IntraHealth Senior Technical Advisor Presents at Equity in Health Conference

Constance Newman, IntraHealth International’s Senior Technical Advisor for Gender Equality and Women’s Rights, presented the results of three gender-related studies at the 5^th Conference of the International Society for Equity in Health, in Heraklion, Crete, Greece, June 9–11, 2009. This conference, in partnership with the Greek School of Public Health and the Canadian Society for International Health, focused on social and societal influences on health equity.

Titled “Health Services for Survivors of Gender Violence in Rwanda,” Newman’s paper presentation was based on the Twubakane Program’s 2008 assessment of the readiness of health facilities, the politico-legal environment and the community to respond to violence against women (VAW) in three Rwandan districts. The presentation examined the cultural/psychological, socioeconomic/external and structural/institutional barriers to service use. While positive health provider attitudes about caring for victims were identified by the assessment, issues arose such as weak knowledge about VAW; weak knowledge and skills; lack of service delivery protocols and client education materials; geographically and financially inaccessible antenatal care services that are unresponsive to survivors; economic dependence of women living in violent relationships; and a culture of silence and impunity which perpetuates violence. Based on these results, the study recommended:

• a multi-level response targeting policy, health systems and community
• multi-sectoral collaboration between health facilities, police and community organizations to support women, to end impunity for violence and increase access to client-friendly health services, psychosocial support  and solidarity networks, justice and to productive and economic resources.  

Follow-on activities include the development and implementation of GBV sensitization and training modules and technical assistance to the Rwanda National Police to revise their GBV standard operating procedures.

Newman also presented the results of two Capacity Project studies in two posters: “Alleviating Women’s Burden of HIV/AIDS Care in Lesotho” and “Violence and Gender Discrimination in the Health Sector in Rwanda” The former covered the burdens placed on women and girls by gender-segregated HIV/AIDS caregiving in Lesotho. Stereotypes about essential “male” and “female” traits and status beliefs have kept women in voluntary HIV/AIDS caregiving and men out of it. The poster presentation highlighted that engaging men in caregiving is feasible with financial incentives, training and support, but that programs need to continue supporting the women who carry a disproportionate burden of caregiving. The second poster presented the results of a 2007 study conducted by IntraHealth through the Capacity Project in Rwanda, to determine the nature, prevalence, causes and consequences of workplace violence on health workers. The study found that 39% of health workers in the Rwanda sample had experienced some form of workplace violence in the preceding year. Negative stereotypes, sexual harassment, discrimination based on maternity and family responsibilities and the “glass ceiling” affected some female health workers’ experiences and career paths. Unequal experiences at work were associated with absenteeism and health impacts. The perception of gender discrimination is related to increased odds of experiencing violence at work. Negative stereotypes of women at work seem to justify violence. Violence and discrimination must be addressed concurrently.