scholarly journals Gender equity and norms in health programs: learnings from a drowning reduction program in Bangladesh

2020 ◽  
Author(s):  
Medhavi Gupta ◽  
Aminur Rahman ◽  
Notan Chandra Dutta ◽  
Md. Shafkat Hossain ◽  
Devaki Nambiar ◽  
...  
Keyword(s):  
Rural Communities ◽  
Gender Equity ◽  
Family Health ◽  
Women In Leadership ◽  
Health Programs ◽  
Leadership Roles ◽  
Cultural Perceptions ◽  
Middle Income ◽  
Reduction Program ◽  
Part Time

Abstract Background: Community-based health programs implemented in low-and middle-income countries have additional health impacts beyond their targeted outcomes, such as on gender norms, roles and relationships, partly due to their engagement of local human resources. We conducted a gender analysis on a drowning reduction program in rural Bangladesh providing survival swimming classes to children to identify unexpected consequences.Methods: A mixed-methods approach was used. Quantitative program monitoring data was analysed to assess gender differences in program staff recruitment, participation and engagement. A qualitative approach using interviews, focus group discussions and observations aimed to find explanations for quantitative findings and additional experiences of the program. The analysis was conducted using Family Health International 360’s Gender Integration Framework.Results: Women were not hired in leadership roles in the implementing organisation due to constraints on transport access and perceptions on women’s ability to conduct labour-intensive activities. However, the program influenced communities to become more accepting of local women’s mobility and involvement in employed work due to their engagement in the program as swim instructors. Women swim instructors were also more satisfied with the pay and part-time nature of the work as men were able to earn more elsewhere, and so women were recruited in higher numbers by the implementing organisation. Fewer girls participated in the swimming classes than boys due to cultural perceptions on appropriate activities for girls and their greater involvement in domestic work.Conclusions: Within the implementing organisation, changes to attitudes and the formulation of gender-specific strategies will support women in leadership roles, ensuring that women-specific issues are considered in program delivery. The implementing organisation may also consider strategies to combat perceptions that lower-paying part time work is more suitable for women than men. Systematised strategies are required to ensure equal participation of girls and boys in swim classes and enable equitable drowning outcomes. Addressing these issues would have positive implications for the health and equity of both men and women in these rural communities.

scholarly journals Impact of a rural drowning reduction programme in Bangladesh on gender equity, norms and behaviour: a mixed-method analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041065
Author(s):  
Medhavi Gupta ◽  
Aminur Rahman ◽  
Notan Chandra Dutta ◽  
Md Shafkat Hossain ◽  
Devaki Nambiar ◽  
...  
Keyword(s):  
Gender Equity ◽  
Low Income ◽  
Mixed Method ◽  
Gender Norms ◽  
Family Health ◽  
Leadership Roles ◽  
Middle Income ◽  
Gender Integration ◽  
Part Time ◽  
Gendered Roles

ObjectivesCommunity-based health programmes implemented in low-income and middle-income countries impact community gender norms and roles and relationships, which in turn affect individuals’ health outcomes. Programmes should measure their effects on gender norms, roles and relationships in the communities in which they operate to respond to unexpected health consequences. We conducted a gender analysis on a drowning reduction programme in rural Bangladesh to identify its impacts on gendered roles and behaviours in the community.DesignA mixed-method approach was used. Quantitative programme monitoring data were analysed to assess gender differences in participation and engagement. A qualitative approach using interviews, focus group discussions and observations with purposively selected programme implementing staff and participants aimed at finding explanations for quantitative findings and additional impacts of the programme on gender in the community. The analysis was conducted using Family Health International 360’s Gender Integration Framework, which identifies both internal (norms) and external (behaviours) effects.ResultsFewer girls (n=5030) participated in swimming classes than boys (n=6425) due to cultural restrictions and involvement in domestic work. Women were not hired in leadership roles in the implementing organisation due to lower transportation access and their perceived ability to conduct labour-intensive activities. However, communities become more accepting of local women’s mobility and employment due to their engagement as swim instructors. Women swim instructors were more satisfied with the pay and part-time nature of the work as men were able to earn more elsewhere. Menstruation management was ignored as all supervisory staff were men.ConclusionsSystematised strategies are required to ensure equal participation of girls and enable equitable prevention outcomes. Within the implementing organisation, programmatic changes will support gender transformation, such as ensuring women’s mobility and engagement in leadership roles. Strategies to combat perceptions that lower paying part time work is more suitable for women than men may be considered.

