Gender and Health Relationship In Sariahi Nepal

The following plan is for an evaluation of the relationship between gender and health in Sariahi, Nepal that leads to an intervention programme plan.

Project location

The project will be carried out in Sariahi, Nepal. Sariahi is one of the districts in Nepal, a country in South Asia that is deemed as one of the world`s poorest countries. The reason for the abject poverty is attributed to the country`s autocratic rule and political instability for long. Other factors that have contributed to the county`s poor condition is the lack of access to quality education and the unawareness of the citizens. Consequently, the people of Nepal have superstitious views and still struggle with issues related to gender discrimination. Like women in other parts of the country, women in Sariahi are in an indigent socio-economic status and face discrimination in almost every aspect of their lives.

Aims and objectives

The goal of this plan is to provide an intervention strategy to reduce rates of morbidity and mortality among women in Sariahi, Nepal hence increasing the life expectancy of women through techniques such as equality sensitisation and women empowerment

Main activities

The completion of this intervention programme will involve a number of activities. The primary activity of the intervention programme will be to sensitise and create awareness about how the health of women in Sariahi can be improved in order to increase the life expectancy of the female gender. As such, there will be training sessions regarding gender sensitivity in Sariahi, planned meetings, and joint working sessions.

Literature review

According to a study by Kabir (2008), it has been established that in a majority of the developed countries, women live longer than men. In 1996, the life expectancy of the girl child in the United Kingdom was 79.6 years while that of the boy child was 74.4 years. Despite the fact that the male to female birth ratio, 1: 1.05 in 1991 (Lubitz et al., 2003) might seem advantageous to males, on the contrary, men have been found to have a higher rate of stillbirth, foetal death, and neonatal mortality. Further, the rate of death in males continue to rise at a higher rate compared to that of their female counterparts through adulthood. This difference in the rate of mortality among men and women reaches a maximum in early adulthood and late adolescence. This is attributed to an increase in the occurrence of accidental deaths among men (Breyer & Felder, 2006). The differences between female and male mortality suggest some essential biological differences between women and men. However, assuming that the situation is an unchangeable human condition feature is not appropriate. Higher female longevity is considered a rather recent phenomenon (Singh & Miller, 2004). As stated by Singh and Miller (2004), in the Paleolithic period and the industrial revolution, men`s life expectancy was longer, at about 40 years against women`s 35 years.

During the 19th century, the life expectancy of women reached the same rates as that of men. Further, in 1841, men`s life expectancy at birth rose to 41 while that of women increased to 43. Ever since, there has been a dramatic improvement in life expectancy, especially for women. Mathers et al. (2001) argue that much of the increase occurrence has been in the 20th century and is as a result of the significant decline in mortality due to infectious diseases. It is worth noting that in the less developed countries such as Nepal, Pakistan and Afghanistan men have a longer life expectancy than women (Mathers et al., 2001). This is because, in such countries, infectious diseases are a critical threat to human health while there are also other occupational and environmental exposures that are potentially harmful and unregulated. Besides, in these countries, women give birth at younger ages under poor nutritional conditions.

Studies carried out across northern and western Europe as well as North America show that higher mortality rates for men often contrast with greater morbidity rates for women (World Health Organization, 2010). In adulthood, women from these parts of the world have been reported to often give their health a less positive rating and have a more frequent reporting of both psycho-social and physical symptoms. Also, the studies found that women were more likely to seek help from health professionals and made consultations more often. In a study carried out in Europe by Salomon, et al. (2013), it was established that women enjoy higher conditions that are less life-threatening compared to men. The author compares the situation in Europe to that in Nepal whereby the health of people in Nepal is described to be among the lowest, particularly for females. This is further supported by Matsumura and Gubhaju (2001) who state that Nepal is among countries with a lower women life expectancy compared to that of men in the world. A study by Furuta and Salway (2006) found that the empirical data exists that indicate that the Nepalese women find themselves in a life situation that is too severe compared to that of men. The Nepalese woman`s case is said to be destitute, not only in terms of health but also in other aspects of life such income generation, participation, education, self-confidence, human rights and decision-making. In Nepal, about one-fifth of the country`s women enter into a marriage at an early stage, 15-19 (Furuta & Salway, 2006). Consequently, due to early pregnancy, there has been a high death rate amongst the country`s women. Thus, poor health amongst women in Nepal is demonstrated by low life expectancy, high birth rates, high maternal and infant mortality rates as well as high death rates (Mullany, Hindin & Becker, 2005). According to the country`s national statistics, literacy rate amongst Nepal`s women is at 30 percent against 66 percent for the males (Mullany, Hindin & Becker, 2005). Further, the statistics show that only 24.95 percent of women in Nepal enrolls in higher education in the country. The fact that the presence of Nepalese women in education is not well felt suggests that the female gender in the country has a limited understanding of and access to information regarding the management of diseases, control, and prevention. This is also a key factor in demonstrating and explaining the high morbidity rates amongst Nepalese women.

