NATIONAL MEETING ON WOMEN, HEALTH AND DEVELOPMENT

Item

Title: NATIONAL MEETING ON
WOMEN, HEALTH AND
DEVELOPMENT
extracted text: NATIONAL MEETING ON
WOMEN, HEALTH AND
DEVELOPMENT
New Delhi, 21 October 1993

World Health Organization
Regional Office for South-East Asia
New Delhi, India

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NATIONAL MEETING ON
WOMEN, HEALTH AND
DEVELOPMENT

New Delhi, 21 October 1993

World Health Organization
Regional Office for South-East Asia
New Delhi, India

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Participants

LIST OF PARTICIPANTS

National Meeting on Women, Health and Development
New Delhi, 21 October 1993
Government
Dr (Ms) Jotna Sokhey. Deputy Commissioner, Department of Family Welfare, Ministry of Health & Family
Welfare, Nirman Bhawan, Maulana Azad Road, New Delhi-110011

Mrs Namita Pradhan, Director (International Health), Ministry of Health & Family Welfare, Nirman
Bhawan, Maulana Azad Road, New Delhi-110011

Dr (Mrs) Prema Ramachandran, Deputy Director-General, Indian Council of Medical Research, Post Box
4509, Ansari Nagar, New Delhi-110029.
Ms Geeta Sethi, National Consultant, National AIDS Control Organization, IRCS Building, 2nd floor, 1,
Red Cross Road, New Delhi-110001.

Institutions and Nongovernmental Organizations
Ms Indu Capoor, Centre for Health Education, Training, and Nutrition Awareness (CHETNA), Lilavatiben
Lalbhai's Bungalow, Civil Camp Road Shahibaug, Ahmedabad-380004

Ms Divya Pandey, SNDT Women’s University, Vithaldas Vidyavihar, Juhu Road, Santacruz West,
Bombay-400049
Ms Jessie Edith, Programme Coordinator (Health), Working Women's Forum. 55, Bhimasena Garden
Road, Madras-600004

Dr Veena Shatrughna, Shree Shakti Sangathana, C/o National Institute of Nutrition, Jamia-Osmania,
Hyderabad-530001

Ms Mirai Chatterjee, Self Employed Women’s Association (SEWA), Opp. Victoria Garden, Ellis Bridge,
Ahmcdabad- 380001

Dr Thelma Narayan, Coordinator, Community Health Cell, and Medico Friends Circle, Jakkasandra, 1st
Main, 1st Block, Koraniangala, Bangalore-560034
Dr Sara Bhattacharji, Professor of Conununity Health, Department of Conununity Medicine, Christian
Medical College. Thorapadi, Vellore-632 002
Dr Amita Varma, Director, Household Development Studies Information, Department of Women
Development & Family Studies, Faculty of Home Sciences, M.S. University. Baroda-390002
Ms Hamida Allana, Inchaige, Women's Portfolio, Aga Khan Council for India. 305, Maker Bhawan, 21,
New Marine Lines, Bombay-400020
Ms Kalpana Mutatkar, Chief, Leprosy Relief Organization, 634 Anand Park, Aundh, Pune-411007

Dr Neena Raina, Survival for Women & Children Foundations WACH), 636, Sector 16-D,
Chandigarh-160015

Ms Nei Donuo, Naga Mother's Association, Post Box 10, Kohima

Dr Padma Prakash, 19, June Blossoms Society, 60-A. Pali Road, Bandra, Bombay-400050

Mrs Aloka Mitra, Women's Interlink Foundation, 23/1 Ballygunge Station Road. Calcutta-700019
Dr Shobhalal Kapoor, A-103, Eden Enclave. Hiranandani Garden. Powai, Bombay- 400076

Dr Elizabeth Vallikad, Professor of Gynaccologic Oncology, Kidwai Memorial Institute of Oncology,
Hosur Road, Bangalore-560029

