Rural Womens Health in Asia Michelle Rogers, AsianPacific Resource and Research Centre for Women ARR - PowerPoint PPT Presentation

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Rural Womens Health in Asia Michelle Rogers, AsianPacific Resource and Research Centre for Women ARR

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Michelle Rogers, Asian-Pacific Resource and Research Centre for Women. ARROW ... Fail to involve Asian rural women in planning and implementing health policies ... – PowerPoint PPT presentation

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Title: Rural Womens Health in Asia Michelle Rogers, AsianPacific Resource and Research Centre for Women ARR


1
Rural Womens Health in AsiaMichelle Rogers,
Asian-Pacific Resource and Research Centre for
WomenARROW
2
Rural Womens Health Experiences
  • Shukri Devi Bhawanipur village, Mirzapur
    district, UP
  • As soon as my daughter-in-laws labour pains
    started we took her to the nearest private
    clinic, 10 km away. The Primary Health Clinic
    (PHC) is 40 km from our house and we had no means
    of taking her so far. At the private clinic, we
    were told to return as the birth was not due yet.
    But as soon as we got back home, the pains
    started again. The baby was delivered when we
    were returning to the hospital. There was no way
    of cutting the cord. Seeing her like that with
    the placenta hanging out, the hospital refused
    admission. We were taking her somehow to the
    distant PHC when she died on the way
  • Next time, when it was my daughters delivery, we
    took her straight away to a government hospital.
    There they asked us to pay Rs 700 for something
    called User Fee before anyone touched her. We
    told them we were too poor to pay such a large
    amount, but no one listed to us. We ended up
    using our lifes savings for what we thought
    would be free. We are so impoverished now there
    is not even money to buy milk for my grandchild.
    (Voices from the Ground Women Show the Way,
    SAHAYOG)

3
Rural Womens Health Experiences
  • Vandana Gorakhpur, India
  • Three years ago when I was pregnant and did not
    want another child, I confided in my
    sister-in-law. She did not know of any qualified
    practioner, so I was taken to a jhola-chaap
    doctor. She took Rs 300 from us and inserted a
    medicated stick inside me, asking me to return
    after a few days. The family took me to a
    government hospital, there they asked me for so
    much money that I went to a private doctor for
    treatment. I finally spent Rs 15,000, but,
    fortunately, I recovered after the treatment.
    (Voices from the Ground Women Show the Way,
    SAHAYOG)

4
Critical Health Concerns Faced by Rural Women
in Asia
  • Rural women, as a result of poverty, type of
    work, illiteracy, geography, conflict, disaster,
    various sociocultural barriers, and governments
    limited willingness to protect, promote and
    ensure rural womens health, are especially
    vulnerable to
  • Pregnancy- and childbirth-related deaths and
    disabilities (which includes death
    complications from unsafe abortions)
  • HIV/AIDS and sexually transmitted infections
    (STIs)
  • Reproductive cancers
  • Health concerns related to agricultural work,
    particularly pesticide use
  • Malnutrition
  • Chronic fatigue and illness
  • Involvement in sex selection, surrogacy
    (reproductive technologies)

5
Barriers of Poverty, Illiteracy, Geography,
Conflict, and Disaster
  • Poverty cannot afford the costs of facility
    based care, travel costs to reach the facility
    and lost income of those accompanying the woman.
    As well, women forced to engage in activities
    (sex work/prostitution, surrogacy) which can
    negatively impact their health status
  • Illiteracy and Education illiteracy and lack of
    education results rural women being unable to
    access important health information, particularly
    knowledge about HIV, the importance of a skilled
    birth attendant, contraception, and their basic
    rights, etc.
  • Geography long distances from health services
    impacts access and health seeking behaviours.
    Correlation between remoteness and rural womens
    maternal health
  • Conflict increases delays in seeking help,
    often due to lack of transport, fear of
    travelling, security check-post delays and often
    results in rural areas having less medical
    supplies and skilled health care providers
  • Disaster can result in unhygienic conditions
    no clean water, basic supplies, and nutritious
    food and disruption in health services and
    supplies
  • Also, Migration/Displacement and Militarisation

6
Sociocultural Barriers
  • Entrenched gender inequities bias against women
    that displays itself in behaviours, attitudes and
    beliefs that lead to rural women having less
    access to social, health and educational systems,
    which negatively impacts their emotional, mental
    and physical well-being. (e.g. less likely to
    seek health services, receive less nutritious
    food, practice of sex selection)
  • Norms of violence against women social
    tolerance of violence against women (including
    sexual violence) in rural areas is combined with
    rural womens inability to access to services in
    such circumstances
  • Practice of early marriage girls as young as 12
    and 13, with limited education, are left to
    manage their fertility and sexual and
    reproductive lives (including associated risks)
    on their own, and face an increased risk of
    complications as a result of giving birth before
    their reproductive systems are fully developed
  • Religion is part of the reason unmarried
    individuals, particularly women and female
    adolescents, have limited access to
    contraception. As well, taboos around sex limit
    discussions and negotiations regarding safe sex
    practices.