scholarly journals Gender Equity and Norms in Health Programs: Learnings from a Drowning Reduction Program in Bangladesh

2020 ◽  
Author(s):  
Medhavi Gupta ◽  
Aminur Rahman ◽  
Notan Chandra Dutta ◽  
Md. Shafkat Hossain ◽  
Devaki Nambiar ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Outcomes ◽  
Gender Norms ◽  
Health Programs ◽  
Leadership Roles ◽  
Gender Analysis ◽  
Community Based ◽  
Mixed Methods Approach ◽  
Reduction Program ◽  
Part Time

Abstract Background: Community-based health programs implemented in low-and middle-income countries have additional health impacts beyond their targeted outcomes, such as on gender norms, roles and relationships. Programs should measure their effects on gender to respond to any unexpected consequences. Hence, we conducted a gender analysis on a drowning reduction program in rural Bangladesh providing survival swimming classes to children.Methods: A mixed-methods approach was used. Quantitative program monitoring data was analysed to assess gender differences in program participation and engagement. A qualitative approach using interviews, focus group discussions and observations aimed to find explanations for quantitative findings and additional experiences of the program. The analysis was conducted using Family Health International 360’s Gender Integration Framework.Results: Fewer girls participated in the swimming classes than boys due to cultural perceptions on appropriate activities for girls and their greater involvement in domestic work. Women were not hired in leadership roles in the implementing organisation due to constraints on transport access and perceptions on women’s ability to conduct labour-intensive activities. However, the program influenced communities to become more accepting of local women’s mobility and involvement in employed work due to their engagement in the program as swim instructors. Women swim instructors were also more satisfied with the pay and part-time nature of the work as men were able to earn more elsewhere, and so women were recruited in higher numbers by the implementing organisation.Conclusions: Systematised strategies are required to ensure equal participation of girls and boys in swim classes and enable equitable drowning outcomes. Within the implementing organisation, changes to attitudes and the formulation of gender-specific strategies will support women in leadership roles, ensuring that women-specific issues are considered in program delivery. The implementing organisation may also consider strategies to combat perceptions that lower-paying part time work is more suitable for women than men. Addressing these issues would have positive implications for the health and equity of both men and women in these rural communities.Contributions to literature· Community-based health programs have impacts on gender norms, roles and relationships within their context of implementation, which in turn affect individuals’ health outcomes unexpectedly. These effects are rarely analysed.· This study describes a novel application of a gender analysis to a drowning reduction program in Bangladesh, using a mixed-methods approach.· We show that the program had positive impacts on women’s mobility and access to employment, but also identify opportunities for this program to actively transform harmful gender norms for equitable health outcomes.· Implementers of health programs may follow a similar methodology and framework to identify how they are affecting health outcomes through impacts on gendered constraints, norms and relationships.

Leadership and women: The space between us. Narrating the stories of senior female educational leaders in Malta

2020 ◽  
pp. 174114322092903
Author(s):  
Robert Vella
Keyword(s):  
Gender Equity ◽  
Catholic Church ◽  
Social Life ◽  
Educational Leaders ◽  
Women In Leadership ◽  
Leadership Roles ◽  
The European Union ◽  
Female Leaders ◽  
Doctoral Study ◽  
Training Programmes