Ms Seethalakshmi, Principal, Sri Ramakrishna College of Nursing, 395, Sarojini Naidu Road,
Coimbatore-641044
Dr Kumud Sharma, Director, Centre for Women's Development Studies, 25, Bhai Vir Singh Marg, Gole
Market, New Delhi-! 10001

Dr Mira Shiva, Head, Public Policy Division, Voluntary' Health Association of India, Tong Swasthya
Bhawan, 40, Institutional .Area, Near Qutab Hotel, New Delhi-110016

Ms Kalpana Mehta, Saheli, 15-18, Defence Colony Flyover Market, New Delhi-110024
Mrs C.P. Sujaya, Institute of Social Studies Trust, 5, Deen Dayal Upadhyay Marg, New Delhi-110002

Dr Urmil Gupta, Brahmakumari World, Spiritual University, 25, Rohtak Road, New Delhi-110005
Dr (Mrs) S. Sachdeva, President, Geriatric Society of India, S-l 15, Panchshecl, New Delhi

UN and Donor Agencies
Mr B.K. Rao, Programme Officer, United Nations Development Programme, 55, Max Mueller Marg, Lodi
Estate, New Delhi-110003

Ms Madhubala Nath, Regional Programme Adviser, United Nations Development Fund for Women, World
Wildlife Building, 172-B, Lodi Estate, New Delhi
Dr Saroj Pachauri, Ford Foundation, 55, Max Muellor Marg, Lodi Estate, New Delhi -110003

Dr Nalini Abraham, Programme Officer, Danish International Development Agency, Royal Danish
Embassy, 11, Aurangzeb Road, New Delhi-110011
Dr Monisha Behl, WID Adviser, Canadian International Development Agency, G-l/66, Vasant Vihar,
New Delhi
Mrs Deepa Rajan, Health & Population Projects Manager, British Council Division, 17, Kasturba Gandhi
Marg, New Delhi-110001

WHO Secretariat
South-East Asia Regional Office
Dr (Ms) Sally Ann Bisch, Chairperson. (WHD), World Health Organization, World Health House,
Indraprastha Estate, Mahatma Gandhi Road. New Delhi-110002
Dr Saroj Jha, Co-Chairperson, WHD
Mrs Vijay Sethi, Secretary, WHD
Mrs Preeti Chandra
Mrs .Asha Kukreja
Miss Nisha Jain

Office of the WHO Representative to India
Ms Carol Larivee, Health Education Specialist, GPA-I, World Health Organization, IRCS Building, Second
floor, 1, Red Cross Road, New Delhi-110001
Mrs Radha Swaminathan, WHD Focal Point, World Health Organization, Room 533, A Wing, Nirman
Bhawan, Maulana .Azad Road, New Delhi-110011

The National Meeting on Women, Health and Development (WHD) was
organized by the India Office of the World Health Organization (WHO) on 21
October 1993 at the Hamdard Convention Centre, Hamdard Nagar, New
Delhi. In all, 40 participants attended the meeting, representing the Ministry
of Health and Family Welfare and other bodies of the Government of India;
health and educational institutions and non-govemmental organizations from
various States; WHO Offices for India and for the South-East Region; and UN
and donor agencies. The list of participants is attached.

The overall purpose of the meeting was two-fold: (1) to provide an
orientation on the Women, Health and Development initiative in WHO and the
newly established Global Commission on Women's Health, and (2) to identify
issues of major concern to the health of women in India and propose broad
strategies for addressing the issues identified. It was intended that the outputs
of the meeting would provide means for identifying priorities for country level
WHO activities related to WHD as well as substantial technical inputs to the
Global Commission on Women's Health.

The meeting was inaugurated by H E. Mrs Margaret Alva, Minister of
State for Personnel, Public Grievances and Pensions, Government of India. Dr
D.B. Bisht, Acting Regional Director, Regional Office for South-East Asia,
welcomed the participants on behalf of WHO.

