Gender, Health and Development

(GHD)

By: Tadesse N.

June 2022
 Objectives of the session
At the end of the session students will be able to:
Describe the relationship between gender, Health and
Development.
 Explain the roles of women and the effect of these roles on
Health and Development.
 Compare and contrast the two Feminist developmental
approaches (WID and GAD )
Explain morbidity and mortality profiles of men and women
Describe effect of gender on access to health care

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Gender and Health
The World Health Organization defines health as: "A state of
complete physical, social and psychological well-being and not
merely the absence of disease or infirmity".

 Health is not purely a physical phenomenon, but influenced

by socio-cultural, economic and psychological factors.

The social understandings of health offer a gendered way of

analyzing:
 The influences of socio-economic relations on health and
 The broader socio-political intervention that may be
needed to improve the over all health situation.

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 GHD ….

Gender based power inequalities can contribute to poor health

outcomes:

On issues that require decision making, men’s opinion about

the issues may over rude women’s

However, women often must implement the decisions made

on these matters.

Research shows that couples often disagrees about the

desirability of pregnancy and the use of contraceptives.

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 GHD …
 Gender based power inequalities can also contribute to poor
health/RH outcomes by:
Hindering Communication between couples
Reproductive health decisions
Constraining women’s access to RH services,
Preventing women and men’s attainment of sexual health
and pleasure,
Increasing the risk of contracting HIV infection and other
STIs.
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 GHD...
Gender differences in society can influence both women's and men's:
 Exposure to risk factors;
 Access to and understanding of information about disease
management, prevention and control;
 Subjective experience of illness and its social significance;
 Attitudes towards the maintenance of one's own health and that of
other family members;
 Patterns of service use;
 Perceptions of quality of care

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 Gender and access to health
care
The effects of gender inequalities can be clearly seen when
access of women to both preventive and therapeutic measures is
compared to men.

In general women have to overcome more obstacles to reach

treatment

Different studies showed that an increased number of male

patients attending medical services in areas where disease rates
are practically the same for both sexes.

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Gender and access…
Even if direct and indirect costs (such as the cost of transport)
can limit access to treatment

On the whole, women have limited access to cash/ money

which is needed for coping with illness costs, compared to men.

The triple burden of household chores (tasks), childcare and

agricultural work limits time for women to attend health care
facilities

Long traveling and waiting times amplify the problem.

The decisions to seek care lie on male, making
women dependent on men for accessing health services for
themselves and their children.

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 Gender and access…
Few authors systematized the obstacles which women face into
different categories:
Institutional barriers: unequal treatment by health care providers
Economic barriers: different access to resources
Cultural barriers: social status of women which situates them in socially
inferior positions, male doctors who attend women with sensitive health
problems… etc.
Education barriers: women having less access to education
Geographical barriers (too far to travel)
Personal obstacles: lack of information, traditional medical knowledge and
midwives
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Gender & access to healthcare…

Across the healthcare landscape we see different utilization

rates, as well as different barriers and enablers to healthcare
access.
For example, women in high- income countries are more
likely to engage in preventative health activities than are
men.
They are also more likely to seek treatment for most
diseases and to do so early in the course of an illness.

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Gender & access to healthcare …
In contrast, women within emerging economies, have been
shown to utilize health systems less than men during their
lifespan due to restrictive barriers such as childcare duties and
care giving obligations, as well as service cost

Irrespective of country of origin, women in general are less

likely to perceive their overall cardiac risk level and therefore
are less likely to attribute their symptoms to a possible cardiac
related health issue .

Men’s lower healthcare utilization rates in high- income

countries are linked to the trend that they are fulltime workers,
work longer hours, and have less flexible schedules than
women do.
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 Gender Differences Morbidity and
Mortality
In most regions of the world, life expectancy among women is
higher than among men.
The shorter life expectancy in men is thought to be the result of
male behaviours including greater risk taking in relation to
tobacco and alcohol use.

It is also attributed to masculine attitudes towards health, such

as not expressing pain or discomfort or acknowledging emotions.

Men are said to be ‘‘more vulnerable from the beginning of

life,’’ with mortality rates among men being higher than those
among women throughout the lifespan.

