ROLE OF GENDER IN RELATION TO HEALTH.

Definition of gender

•This is the socially constructedroles and responsibilities assigned by society to men, women, boys and girls and the relationships between men and women, boys and girls in a given culture, setting.

•This changes over time, from birth, childhood, puberty and adult life. This is also reflected in the impact•This is related on how men and women are perceived and how they perceive themselves, how they are expected to think or behave because of the way society is organized and because of the biological differences.

Health•State of well-being:-physical, mental and psychological and not merely absence of disease.

Gender issues that relate to health1. Education

2.Marriage

3.Fertility and family planning

4.Contraceptive use

5.HIV/ AIDS as a gender issue

6.Physical violence as a gender issue

7.Sexual violence as a gender issue.

Gender issues and Health.1. Education:Women are less educated than men.(i) Comparative lack of education limits access to opportunities for employment, choices and exercise of rights. (ii) Lack of education leads to;•Poverty•ill health•poor access to health services•Lack of participation in decision-making (ignorance and lack of financial resources)•Lack of information.2. MarriageMen marry later than women. This gives them a comparative advantage in terms of access to:(i) Information(ii) Education(iii) Better jobsTherefore better bargaining power than women counterparts who get married early particularly in decision making

3. Fertility and family planning(a)Gender differences are among the many influences of •child birth patterns (where to give birth)

•numbers of children,

•contraceptive use,

•fertility preferences: men seem to want more children than women.

4. Contraceptive use thought to be a women’s issue.Access by women-Decision-ResourcesAccess by men:(i) Most methods are female related(ii) Access to services –Health systems are usually female oriented.

5. HIV/ AIDS as a gender issue•Women have less individual choices in sexual relationships they are expected to be submissive)

•Women lack ability to protect themselves (male condom use)

6. Physical violence as a gender issue•Studies done show that women get affected by physical violence more often than men

•Perpetuatorsin women are most often intimate partners

•Married women are more likely to experience violence than unmarried

7. Sexual violence as a gender issue•4:10 women experience sexual violence compared to 1: 10 men

•Commonest among women divorced, separated and married

•A 1/4 of women their first sexual encounter is forced.

•Few men experience emotional violence from wives

Health Implications1.Physical trauma

2.Psychological trauma/stress.

3.Social implications

4.Sexual Reproductive Health Implications (Rape and Defilement)

5.Implications for HIV/ AIDS

6.Violence in pregnancy Women

7.Family planning implications

Health Implications1.Physical trauma such as injury causes victims to feel a high level of fear (Tjaden&Thoennes, 2000).

2.Psychological trauma/stress. This occurs with all forms of violence. It is associated with humiliation (Garcia-moreno et al., 2005)

3.Social implications though the effects may take longer to manifest e.g remarrying, have extramarital relations, child abuse and care4. Sexual Reproductive Health Implicationsi). Rape and Defilement;a) STIs including HIV infectionsb) Tears and lacerations of the genital tract that may require surgery for repair and its associated complications, bleeding, infectionc) Psychological trauma of the experience; anxiety, depression, fear sex thereafter as they associate it with the experience

ii). Pregnancya) From unknown fatherb) Unwanted/ unplannedc) Unsafe abortion and associated complications, infection, trauma to the genital tract including perforation of the uterus –may be taken out, girl remains infertile for life-can die. Death of the affected from the acts, intentional murder (Heise et al., 1999; Guedes, 2004) Krug et al., 2002)

5. Implications for HIV/ AIDS•Lack of disclosure resulting in infecting partner, MTCT

•Violence resulting in separation, physical trauma, psychological trauma through stigmatization, segregation.

•Forced sex (Jansen et al., 2002)

•Refusal to use safer sex means because they are either threatened, or are exploited and cannot insist on use of condoms.

6. Violence in pregnant Women•Abortion

•Intrauterine death of the fetus as result of placental separation

•Premature birth -resulting in poor survival, later in life may result in poor intellectual performance

•Premature labour and delivery

•Induced abortion results death and related adverse health effects

7. Family planning implications•Refusal of women to use contraceptives

•Physical and Psychological trauma/stress

•Unwanted pregnancy

•Induced abortion

•Maternal death

How sex of an individual affect health outcomes.•Smoking (nicotine)a) Male smokers suffer reduced fertility and potency while female smokers suffer, low birth weight, early menopause, and cardio vascular Diseases•HIV-Females are more vulnerable

a) Due to larger surface area exposed during sexual intercourseb) Due to friction and possible bruises that enhance transmission

How Gender may affect health Outcomes.•Adolescent girls may be very conscious of their bodies leading to extreme slimming resulting in menstrual complications, ovarian failure etc.

•Inadequate cooking facilities expose women to higher risk of respiratory infection

•High risk behavior among driving men than women.

Gender Gaps•More male involvement in health matters

•Health facilities that are male friendly

•Timing of services to suit every one.

•Health workers appreciation between men and women

•The less assertiveness of women while men rarely admit ignoranceSupportive environment for men to fight gender violence•IEC materials for men

•Specific services for men

•Community activities for men’s health

•Understanding of men by health professionals

Conclusions•Gender has a critical role in the promotion or hinders good health

•Communities and health professionals need to be aware of the differencesin response to various situations by different sexes

•There is need to address the inequities created as a result of one’s sex and the gender roles, responsibilities, biases as well as services provided.