INTRODUCTION
Dr Sally Ann Bisch, Chairperson, Women, Health and Development, WHO
Regional Office for South-East Asia, presented an overview of the WHD
initiative in WHO and recent developments, including the establishment of the
Global Commission on Women's Health. The Commission consists of
political, scientific and professional leaders throughout the world, the largest
number of whom are women, who serve in their personal capacities. The
Commission is expected to adopt a grassroots strategy whereby the technical
groundwork, including inputs and follow-up actions, will be supported by

country and regional networks of individuals, institutions and organizations,
both governmental and non-governmental, who are already actively involved
in a broad range of women's health and related development issues. The
Commission will soon convene its first meeting and is expected to provide a
forum for consultation and dialogue on women's health, to advocate for
women's health issues and to produce an agenda for action on women's health
She noted that the WHD initiative and the Commission are adopting a life
cycle approach in which women's health is conceived as encompassing their
health throughout their entire life-span, not only through the reproductive
years, and in all aspects of their lives. Facets of women's health deserving
greater attention include health issues of women at work in the home as well
as in the formal and informal work sectors, life-style related health conditions,
health consequences of violence, and aging.

The participants continued the discussion in four working groups. The
atmosphere of tire group discussion was marked by enthusiastic dialogue and
open debate on priority women's health issues and strategics. The participants
welcomed the opportunity' for a free exchange on a broad range of issues,
although the time to address each issue was limited.

OUTCOMES
The issues that emerged from the group discussions fell into three main areas;
(1) issues dealing with specific women's health concerns, (2) issues related to
health services, and (3) issues related to macro-level policies affecting
women's health. An overall theme that emerged was the endorsement of a life
cycle approach as the basic framework for addressing women's health and
development issues. In fact, many of the specific women's health concerns that
emerged followed this framework, i.e. from the concerns surrounding selective
abortion of female foetuses and female infanticide; nutrition, education and
child abuse in early childhood; early marriage, early pregnancy and sexual
exploitation in adolescence; reproductive and sexual health, fertility regulation,
occupational health hazards, overburden and stress-related disorders in the
productive and reproductive age category; and menopause and emotional
health associated with aging.

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Issues

Broad Strategics

SPECIFIC WOMEN'S HEALTH CONCERNS
General lack of accurate
gender and age specific
morbidity, mortality and
disability data which is
essential in order to have an
understanding of a complete
picture of women's health
problems across their life
span and in all aspects of
their lives.
2.
Health issues of women at
work in both formal/ infor
mal (unorganized) sectors
and in the house-hold. Lack
of
information
about
women's workload and
impact on health, including
exposure to environmental
and work-related health
hazards. Undervaluing of
women's health complaints
relative to work, especially
sexual harassment and
psycho-logical stress.
3.
Violence against women,
including
physical
and
emotional abuse in the home
and the workplace, sexual
harassment, rape, incest,
dowry harassment, human
rights violations. Lack of
adequate information on the
nature and extent of health
consequences despite the
increase in incidence.

Collect gcndcr/age disaggregated data at all levels by
national, regional and community-based organizations
Inculcate sensitivity on gender issues in health and
development related research.
Reorient research institutions and support research studies
to focus on gender differentials, e.g. in communicable
diseases like IB and STDs, with wide dissemination of
findings.

Stimulate and support small-scale studies by governments,
NGOs. and women's, health and consumer groups
Provide resources to study new, less hazardous technolo
gies.

Impart health education in the workplace on workers'
health and safety'.
Review and analyze existing occupational health laws and
regulations and development of mechanisms to ensure their
proper implementation.

Institute mechanisms to provide pensions and social
security for women.

Stimulate further dialogue by women and women's groups.
Conduct seminars to inform and sensitize mass media.

Use media, existing movements, networks and campaigns.

Review and analyze existing laws and regulations.

Support legal literacy.
Promote economic empowerment of women (work and
asset creation).
Develop shelters for women through women's groups.
Provide rehabilitation for women, including emotional
support and work opportunities.

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4.
Impact of new contra
ceptive and reproductive
technologies on women’s
health, particularly adverse
side effects. Treatment of
women as targets in family
planning
programmes
contributing to continued
low status of women.