7
Governments Failure to Protect, Promote and
Ensure Rural Womens Health
  • For real equity in health to occur, Asian
    governments must recognise and account for the
    barriers that negatively impact rural womens
    health and actively work towards erasing such
    barriers!
  • Unfortunately, this rarely happens, as
    governments
  • Often fail on the implementation side (lack
    commitment)
  • Maintain laws and policies that violate womens
    human rights (e.g. restrictive abortion laws,
    mandatory health testing)
  • Maintain policies and programmes that are not
    comprehensive (e.g. fail to include
    contraception, violence against women, abortion,
    and accurate and adequate health information)

8
Governments Failure to Protect, Promote and
Ensure Rural Womens Health (Cont)
  • Shrink national health budgets, with more money
    being allocated to military spending and economic
    development, rather than going towards an
    affordable, accessible public health system
    available to all residents (including foreigners)
  • Adopt World Bank health sector reforms, which
    increases involvement of the private sector and
    alternate approaches to finance (impact less
    access for remote areas, limited range of
    services and unaffordable)
  • Fail to involve Asian rural women in planning
    and implementing health policies and programmes,
    and recognise their traditional contribution to
    health and wellness in rural communities

9
Asian Governments Commitments to Womens Health
  • International human rights and womens human
    rights instruments clearly outline that all
    people are born equal in dignity and rights and
    have the right to health.
  • Cairo Declaration (ICPD) urges governments to
    remove all remaining barriers that inhibit access
    to family planning services, information and
    education, as well as to help support the
    provision of reproductive health and family
    planning services
  • Beijing Declaration (Fourth World Conference)
    articulates the recognition and reaffirmation of
    the right of all women to control all aspects of
    their health, including their sexual and
    reproductive health
  • Convention on the Elimination of Discrimination
    against Women (CEDAW) outlines that measures be
    taken by governments to ensure that all women
    have equal access to appropriate services in
    connection with pregnancy, confinement and the
    post-natal period, inclusive of granting free
    services where necessary
  • International Covenant on Economic, Social and
    Cultural Rights (ICESCR) details that
    governments must make provisions for improvements
    in the areas of maternal health environmental
    and industrial hygiene the prevention, treatment
    and control of epidemic, endemic, occupational,
    and other diseases and the creation of
    conditions which would assure medical services to
    all.

10
Rural Women Resist and Speak Up!
  • EXAMPLE
  • Voices from the Ground Policy Dialogues on
    Womens Right to Maternal Health 3-day policy
    dialogue in New Delhi, India (27-29 Dec. 2005)
    organised by SAHAYOG, CHETNA and the Centre for
    Health and Social Justice
  • Rural and urban low-income women were able to
    directly address the media, Ministry, Planning
    Commission, and donors regarding demands for the
    improvement of maternal health services in India
  • Women gave testimonies and NGOs supported them in
    drafting a concrete set of recommendations for
    government
  • Critical issue raised was the clustering of
    deaths among rural women, Dalit women and tribal
    women

11
Rural Women Resist and Speak Up! (Cont)
  • Outcomes
  • Governments asked for detailed descriptions of
    maternal deaths cases, so action could be
    initiated
  • Organizers invited to speak at 3 state-level
    meetings on maternal health
  • Rural women and NGOs from Uttar Pradesh wanted to
    create further pressure on the government and
    therefore launched a state-wide campaign focused
    on womens right to maternal health (35,000
    signatures collected supporting their demands
    were delivered to the Minister of Family Welfare
    on the eve of 28 May 2006 (International Day of
    Action for Womens Health)
  • Rural women in Uttar Pradesh met with members of
    the State Commission for Women and made
    presentations inside the State Legislative
    Assembly
  • Ministry of Family Welfare began making
    announcements in the media regarding the
    importance of maternal health
  • At the invitation of local health officials, NGOs
    asked to be more involved in implementing the
    National Rural Health Mission in Uttar Pradesh
  • Rural women themselves declared the launch of a
    state-level organization to continue working on
    the issue of womens right to maternal health
  • Rural women are clearly able to articulate their
    needs, concerns and preferences and should be
    directly involved in discussions on policy and
    programme development and implementation!
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