migration of girls & women - · pdf file · 2015-06-242015-06-24 ·...
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MIGRATION OF GIRLS & WOMEN
Carol S. Camlin, PhD, MPH Dept. of Obstetrics, Gynecology & Reproductive Sciences
& Center for AIDS Prevention Studies University of California, San Francisco
Summer Institute on Migration and Health
24 July 2015, Oakland, CA
CONSEQUENCES FOR THEIR EMPOWERMENT
& HEALTH
Migrant adolescent girls and women: an important population in a world
undergoing rapid social transformations
International migration is increasing…
… and about half of all int’l migrants are female
Source: P. Martin, Population Reference Bureau, 2013
A feminization of int’l migration is underway
Percentage of women among all international migrants, 1990-2013
Source: UN Dept of Economic & Social Affairs, 2013
A global feminization of internal migration underway even longer (since ~1970s)
• Most migration is internal migration • Intra-sub Saharan Africa (SSA) emigration rate (65%) =
largest movement of people in the world (IOM 2005)
• Even in Africa, ≥ half of internal migrants are female (it’s not just truckers & miners) • Internal migration rates peak in young women
• Novel, complex forms of mobility are starting to predominate, because of women’s participation
Migration a major force for development – especially female migration
• Migration an important livelihood strategy for poor groups across the world • It’s not only a response to household shocks (IOM 2005)
• Female migration particularly benefits the poorest of the poor
• Migration as a force for development – especially women’s migration – is under-recognized
• Women's migration as a consequence of empowerment
• Changes in gender norms lifting of traditional constraints on women’s migration (Bozzoli 1991, Chant & Radcliffe 1992, Todes 1998, Jones 1994)
• Women's migration as a cause of empowerment
• Employment in destinations puts resources under women's control increased valorization as contributors to household income more equitable gender relations
• Provides opportunities to achieve aspirations, e.g. for autonomy, independence, and more gender-equitable relationships
(Assogba and Fréchette 1997, Lesclingand 2004, Hunter 2007, Camlin 2013)
Migration also a major force for women’s empowerment
Our research among female migrants in Kenya
Dignity, self-confidence & self-sufficiency • “I can now survive and look after myself.”
• “I can live independently… I have learned how to manage my finances.”
• “I can now see and detect when someone wants to harm me.”
Autonomy in decision-making • P2: “There are things that I can now do on my own that gives me joy and pride. If you
are living with someone, there are things that you cannot do because of fear. But now I feel liberated…. Ultimately it is me who gets to choose what to do and what not to do, not someone else.”
Social capital • “…coming to Kisumu has connected me to many other people”
• “I came to Kisumu and met a lot of friends… These are people who even advised me to have an HIV test […] These friends helped me to get a market stall.”
Improved gender relations in household • “We have in fact loved each other more than ever. We both make our money and no
one is a burden to the other.”
• “Nowadays he is a gentleman. He asks for things in a polite tone. His approach towards me is kind unlike in the past when he used to beat me and hurl insults at me.
But migration has negative health consequences, e.g. increased risk of HIV
• Aims of my studies in Kenya since 2008: • Characterize forms of mobility among women
• Describe spatial & social features of key destinations
• Describe behaviors and factors in social contexts that
facilitate risks for female migrants
• Test strategies to sample populations of highly mobile
women for surveys of mobility & HIV prevalence
Kibuye female market trader survey (2014)
Design:
1. Every market stall mapped
using GPS coordinates,
along with gender of trader
• Sampling frame: Total N=
6,674 stalls
2. Sample of n=306 stalls with
female traders randomly
selected from sampling
frame
Kibuye female market trader survey: HIV
prevalence
Overall: 25.8% (21.2 - 31.0, 95% CI) • Higher than Kisumu County prevalence in women in 2009 (20.9%) and
KAIS estimate for Kisumu women ages 15-49 (15.1%) in 2013
11.6
29.3 27.4
0
10
20
30
40
50
18 to 24 25 to 34 35 or older
Pro
po
rtio
n
HIV Prevalence (95% CI) by age group
Results of qualitative research (2010-2013)
Aspects of women’s migration experiences that may facilitate HIV acquisition risk at origin:
Before migration:
Widowhood
Separation or divorce
Gender-based violence
Exposure to HIV from spouse or ‘inheritor’ LOSS of property, housing, land, livelihood Social isolation & vulnerability
Results
Aspects of women’s migration experiences that may facilitate HIV acquisition & transmission risks at destination:
• Transactional sex among female informal sector traders: “she mixes her business”
• At beaches, participation in sex-for-fish economy - “jaboya system”
• High HIV risk behavior and vulnerability to sexual assault among house-helps
Transactional sex & commercial sex work among traders: Covert Overt
Source: internet (no copyrights)
Highly mobile women in western Kenya
• At high risk of transmitting HIV • Circumstances that drive migration, e.g. widowhood, also increase HIV risk
at origin
• At high risk of acquiring HIV infection • Migration contexts facilitate multiple main partners, transactional sex,
CSW
Conclusions re: HIV risks
Conclusion
Highly mobile women in western Kenya
• At high risk of transmitting HIV • Circumstances that drive migration, e.g. widowhood, also increase HIV
risk at origin
• At high risk of HIV acquisition • Migration contexts facilitate multiple main partners, transactional sex,
CSW
• Migration can be empowering • But women are still disempowered relative to men
• Thus are still at higher risk of HIV because of disempowerment
In conclusion
• Migration processes for women provide opportunities for empowerment that could be better harnessed
• Gender empowerment is the critical next step to mitigating the negative health consequences of migration
Acknowledgments
• Participants in the research
• Co-Investigators and collaborators: Z. Kwena, E. Bukusi (Kenya Medical Research Institute-KEMRI), C. R. Cohen, S. Dworkin, M. Johnson, T. Neilands, M. Comfort, W. McFarland (UCSF)
• Research team members: L. Achiro, S. Ambunya, M. Okumbo, P. Olugo, C. Makokha, D. Ang’awa (KEMRI)
• Funders • NIMH: (1K01MH093205-01)
• NIAID: UCSF-Gladstone Institute of Virology & Immunology Center for AIDS Research (CFAR) (P30 AI27763) & UC Berkeley Fogarty Int’l AIDS Training Program (AITRP), NIMH: UCSF-CAPS (2 P30 MH-062246-11)
• University of California Global Health Institute (Junior Faculty Fellowship)