Psychological and mental
health, i.e. low self-esteem;
substance abuse.

Conduct more research on new technologies and their
sidcefTccts.

Disseminate widely debate on findings before large-scale
promotion of technologies.

Support development of safe, effective female-controlled
technologies.

Use available resources to create/promote positive images
of women in society, i.e. mass media, education in the
schools, changes in parenting practices.
Make counselling and education services available and
easily accessible.

Advocate to create awareness and support.

Mobilize women's self-help groups.

6.
Special
problems (e.g.
health, social, legal) of
aging/cldcrly
women.
Breakdown of traditional
support system and increase
in number of older women
necessitating greater outside
support to attend to their
needs, but which is not
being adequately addressed
in the health care system.
7.
STDs and AIDS, parti
cularly negative messages
and misinformation. View
of women as vectors of the
vims and responsible for the
spread of HIV infection
rather than as vulnerable
recipients.

Tram personnel to care for elderly women in their homes
through assistance of NGOs along with governments.

Initiate health promotion programmes for older women to
maintain health and well-being.

Support families who have disabled older female members
to enable them to obtain the health care needed

Widely disseminate information through health education
and training involving local and community-based groups.

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HEALTH CARE SERVICES
1.
Gender discrimination in
health care as a reflection of
society
as
a
whole,
insensitivity to women's
perspectives, and distortions
in health care expenditures.

Reorient and restructure the health care system
(modification of PI-IC approach) to be sensitive to
sociocultural milieus and to women's needs and priorities,
i.c. timings and location of health facilities suitable to
women's work/houschold responsibilities.
Reorient and sensitize medical professionals to women's
perspectives and concerns.

Integrate gcnder/sexuality issues in existing curricula.

Conduct participatory research involving women in the
design, implementation and analysis of studies.

Promote awareness-raising and advocacy using mass media
on specific discriminatory practices, eg. female
focticide/in fanticide.
Allocate appropriate health resources for programmes
directly affecting women

Mobilize NGOs to create strong political lobby
2.
Centralized health care
system fostering inadequate
involvement
and
consideration of choices of
women.
Limited
local
accountability,
decision
making and control.

Decentralize health services planning and implementation
to local level.
Use Panchayati Raj for local planning and monitoring of
health services.

Strengthen local women's groups and organizations to
develop and be responsible for local planning,
implementation and monitoring of health services
Promote involvement of local female health functionaries.

Restructure health care delivery from a vertical to an
integrated, rational, humanistic approach.
Link health services to other development programmes at
local level, i.e. PDS, ICDS. education, employment, etc

Develop qualitative indicators for monitoring health
services
3.
Target approach in health
services delivery,
with
women viewed as targets for
specific purposes, such as
population control.

Promote involvement of women as active participants in
policy and decision making at national and local levels and
in the formulation, implementation and monitoring of
programmes.

Redefine targets for health indices, e.g. MMR.

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4.
Women's
health
care
including
reproductive
health and contraception.

Develop integrated female-oriented services which are
nondiscriminatory, easily accessible and which provide
sensitive counselling and education in addition to direct
services.
Expand reproductive health services to include RTIs,
STDs. AIDS and common gynaecological problems.

Promote research and innovative interventions which
incorporate men's responsibility as well as women's (or
families') for contraceptive use.
Promote sexuality and lifestyle education in schools.

Strengthen MTP services.
5.
Lack of proper information
for women on their own
bodies and health, the health
system,, etc. Yet information
and education can be
empowering, leading to
greater awareness and
greater demand for services.

6.
Inadequate use of traditional
wisdom and knowledge of
women related to food,
health, etc. and traditional
practices.

Produce and disseminate health education materials.

Create forums for exchange of experiences on health
matters, i e. small group discussions, training.

Use mass media.

Conduct research on traditional practices.
Integrate of traditional and modern practices and resources.