The main objective of this research is to investigate the perceptions and experiences of senior female educational leaders in Malta, where senior leaders are considered as those leaders from the Minister of Education to leaders at directorial level. Although Malta’s laws relating to gender equity are in line with those of the European Union, traditional beliefs and values, including those shaped by the Catholic Church, mean that in many areas of social life, women and girls continue to be perceived as inferior. The study is framed within a constructivist and interpretivist paradigm and takes a narrative approach. Throughout 2017 to 2018, in-depth interview data was collected from eight senior female leaders in the Maltese education department. Data used from an ongoing doctoral study was analysed manually using a hybrid method in order to establish the relevant themes. The findings from the study demonstrated that women in educational leadership roles in Malta have to face challenges specific to their being female. The study recommends, among other things, real family friendly measures by organisations, organised professional development programmes for women in leadership and for those aspiring to be leaders, and training programmes focused on how to build healthy collegial relationships.

scholarly journals The intersectional role of paternal gender-equitable attitudes and maternal empowerment on child undernutrition in India

2021 ◽  
Author(s):  
Anupam Joya Sharma ◽  
Malavika Ambale Subramanyam
Keyword(s):  
Gender Equity ◽  
Family Health ◽  
Health Concern ◽  
Indian Children ◽  
Related Factors ◽  
Middle Income ◽  
Severe Stunting ◽  
Logistic Regression Models ◽  
Child Undernutrition ◽  
The Government

AbstractObjectivesUndernutrition is a major global health concern, especially for the low- and middle-income countries. Despite several programmatic efforts by the government, prevalence of undernutrition among Indian children under five years was about 38% in 2015. While studies have extensively investigated the influence of sociodemographic and maternal related factors on child undernutrition, the paternal factors and their interactions with other causal factors are understudied. To fill this gap, we conducted an intersectional analysis to assess the relationship between maternal, paternal, and wealth related factors with stunting and severe stunting among underfives in India.MethodsWe used a sample of 22,867 mother-father-child triads from the fourth round of India’s National Family Health Survey (2015-16). We fitted survey adjusted logistic regression models and further adjusted our models for several sociodemographic variables. Results: Our statistical models revealed that even among children from poorer households, those with either an empowered mother or a father with gender-equitable attitudes versus those with none such parents, had a lower odds of stunting (AOR: 0.92, CI: 0.84, 1.02) and severe stunting (AOR: 0.87, CI:0.77, 0.98), independent of all covariates.ConclusionWe argue that while women’s autonomy could reduce the risk of child undernutrition, focusing on men’s attitudes towards gender equity also holds promise for reducing undernutrition. Our findings not only underscore how patriarchy is embodied in undernourished children, but also suggest programmatic interventions to address this deep-rooted scourge in India.

Inclusion of people with psychosocial disability in low and middle income contexts: a practice review

2017 ◽  
Vol 4 (3) ◽  
pp. 72-81 ◽  
Author(s):  
Helen Lea Fernandes ◽  
Stephanie Cantrill ◽  
Raj Kamal ◽  
Ram Lal Shrestha
Keyword(s):  
Mental Health ◽  
Local Community ◽  
Global Mental Health ◽  
Economic Life ◽  
Health Programs ◽  
Middle Income ◽  
Psychosocial Disability ◽  
Practice Review ◽  
Mental Health Programs ◽  
Low And Middle Income

Much of the literature about mental illness in low and middle income countries (LMICs) focuses on prevalence rates, the treatment gap, and scaling up access to medical expertise and treatment. As a cause and consequence of this, global mental health programs have focused heavily on service delivery without due exploration of how programs fit into a broader picture of culture and community. There is a need for research which highlights approaches to broader inclusion, considering historical, cultural, social, and economic life contexts and recognises the community as a determinant of mental health — in prevention, recovery, resilience, and support of holistic wellness. The purpose of this practice review is to explore the experiences of three local organisations working with people with psychosocial disability living in LMICs: Afghanistan, India, and Nepal. All three organisations have a wealth of experience in implementing mental health programs, and the review brings together evidence of this experience from interviews, reports, and evaluations. Learnings from these organisations highlight both successful approaches to strengthening inclusion and the challenges faced by people with psychosocial disability, their families, and communities.  The findings can largely be summarised in two categories, although both are very much intertwined: first, a broad advocacy, public health, and policy approach to inclusion; and second, more local, community-based initiatives. The evidence draws attention to the need to acknowledge the complexities surrounding mental health and inclusion, such as additional stigmatisation due to multidimensional poverty, gender inequality, security issues, natural disasters, and additional stressors associated with access. Organisational experiences also highlight the need to work with communities’ strengths to increase capacity around inclusion and to apply community development approaches where space is created for communities to generate holistic solutions. Most significantly, approaches at all levels require efforts to ensure that people with psychosocial disability are given a voice and are included in shaping programs, policies, and appropriate responses.

