WOMEN'S HEALTH EMPOWERMENT ISSUE-3
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- WOMEN'S HEALTH EMPOWERMENT ISSUE-3
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A Collaborative effort of MOHFW & NGOs
ISSUC-3
Women's
Health
Towards
Dear Readers,
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We hope you enjoyed reading our second
newsletter and found the information on Tobacco
Consumption and its ill effects on Women’s Health
to be useful and interesting.
In a region where women continue to be valued
less than men, older women’s health reflects their
life-long experience of discrimination, deprivation,
and neglect. In today’s context, older women
face situations of poverty, malnutrition, poor
health care, over burden of work and unhealthy
work environments similar to that of their
younger years. Along with high infant mortality
rates, they also have a greater risk of higher
maternal mortality and morbidity and
reproductive tract infections. To add to all these, few of them received immunization as children or benefited
from the public health interventions, that have developed since.
In an effort to voice the concerns of marginalisation of older persons, which includes older women, the
United Nations declared the year 1999 as the International Year of Older Persons, with the theme,
“Towards a Society for All Ages”.
Keeping this in view, the focus of this newsletter is on Wiser Older Women’s Health. The newsletter will
highlight critical issues regarding older women that we hope will make a difference in the attitude and
practices of people towards their older family members.
We thank all organisations that have contributed their rich field experiences. We also look forward to further
sharing of experiences, case studies and photographs. A module on Wiser Old Women’s Health at the
State, District and Village level is available in English, Gujarati and Hindi languages at CHETNA. If you are
interested in receiving it, please write to us. You will be charged the cost of photocopying the material alone.
gpAnnoucement"j
world conference. on
twenty years later, the United Nations is sponsoring the 2nd World
Conference on older Persons, which will be held in the year 2002 in Madrid,
Spain. The lsl World Conference on Older persons was held in Vienna in
1982. According to the Coalition of services of elderly (COSE) the lsl World
Conference surfaced broad issues relating to the ‘ageing population’. The
2nd World Conference will look at particular strategies of developing
countries-such as community-based programmes and alternative livelihoodthat will allow older people to help themselves.
Source: Women in Action, Older Women. No. 3,2000; Isis International-Manila; Website: http://www.isiswomen.org
why Focus on Elderly women
The period of senior citizenship should be a golden time, when one rests from a lifetime
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of labour, basking in the warmth of familial affection and social adulation. But it is rarely the idyll
that philosophers visualised, quite the contrary if one happens to be an elderly female in India.
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Elderly females are increasing rapidly in numbers through out the world and this trend is
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magnified manifold in India. Today, India has about 65 million elderly and in about 20 years, the
number will increase to 150 million or even more. The population of elderly females is set to
explode and the need to improve their condition will soon assume greater urgency in the future. /
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All through the life cycle, elderly women are subject to various kinds of discrimination,
oppression and exploitation, despite being central to the family and society. Despite their
numerical strength in the population and their crucial role in the domain of the family,
their contributions to family support in various forms - social, economic, emotional and
psychological - have mostly been either taken for granted or ignored. As females
continue to age, their contribution either as producers or reproducers to society is slowly
marginalised. As a result society has tended to neglect them.
For the majority of older people, who live on or below the poverty line, the future also carries great
uncertainties. Far too many older people remain on the margins of their societies. Too many older
people spend the last years of their lives in poverty, beyond the reach of even the most basic provision
for social well-being and health. The majority of older people are women, often widows who suffer
multiple disadvantages on the basis of their gender ranging from abandonment; to failing health.
Statistics on the
Growth of the
Elderly population
(The number of individuals (in millions) Aged 65 and
above from 1900 to 2030)
Did you fehow thoit...
O The proportion of the world’s population over 60 years
is increasing more rapidly than in any previous era.
O In 1950, there were about 200 million people over 60
throughout the world. In the year 2000, there will be about
550 million, and about 2025 there will be about 1.2 billion.
O The 20th century is witnessing a rapid demographic
transition from high birth to low fertility and mortality.
O Presently, sixty percent of the global population of
people over 60 live in developing countries, this will be 70
percent by 2025.
O The number of older people in developing countries will
more than double over the next quarter century, reaching
850 million by 2025.