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 Morbidity and Mortality …..
Research in the 1970s and 1980s routinely showed higher
morbidity among women; this discrepancy between morbidity
and mortality rates is referred to as the ‘‘gender paradox”
A wide range of genetic, hormonal, social, and cultural factors
are likely to play a role in shaping male and female patterns of
morbidity and mortality.
However, these forces need not influence men’s and women’s
health in the same way, leading to gendered patterns of mortality
and morbidity.
Currently, men have more lethal conditions, whereas women
have more disabling chronic conditions.
Men and women have somewhat different health problems; one
sex cannot be characterized as having better health.

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Morbidity and Mortality …

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Morbidity and Mortality ….

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Morbidity and Mortality ….

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Development
United nations documents emphasize “human development,”
measured by life expectancy, adult literacy, access to all three
levels of education, as well as people’s average income, which is
a necessary condition of their freedom of choice.

 In a broader sense the notion of human development

incorporates all aspects of individuals’ well-being, from their
health status to their economic and political freedom.

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 Development…
According to the Human Development Report 1996, published by
the United Nations Development Program,
 “human development is the end — economic growth a
means.”

Literatures indicated that richer people usually reported slightly

higher levels of happiness than poorer people,

 People in countries with more equal distribution of wealth

appeared to be generally happier.

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 Gender and development
Development in the third world is not merely about increased
productivity and welfare but also it is about meeting the needs
that women are most in need,
 About increased participation and equality.
Development is therefore:
Enabling people to take part of their own lives
Escape from poverty, which arises not from lack of
productivity but rather from oppression and exploitation
Ideal state of development is when gender relations are
equitable.

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 Gender and development …
 In these situations the central priority issue for women is
making them empowered through education and employment
so that they will have equal place with men in all developmental
processes.

 Then the issue of productivity and effectiveness will come later.

 Women empowerment and education have also a direct

impact on Health

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Gender and development …
 The issue of gender and development is important because
women constitute half of the world’s population

 Women are also a center to the economic as well as to the

well-being of societies.

 Ignoring half of the population in development does not

bring full, effective and efficient development.

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 The Triple Roles of women
Productive: Comprises the work done by both women and
men for payment in cash or kind.

Reproductive: Comprise the childbearing/rearing

responsibilities and domestic tasks required to guarantee
the maintenance and well-being of household members.

 It includes not only biological reproduction but also the

care and maintenance of the persons who comprise the
household.

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 Roles of women…
Community Management Role: Comprises activities
undertaken at the community level to contribute to the
development of the community.

Community activities are voluntary and unpaid which

contribute to its welfare and organization:

It should be emphasized that not all human activities can be

restricted to mutually exclusive

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 Roles of women…
Reproductive role comprises the childbearing/rearing
responsibilities and domestic tasks undertaken by either sex,
required to guarantee the welfare and survival of the
individuals included in the home.

For example: rearing, educating, feeding, looking after and

nurturing household members and other tasks related to
organizing and maintaining the home.

 Some of the categorizations are too fixed.

Some activities might fall under both categories. For example,
a woman bakes bread and serves half of the bread to her
family and sells the rest.

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 Roles of women…
  Is this a reproductive role? A productive role? It is both.
Without reproductive roles, productive roles could not be
carried out, or would be critically condensed.
Who is generally carried out the tasks, responsibilities and
activities assigned under reproductive roles?

The reproductive role is less valued socially because it is the

work "of women"

Many types of work in the area of production of goods and

services, such as in the area of health and primary school
education, have also been divided in accordance with gender
roles.  

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Community management roles
There is a division of functions according to gender.
Mostly women are responsible for carrying out community
management work attending to sick neighbors, involvement in
church/religious activities,

Men are more likely to participate as community leaders who

negotiate with municipalities or other political authorities.

This latter work is associated with status and is sometimes

remunerated/rewarded.
The Community Management role has particular relevance for
the health field.

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 Community management roles…
The voluntary participation of women in community activities, as
health workers, active participants in vaccination campaigns has
been considered indispensable for the promotion of health.

The type of community management work that women carry out

is strongly associated with their reproductive role and with
stereotypes that assign them certain types of work.

