervention studies are needed are identified.
This paper examines the underlying assumptions that have led to a lack of attention to women's health, particularly in developing countries, beyond the context of their reproductive roles. It is argued that the peculiar nature of women' responsibilities both in economic production and within the family, may have a profound impact on the extent to which they are affected by tropical diseases and their responses to disease. It is suggested that the gender relations of health are of considerable significance in explaining the differential consequences of tropical disease on women, men and children. The paper proposes a framework for gender-sensitive research on this topic and suggests some new directions for research.
Doing good. The Australian NGO community
- L Zivetz
Zivetz, L., et al. (1991). Doing good. The Australian NGO community. Sydney, Australia: Allen & Unwin. Downloaded by [Florida Atlantic University] at 00:35 20 November 2014
Class structure and female autonomy in rural Java Indonesian women: Some past and current perspectives (pp. 124-150)
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Gender issues in food production: The case of Africa
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Women and health in Vietnam
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Bringing the people in: Community participation and the control of tropical disease (Resource Paper No. 1, Social and Economic Research in Tropical Diseases
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Women in development [Special issue] Access to care: More than a problem of distance The health of women. A global perspective
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Australian foreign aid and women in the Third World Australian women: New feminist perspectives
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Taboo talk: Reproductive health videos by Pacific Island women
- M Winn
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Mid-term review of PHC/MCH project. Sayabouri province, Lao PDR
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South Pacific women's reproductive health videos
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Literature review of successful interventions which have impacted on womens' utilization of health services and, ultimately, their health. Paper for presen-tation at the Healthy Women Counselling Guide
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Mid-term evaluation report, South Samfya community health and development project, Zambia for the people and govern-ment of Zambia, implemented by World Vision Zambia and World Vision Australia. Unpublished report. Puentes-Markides Women and access to health care
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Literature review of successful interventions which have impacted on womens’ utilization of health services and, ultimately, their health
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