It is vital to understand the determinants of health in order to know the key aspects that the intervention plan should focus on. In this regard, health determinates are defined as factors that affect an individual`s health. One category of these factors is social or cultural and includes norms, roles, traditions, occupation and values (Stafford et al., 2005). The other category is economic factors which determine the ability to purchase healthcare services. Other categories are political, environmental and biological factors (Macinko & Starfield, 2001). Under the environmental group, the physical environment in which a person resides has an effect on their health, for instance, clean air environment or one with safe drinking water and protective houses. Based on this literature review, it is evident that a health intervention in relation to the little female life expectancy in Nepal is vital, which forms the basis for this paper.

Gender sensitivity is a research approach in which one takes into account “gender” as a key variable. It is an important aspect in that it makes sure that none of the two genders, men or women, is ignored or left out of a research work. Besides, gender sensitivity provides a platform through which gender inequalities and other issues are addressed. To ensure gender sensitivity in this plan, the ideas and opinions that will be expressed in the programme will reflect the necessity to understand the health aspects of both sexes. Further, the plan will use a language that is sensitive to both genders. This will be achieved by addressing both genders in the plan making the visible with dignity, value, and respect. For instance, terminology that is gender biased and can influence expectations and attitudes will be avoided. Also, a proper language will be used in reference to various disabilities and weaknesses in both genders.

Programme justification

As demonstrate in the literature review section, there is a need to have a gender sensitive health programme to help the disadvantaged female gender in Nepal, particularly those who live in rural areas such as Sariahi. Further, such a programme will assist in shedding light on various key issues such as gender inequalities that have an influence on the health status of individuals. This is because when such variations occur in the context of health services, they may lead to disparities between males and females. As noted by Blas and Kurup (2010), a society with high gender inequality is unhealthy for both men and women. The gender-sensitive health programme is supported by the feminist theory which emphasizes women`s healthcare. In a feminist model, the primary focus is to bring changes in the manner in which health care services are delivered to women while also seeking transformations. Further, from a feminist perspective, there are enough reasons why the health of women should be given some special attention. Some of these reasons include menstruation, pregnancy and giving birth (Blas & Kurup, 2010). Besides, women are charged with a more responsibility when it comes to contraception and disease control such as STD prevention. Most importantly, women may face discrimination in insurance systems and health care (Macinko & Starfield, 2001). On the basis of these conditions, feminists have a reason to push for better healthcare for women across the world, particularly in the less developed countries such as Nepal.

It is worth noting that the health of women differs from one woman to another according to some factors such as class, race, age, and disability. Also, the fact that only biological women can conceive and have children explains a range of health risks that only women are exposed to. This further justifies the need to have a health programme that focuses on women as it is clear that the reproduction health of women is a serious issue that requires particular attention across the world. However, this should not be taken to imply that the health of men is not as important as that of women. In fact, the fact that men`s health is also affected by some of the aspects affecting the health of females such as birth control and STD prevention (Coker et al., 2002) is a clear indication that men`s health is also an issue in feminism. However, in most cases, the health status of women raises a lot of concern in comparison to that of their male counterparts, especially in the less developed states, but without involving men as well, then the health care will not be very useful.

Intervention focus and justification

The intervention described in this plan will mainly focus on women. This is because they are the victims of gender inequality and are the most disadvantaged when it comes to gender and health. For instance, in most cases, women are the ones in charge of caring for others, mostly without relief or compensation. This has an implication that they have a higher likelihood to suffer physical injury and stress in comparison to men and may also lack adequate financial resources to cater for their own health care. However, due to masculinity reasons, their male counterparts may also stand higher chances when it comes to engagement in risky behaviours such as drinking and smoking or even extreme sports which can negatively affect their health. Additionally, ideals of masculinity may encourage the male gender to pay no attention to pain and other illness symptoms making them less likely to consult healthcare professionals than women.

Furthermore, the biological differences that women have from men, which make them to have an additional health need to the basic health need also justify the reason for focusing on the female gender in the plan. For example, women typically go through various steps of their life during the reproductive age. From the secondary sexual character development, women are said to undergo a range of changes like pregnancy, menopause, menstruation and childbearing. Increased risks also face the female gender to diseases such as cervical cancer, breast cancer and osteoporosis (Van den Bergh et al., 2011). Moreover, women experience hormonal fluctuations on a monthly basis and during different stages of their life that cause numerous changes in their emotional and physical health (Van den Bergh et al., 2011). These biological differences put the female gender at particular need while exacerbating their medical need and may contribute to the deterioration of their health condition.