Women performing in a single day (sometimes simultaneously)

two or three different roles.

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 Women's roles …
Given that reproductive roles are performed mostly by women,
multiplies their roles.

Maintaining this balance has consequences in terms of time

management and its effects on the person's mental and physical
health.

Women have to bear to a greater extent of burden than men.

The detection of these gender roles makes previously

unrecognized work visible.

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 Women's roles…
 In general, in capitalist economies, only productive work, due
to its exchange value, is considered as "work"

 Reproductive work and community management work are not

valued because they are considered "natural" and non-
productive.

 This has serious consequences for women, because it means

that most of their work continues to be invisible and,
therefore, undervalued.

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 Women's roles…
Women carry out more fragmented tasks and have to divide
their time between reproductive and productive tasks;
 
The tasks of men are usually devoted to wage earning activities.

 It is women who are responsible for domestic tasks, although

men may "help" them.

Women perform productive tasks in addition to their

reproductive ones; men carry out productive tasks instead of
reproductive ones.

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 Women in Development (WID)
Evolved in the early 1970s from a ‘liberal’ feminist framework
Grew out of the idea that women have been out side the health and
development process.
An approach that focus on women in isolation & correct the situation.
 Projects to generate income.
Improve the nutritional status of women, children & control fertility.
 women are active participants in the development process, by their
productive and reproductive roles provide a critical, if often
unacknowledged, contribution to economic growth

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WID…
 Starts with the basic assumption that economic strategies have
frequently had a negative impact on women.
 It acknowledges that they must be “brought into” the
development process through access to employment and the
market place.
 It therefore accepts women’s practical gender need to earn a
livelihood
 E.g. Creating employment and income-generating
opportunities, improving access to credit and to education.
 Women have less leisure time and work more hours than men.
 Since women are at a disadvantaged wing that negatively
affects their health, it is necessary to promote interventions
that will improve their disadvantaged situation.
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Some critiques of WID
WID approach has proven incapable of challenging gender
stereotypes and male structures of power.

Failed to acknowledge the specific social and cultural contexts

of women’s lives.
Did not question the existing structures so as to find out why
women fared badly from development processes.

Never examined the nature and the sources of women’s

subordination and oppression.
Women were viewed as separate units of analysis

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Some critiques of WID…
The problem arise from inequitable gender r/ns

Women have subordinate position with respect to access and

control over resources that promote health and development

It is inequity in r/n b/n the two sexes places one or the other
sex at a disadvantage, in terms of access and control over
resources that are needed to promote health and
development

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Gender and development(GAD)
 It replace “women” with the more neutral term “gender” to
avoids the drawback of economic determinism(WID approach)

 Have short and long term goal for development with gender-
sensitive approach rather than a woman-only approach.

 The short-term goals of GAD similar with WID, i.e. they involve
education, credit, improvements in the legal system, etc.

 The long-term goals include ways to empower women through

collective action, to encourage women to challenge gender
ideologies and institutions that subordinate women

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 Gender and development(GAD)…
WID addresses the status of women, then gender
empowerment redresses the imbalance in that status through
affirmative action to improve the quality of women’s lives

GAD theory focuses on women’s empowerment at two levels:

 personal level its concern is women’s self-confidence and sense of personal
strength;
 higher political level women’s capacity to make public decisions and control
resources is the focus

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Gender and development(GAD)
…
It must address not only women’s immediate, practical needs for
their own and their families’ survival, but their longer-term,
strategic needs for greater gender equality
The GAD approach is to balance this inequity and believes
 In order to balance these relations the entire process of
promoting health and development should be looked at through
the gender lenses.
Efforts should be made to correct imbalances b/n men and
women in terms of access and control over resources.
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While caring out developmental
interventions;
Consider gendered power relations b/n the two parties that
has an impact on access to and control over resources

The fact that women and men are socially assigned different
roles and responsibilities has direct implications for the level of
access to and control over resources needed to promote their
health.

Fair distribution of resources is necessary for the promotion

and protection of one’s health as well as the health of others.

A Gender approach to development can better meet the

needs of both men and women, enhance the health and well-
being of family, community and the society at large
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