The ageing of the global population is a
triumph of the 20th century and presents
unprecedented opportunities. But for the
majority of the older people, who live on or
below the poverty line, the future also carries
great uncertainties.
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O The total number of older women in Asia currently
exceeds the total for all older women in developed
countries and will increase from 144 million today to 355
million by 2025.
O Older women often suffer
multiple disadvantages arising
from biases of gender, widowhood
and old age.
Feminisation of Ageing in
Asia: Health implications
As life expectancy increases in most countries, it is
estimated that the number of women over the age
of 65 will increase from 330 million in 1990; to 600
million in 2015. In most Asian countries, this trend
of women outliving men which is called the
feminisation of ageing, is becoming more
pronounced with women living on an average of
one to seven years longer then men. Women aged
above 60 comprise up to nine per cent more than
their female counterparts in the region. Part of the
reason why women outlive men is biological. Even
as infants, they are more resilient than men. In
adulthood too, women may have a biological
advantage at least until menopause, as hormones
protect them from diseases. However, though
women’s longer life expectancy means they live
more disability free years, the proportion of their
remaining years that are disability free is lesser
than for older men. They are more susceptible to
chronic diseases such as arthritis, osteoporosis,
diabetes, hypertension, urinary incontinence and
Alzheimer’s disease. Some of these diseases are
due to years of neglect, discrimination and the
hardship of their childbearing years. Thus, their
biological advantage is often undermined by their
social disadvantage.
ease do w©t despise vwe if M avw
to© old tv%. tlve Iveod awd shvowlders
to© iwadec|Meitely sck-©©led
tke
Ins and ©uts of todovf
but since
ve lived tlvree score
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Q would be
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Source: 1&2 Asian and Pacific Women’s Resource and Action Series: Health
MYTHS ABOUT MENOPAUSE
IT’S NOT TRUE THAT
I’ll go crazy
I’ll stop
enjoying
sex
I’ll gain 15
pounds and my hair will
turn grey
I II have
to have
a hysterectomy
Taking
estrogen
will make
me sexy
I’ll start
chasing men
Source: Women’s Global Network for reproductive Rights(WGNRR)1997
Health issues of Older women
Health problems are supposed to be the major
concern of older women, as they are more prone to
suffer from ill health than the younger ones. It is
often claimed that ageing is accompanied with
multiple illnesses and physical ailments. Besides
physical illnesses, the older women are more likely
to be victims of poor mental health, which arises
from senility and neurosis. In most of the primary
surveys, the Indian elderly are stated to be having
some kind of health problems. A majority of the
older women suffer from diseases like cough, poor
eyesight, anaemia, dental problems, arthritis and
loss of memory. The proportion that is ill among the
elderly is found to be increasing with advancing
age and the major physical disability is found to be
blindness and deafness.
Besides physical ailments, psychiatric morbidity is
also prevalent among a significant proportion of the
older women. Mental illnesses start beyond the
age of sixty years and while distinguishing
between the functional disorders (form of disorders
where there are no detectable abnormalities in the
body) and organic disorders (symptoms are the
result of disturbances in the body), functional
disorders are more common compared to organic
disorders which occur beyond seventy years of
age. A major killer among the older women is
respiratory disorders and disorders of the
circulatory system. The sick elderly lack proper
familial care and at the same time public health
services are insufficient to meet their health needs.
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CHETNA conducts a study...
2000 - 2001
CHETNA conducted an action research study
titled “To assess, understand, and improve
the status of ageing women (AW)”. The Mahilla
Samakhya Society (MSS), Gujarat and Consumer
Unity and Trust Society (CUTS), Rajasthan were
the partner organisations along with the Canadian
International development Agency (CIDA). The
results of the study indicate general trends about '
the status of AW in Sabarkantha district of Gujarat
and Chittorgarh district of Rajasthan. About 150
AW and 150 young adults were interviewed.
The findings of the study indicate that food Gf
restrictions were imposed upon the AW by either
their families or themselves and were due to the
belief that some food items could cause health
problems. All the AW (except about 10 %) in both
districts showed signs of anaemia and 30 % had
ulcers in their mouths, which is a manifestation
of vitamin B deficiency. About 20% of AW suffered
gynaecological problems and mental health
problems. A much smaller number suffered from
Tuberculosis (TB), Leprosy and Parkinson’s
disease.