scholarly journals 587. Equity in academic advancement: findings from an IDSA-sponsored survey of infectious disease physicians

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S357-S357
Author(s):  
Jennifer Manne-Goehler ◽  
Douglas Krakower ◽  
Jasmine R Marcelin ◽  
Carlos Del Rio ◽  
Wendy Stead
Keyword(s):  
Poisson Regression ◽  
Women In Leadership ◽  
Full Professor ◽  
Academic Advancement ◽  
Full Professorship ◽  
Research Survey ◽  
Time Work ◽  
Academic Faculty ◽  
Part Time ◽  
Part Time Work

Abstract Background Recent evidence has shown substantial disparities in the rate of advancement to full professorship among women as compared to men faculty in academic infectious diseases (ID). We sought to identify barriers to academic advancement overall and by gender among faculty physicians in this field. Methods We conducted a web-based survey of academic faculty in ID. The survey was made available to the IDWeek2019 attendees and digitally via email and social media to the IDSA membership at large from 9/18/19 – 11/8/2019. The survey assessed demographic characteristics and barriers to faculty advancement and achievement, building on prior research. Survey themes included faculty promotion track, part-time work history and a suite of questions about workplace atmosphere and policies related to career advancement. Multivariable Poisson regression models were used to evaluate the association between these factors and full professorship. Results Of 1,036 respondents, 790 were retained in the final dataset [Men: 322 (40.7%), Women: 458 (58.0%), Other: 10 (1.3%)]. 352 respondents were Instructors or Assistant Professors (38.5%), 198 were Associate Professors (25.1%) and 240 were Full Professors (30.4%). Fewer women reported that their promotion process was transparent (57.4% v. 67.6%, p=0.004) and more women Full Professors felt they had been “sponsored” compared to men at their same rank (73.3% v. 53.6%, p=0.002). In regression analyses (Table 1), gender, publications and clinical trial leadership were significantly associated with full professor rank and promotion transparency and NIH grants emerged as possible correlates of this outcome. Salary support, part-time work, women in leadership, faculty promotion track and sponsorship were not associated with this outcome. Table 1. Results of Poisson regression analysis Conclusion Sponsorship and transparency of promotion criteria differed by gender and emerged as potentially important factors associated with full professorship in academic ID. Future policies to promote equity in advancement should address these issues. Disclosures All Authors: No reported disclosures

scholarly journals The how tough is WASH framework for assessing the climate resilience of water and sanitation

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Guy Howard ◽  
Anisha Nijhawan ◽  
Adrian Flint ◽  
Manish Baidya ◽  
Maria Pregnolato ◽  
...  
Keyword(s):  
Climate Change ◽  
Rural Communities ◽  
Universal Access ◽  
Small Towns ◽  
Water And Sanitation ◽  
Middle Income ◽  
Sanitation Services ◽  
Middle Income Countries ◽  
Measurement Framework ◽  
Low And Middle Income