Practical tools and planning frameworks

To achieve the aims of this intervention, a variety of practical tools and planning frameworks will be used. One of the planning frameworks to be used is the Harvard Framework. This framework will demonstrate resource allocation to both genders while illustrating the economic case associated. Therefore, the Harvard Framework will be of significant help when it comes to the designing of a more effective plan. Through the framework, it will be possible to map the resources and work of men and women in Sariahi community while also highlighting the fundamental differences. Using the Harvard tool 1, the collection of data about activities of both men and females in Sariahi community will be possible. This will help to gain quick insights into who does what, tasks carried out by women and men, in which areas, at what time and for how long. Using Harvard tool 2, data regarding the individuals, both men and females, with access and control over resources in Sariahi will be collected. The third Harvard tool will be used while taking into consideration the factors that influence gender relations as well as providing opportunities and constraints for men and women in Sariahi.

Another framework that will be useful in achieving the aims of this intervention is the Moser framework whose goal is setting up of gender planning as a planning type in its own right (Moss, 2002). this will help in achieving equity and equality through empowering women in Sariahi. Using the Moser Tool 1, gender roles will be identified and their mapping will be done in a similar way to Harvard tool 1. This will show what specific genders do in the Sariahi community. This will be followed by an analysis of these roles in relation to the three categories of reproductive, community and productive work given by Moser (Moser, 2012). The second Moser tool will involve the identification of strategic and practical gender needs of women. These requirements will be those the women of Sariahi have as a result of their tasks, responsibilities and roles. Using Moser tool 3, control of household decision-making and resources will be disaggregated. Using the fourth tool, all the existing women responsibilities will be checked and full consideration taken into account in the planning process. Moser tool 5 will be used to analyse the policy aim while tool 6 will focus women involvement in the programme and organisations that are gender aware.

Another framework that will help to achieve the aims of the intervention is the gender analysis matrix (GAM). This framework will help to determine the various impacts that the development intervention will have on the women of Sariahi through the provision of community-based techniques for the identification of gender differences within Sariahi. The main question that will arise from the matrix will be how the intervention will be of benefit even to the non-participants.

Intervention plan and planned outcomes

The intervention to reduce rates of morbidity and mortality among women in Sariahi, Nepal will involve the following key steps.

One of the key steps will be to sensitise about the need to eradicate the extreme poverty conditions in Sariahi and other rural areas in Nepal. By eradicating poverty, the women of Sariahi will have an improved nutritional status which is one of the fundamental aspects of an individual`s health and well-being. Osmani and Sen (2003) argue that poverty plays a key contributor to many early pregnancies and other morbidity and mortality incidents, in adolescents, which are pregnancy related. Further, the author acknowledges poverty as a key HIV epidemic driver. Based on this, it is clear that when poverty is reduced or eliminated in Sariahi, there will be a corresponding improvement in health care which will mainly benefit the suffering female gender.

Next, the pogramme will work towards sensitising about the need to empower women in Sariahi while promoting gender equality in the Nepal as a country. This will have multiple benefits such as poverty reduction and family health improvement for the Sariahi community. When women are given the ability to make decisions about the number of children to give birth to as well as their timing, it serves as a fundamental step to their empowerment. This is because they are put in a position to decide which also expands their education, social participation and work opportunities within the country. According to a study by Klasen (2000), educated women and girls contribute to the whole family`s protects. This implies that empowering women can help to break the poverty cycle in Nepal, particularly in the Rural areas such as Sariahi. The gender sensitivity programme will also create awareness regarding the pivotal role played by men towards achieving gender equality and hence women`s health in Sariahi. The male gender has a significant contribution in reducing HIV transmissions as well as gender-based violence that mostly affects women`s physical and psychological health.

The intervention will also involve improvement of maternal health which will result in better reproductive health for women in Sariahi. This step will significantly reduce the number of women dying from causes that’s that are preventable such as obstructed labour, unsafe abortion, and infections like eclampsia-high blood pressure (Stafford et al., 2005). This intervention will also work towards ensuring environmental sustainability in Sariahi which will result in safer drinking water as well as adequate sanitation that form part of the basic health requirements of women.

Possible programme difficulties

The programme may encounter various problems which may also determine its success or failure. One of the greatest challenges to this programme is achieving maximum participation. This is because the success of the programme will heavily depend on the participation levels of all stakeholders from relevant authorities to the target women participants. Another difficulty that the programme will encounter is having a workforce that is well trained in terms of gender sensitive health issues. The availability of an experienced workforce will bring in a range of skills that is needed to make the intervention programme a success. The workforce will help to ensure consistency of messages communicated during the sensitisation process, programme co-ordination strengthening as well as female health promotion opportunities maximisation.

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