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‘How do you de-worm children in villages?’
‘Obviously, by making sure that the anti-worm tablets are
not thrown away by children or their guardians. We do it through a camp approach.
We administer the tablet in our presence..’
‘Where exactly?’
‘Of course in the village school. That is the place where
you can catch children.’
‘Could there be some children who do not come to school?
who escape this de-worming process?’
‘Well, Yes, there are some drop outs..’
‘Who are these?’
‘Children of very poor families. Backward families…’
‘More often boys or girls?’
‘As we go to upper classes, drop out of the girls is much
more due to…’
We have heard this discussion often. We have been on both ends of this discussion. We have often wondered how gender concern can be made such an integral part of health program planning, that operational ‘common sense’ never blinds us to gender inequality hidden in processes and structures of programs. In other words, we have asked: How does one analyze health issues and programs from the gender point of view? This manual is an attempt to address such concerns.
Gender analysis as applied to Health is somewhat different to what it is in the socio-economic sector, even though the underlying principles and intent remain the same. In the latter setting it is to see how socio-economic interventions affect women and men in significantly different ways; While in the former, it is to understand how experiences of ill-health and attempts at recovery shape out differently for women and men.
This module is based on Swayamsiddha experiences from field and a series of workshops conducted with voluntary agencies dealing with rural development, women’s issues and health. The purpose of this initiative was to facilitate mainstreaming of gender within the ongoing programs. This documentation is an attempt to reflect on this process and disseminate the lessons learnt.
Swayamsiddha is a 5-year project that began in June 2000 to improve the health and empowerment of women and girls in rural India. The project involves nine partner organizations in six Indian states and is co-funded by the Canadian International Development Agency (CIDA) and the International Development Research Centre (IDRC). Overall coordination of project activities is provided by the BAIF Development Research Foundation (BAIF). BAIF is a non-profit organization registered under Public Charitable Trust in 1967. Various programs are implemented by BAIF in twelve thousand villages in eight states of India. (Vide Appendix to learn more about BAIF.)
'Swayam' means self, and 'siddha’
means 'capable'. Swayamsiddha in short, means ‘empowered’. Swayamsiddha
connotes a group of self-reliant and empowered women. In the mainstream concept
of development, women's needs are often sidelined due to gender norms, access
to and control over resources. Unless women are in a position to influence the
decision-making processes, women's lives and the structure of society would not
change. Swayamsiddha aims at creating local organizations of women and men who
would explore and initiate processes for increasing women's participation in
all spheres of life. (Vide Appendix to learn more about Swayamsiddha project).
When we discussed health related topics with community women in Swayamsiddha, we understood that along with unavailability of health infrastructure, gender norms play a major role in women's health issues. Fasting, food habits, workload, norms like women eat last in the house, practices regarding menstruation and pregnancy affect women's health in a negative way. Women's self esteem, the ways women are told to look at their body contribute to women's health hazards. Women have very little access to money, time and they have a very limited mobility. In the beginning of the project we realized that we have to emphasize on analysis of health issues from gender point of view.
BAIF coordinating team based at Pune initiated number of Gender Sensitization Training and Health training programs for the implementing staff and the community members. The Gender Sensitization training module was instrumental in highlighting that gender based disparity is a social structure and it is reaffirmed through various social institutions like family, education, law, religion. Through this training people understood the concepts of sex and gender, gender roles, gender based division of labor, access to and control over resources and participation in decision making. Discussion on how all this discrimination affects women's health was part of the training program. These training programs brought out the truth - gender cuts across class, caste, religion, ethnicity and other social factors. It also emphasized the need of bringing change within to bring change in the world outside.
BAIF team initiated six health modules for the implementing teams and community representatives. They are:
· Water and Sanitation
· Body mapping
· Malnutrition and nutritious food
· Primary treatment and First Aid
· Women's health
· Health communication
During all these health training program, difference between treatment seeking behavior of men and women was discussed at length. These discussions helped to bring gender perspective in health program.
To strengthen this perspective, we perceived a need for a separate training module which would focus on Gender Perspective in Health (GPIH). BAIF coordinating team and IDRC teams brainstormed to design a module based on the needs of the project. This training module is an effort to integrate gender and health.
This GPIH resource is being offered as a ready to use training module for a three day workshop. Program coordinators, facilitators, managers will find it useful to upgrade conceptual, analytical and program planning skills of their health teams. They will be able to conduct the GPIH workshop for their team / staff, often consisting of field functionaries, supervisors, community organizers, ANMs and other health workers. Some prior understanding of Gender, its basic concepts and definitions would certainly be desirable though.
We suggest that the participants are given a prior half a day session on following concepts, before GPIH workshop:
· Sex & Gender, difference
· Gender roles
· Resources: Access & control
· Gender needs: Practical Vs Strategic
· Approaches to Development: Women in Development to Gender and Development