AbstractClimate change presents a major threat to water and sanitation services. There is an urgent need to understand and improve resilience, particularly in rural communities and small towns in low- and middle-income countries that already struggle to provide universal access to services and face increasing threats from climate change. To date, there is a lack of a simple framework to assess the resilience of water and sanitation services which hinders the development of strategies to improve services. An interdisciplinary team of engineers and environmental and social scientists were brought together to investigate the development of a resilience measurement framework for use in low- and middle-income countries. Six domains of interest were identified based on a literature review, expert opinion, and limited field assessments in two countries. A scoring system using a Likert scale is proposed to assess the resilience of services and allow analysis at local and national levels to support improvements in individual supplies, identifying systematic faults, and support prioritisation for action. This is a simple, multi-dimensional framework for assessing the resilience of rural and small-town water and sanitation services in LMICs. The framework is being further tested in Nepal and Ethiopia and future results will be reported on its application.

scholarly journals Inclusive participation, self-governance, and sustainability: Current challenges and opportunities for women in leadership of communal irrigation systems

2020 ◽  
pp. 251484862093471
Author(s):  
Laura Imburgia ◽  
Henny Osbahr ◽  
Sarah Cardey ◽  
Janet Momsen
Keyword(s):  
Water Management ◽  
Irrigation Management ◽  
Women In Leadership ◽  
Small Scale ◽  
Leadership Roles ◽  
Irrigation Systems ◽  
Representation Of Women ◽  
Water Users ◽  
Challenges And Opportunities ◽  
Current Water

Genuine inclusive participation in the self-governance of communal irrigation systems remains a challenge. This article analyses the mechanisms of participation in irrigation water users’ associations (WUAs) with focus on women as leaders of those organizations by drawing on cases from a comparative, multicase mixed-method study in Ethiopia and Argentina. After having being a topic for decades in gender and development debates, in many irrigated areas of the world, WUAs continue to be male dominated at all levels, especially in influential positions. Findings in this article suggest that despite large socio-economic and cultural differences, the current water management systems in both research locations reinforce problems of unequal gender participation; women have more obstacles and constraints in establishing equal access in membership, participation, and decision making in irrigation management. The lack of inclusive participation and the low representation of women in leadership roles lead to WUAs being poorly rooted in their community of users. Incomplete social rootedness of WUAs jeopardizes their effectiveness and equality in water management and, as a result, affects long-term sustainability. Through analysis of empirical data of communal small-scale irrigation systems in both countries, the article discusses who participates, how and why they participate, and the reasons for low numbers of women in leadership roles within the WUAs. Finally, the article reflects on possible enabling conditions that could foster inclusive participation, increase the quantity and capacity of women in management and leadership roles, and the benefits this may bring to sustainable irrigation systems.

scholarly journals Prevalence and maternal socio-demographic factors associated with stillbirth in health facilities in Anambra, South-East Nigeria

1970 ◽  
Vol 19 (4) ◽  
pp. 3055-3062
Author(s):  
Nonye E Anyichie ◽  
Evelyn N Nwagu
Keyword(s):  
Rural Communities ◽  
Demographic Factors ◽  
Health Facilities ◽  
Women Empowerment ◽  
Middle Income ◽  
Anambra State ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Case Files ◽  
Socio Demographic Factors

Background: Stillbirth is a major adverse perinatal outcome especially in low and middle income countries across the globe. Certain factors relating to mothers from such countries may be associated with this adverse condition.Objectives: To determine the prevalence of stillbirth and also explore the maternal socio-demographic factors associated with stillbirth among mothers in rural communities in Anambra Central Senatorial District of Anambra State Nigeria who gave birth between January 2012 and December 2016.Methods: All case files of mothers who were delivered of their babies were accessed at the sampled health facilities in the district. Data were collected using a structured proforma. A total of 313 stillbirth cases were recorded across the health facilities from 2012-2016.Results: The highest prevalence of stillbirth was recorded in 2012 (38.07 per 1,000 total births). The prevalence of stillbirth was significantly associated with the maternal level of education, occupation, age and type of health facility the mother utilized (p<0.05).Conclusions: We recommend that women empowerment should be a priority at both family and community levels to enable women to seek and obtain necessary care during pregnancy and delivery.Keywords: Stillbirth; mothers; prevalence; health facilities.

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