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POLICIES AFFECTING WOMEN
Development of economic
policies and programmes
outside the health sector, i.e.
structural adjustment, envi
ronment, etc., which often
have adverse effects on
women, c.g. erosion of food
security, deterioration of
nutritional status, destruc
tion of natural resources,
increase in prostitution, etc.

Implement short and long term strategies to work for
mitigation and ultimate prevention of negative conse
quences, such as:
assess and analyze effects on women;

provide a health component in development projects;
monitor effects at household level, c.g. food consump
tion;
promote community-level management of development
projects;
dialogue and interlink among the various departments
and sectors involved;

strengthen women's representation in the Panchayat
system;

train women to be able to have effective influence;
make health system sensitive to emerging problems and
consequences of policies;

mobilize various groups, c.g. UN/national agencies,
women's groups, NGOs;
create pressure groups at local, national and interna
tional levels;
sensitize administrators, policy makers, researchers,
media. NGOs, etc. to adverse effects of destruction of
natural resources;

widely disseminate information through campaigns and
mass media to create awareness and support.

2.
Population policies which
arc adversely affecting
women's health and well
being.

Modify family planning programmes to:
eliminate target approach, camps, incentives and
disincentives.
be user rather than provider oriented;
ensure informed consent,

provide appropriate, acceptable contraceptive technolo
gies and essential back-up services.

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CONCLUSIONS
A number of issues were discussed throughout the day. No attempt was made
in the concluding session to arrive at a consensus on the top priorities.
However, several key themes seemed to emerge again and again and thus
pointed the direction for future action. These are:
The need for more gender and age-specific data and research on
women's health issues and related concerns.
The need to sensitize policy and decision-makers, both men and
women, to gender issues.
-

The need for greater involvement of women and women's groups at
all levels in policy-making and in the design, implementation and
monitoring of health programmes.
The need to reorient/restructure the health care system, including
health personnel to be more sensitive to gender issues, humanistic and
responsive to women's needs and priorities.

-

The need to adopt a life-cycle approach to women's health so that
health care strategies are designed to cover the broad spectrum of
women's health problems through an integrated approach.

FOLLOW-UP
A number of suggestions were made for follow-up, including those which
could be undertaken by WHO:

(1)

Compile and review information already available on women's health
from completed and ongoing research, even small-scale studies, in
order to build on this knowledge base and identify priority areas for
continued and/or new research.

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(2)

Critically examine the impact of national development and related
policies on women's health.

(3)

Set up processes for women and women's groups to continue the
dialogue on women's health and share concerns, experiences and
expertise.

(4)

Disseminate information on women's health issues through a newsletter
or other mechanisms.

(5)

Develop a database to promote and support networking among NGOs,
women's groups, government, and UN and donor agencies

(6)

Promote a multicentre study through a network of NGOs to identify
areas of gender bias in the health care system and specific changes
needed to humanize sendee delivery'.

(7)

Consolidate the contribution of NGOs and women's groups in women's
health and health care, especially through local area networks.

(8)

Promote a regional perspective on women's health.

(9)

Develop qualitative indicators for monitoring.

In response to queries regarding the next step, the organizers indicated
that the first follow-up action would be dissemination of the report of the
meeting to the participants and other interested parties. The outcomes and
suggestions would also be shared with the Global Conunission on Women's
Health and would sen e to provide direction to the work of WHO in Women,
Health and Development at country and regional levels. Some of the
suggestions are already being taken up, such as the compilation of existing
research on women's health as the basis for setting a research agenda and for
the future development of a database and dissemination of information
It was generally agreed that the dialogue during this meeting was
productive, even though time was limited, and that the interest and enthusiasm
generated should not end with this meeting. Participants expressed a desire for

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continued networking, even though it was recognized that this would be
difficult without a clear purpose and commitment from the group. Some of the
follow-up actions identified could provide starting points, such as gathering
information and reviewing research studies on women's health. Gender
discrimination in macro-level policies and in the health care system seemed to
emerge as a priority' issue around which collective effort could be mobilized.
The group welcomed this initiative by WHO and looked forward to further
collaboration.

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