It was reconfirmed that the rural population
neglects their own health concerns because of
:
... ..
Chaitanyaa
their life time struggle to meet basic needs such
as food, water, clothes and shelter. Another
disturbing reality was that only less than half of
the AW suffering from a particular health problem,
actually received proper medical treatment. This
was mainly due to the long distance from their
village to the nearest Primary Health Care
Centres (PHCs) and their inability to pay for
treatment at private clinics.
About 60 % of AW in both districts were pregnant
for six to thirteen times. However, large majority
of AW were in favour of young couples adopting
family planning methods. Only one-fifth of the AW
interviewed had adopted family planning methods
themselves.
A majority of the AW in both districts considered
it necessary for widows and divorcees to remarry
especially if they were young since it enabled
women to legitimately satisfy their sexual needs.
In conclusion, it appears that the AWs from rural
areas are much more disadvantaged than their
counterparts from urban areas on parameters
of health, health care and nutrition status
For more details contact: Dr. Gahver Kapadia,
CHETNA.
older Women as a Valuable Resource
Older women are reservoirs of experience and wisdom of life. They continue to provide
guidance, moral and emotional support to the younger generation at the family and
community level. Some roles, such as those related to occupation or parenting may
cease or reduce in importance due to ageing but these should be substituted or modified
by new social and economic activities. As educators, they play a major role in providing
education useful through one’s life.
Some of the new and continuing roles that require renewed emphasis include assisting
in household work, socialisation, informal education and childcare. They also comprise
inculcating values, acquainting children and young people with the local history and
socio-cultural traditions, resolving interfamily tensions and engaging in various social
and economic activities.
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As health educators and caretakers, they play a major role in dealing with common ailments
and prirW health C°ncemS °f the family-They guide the fami|yin terms of diet activities and
thought processes on preventive and promotive health care. They also give attention care and
provide support to younger women during pregnancy, childbirth and post childbirth In India
dais (traditional birth attendants) attend to about 80-90 percent child births, particularly in far
flung rural/tribal areas of the country.
’
what can be done to improve the
Health Status of Older women?
Privileges and Benejits-old Age
Pension for the General Public
discipline along the lines of Pediatrics and
National Old Age Pension
Scheme (NOAP)
neonatology in medical colleges to prepare
physicians with a specialisation to serve the elderly
more effectively.
Under the Old Age Pension scheme,
Central Assistance is available on
fulfillment of the following criteria.
<—jjC Doctors and nurses in the existing primary
O The age of the applicant should
be 65 years or more
Geriatrics should be introduced in a separate
health centres should go through orientation
courses on Geriatrics, Geriatric Nursing and
Health care of the Elderly.
Due to non-availability of PHCs in every
village, bad roads and poor transport service,
d many elderly persons especially AW are not taken
to the doctor/hospital on time and they suffer in
silence. A van equipped with medicines,
accompanied by a physician and trained nurse
should visit the elderly once or twice a week in
every village and give them necessary medicines
or refer them to another physician or a hospital.
Existing models of Health Care Delivery
System for the Elderly should be examined and a
suitable model should be developed to suit
healthcare of the elderly.
Old Age and Widow Pension
An individual (female 60 years or above and male 65
years or above, there is a slight variation in this age
as per state) can get certain amount per month if he/
she has no source of income. If a woman is a widow,
or has one or more children below 18 years, then
she is eligible for pension. The amount given as
pension varies from state to state. It varies from
Rs.75/- to 300/-
Annapurna
e-^0 Under the existing RCH programme, health
concerns of AW need to be urgentlyaddressed .
Counselling services should
£ be facilitated to help the elderly, to
O The applicant must be a destitute
meaning that he/she has no regular means of
subsistence for his/her own source of income or
through financial support from family members or
other sources. The amount of the old age pension is
Rs. 75/- per month.
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O JI
better cope with their health
problems and, to make new
adjustments in the changing family
The Government of India (GOI) has recently initiated
a new scheme called Annapurna. Under this
scheme, food grains up to 10 kg. per month will be
provided to such destitute older persons who are
other wise eligible for pension under the National Old
Age Pension Scheme but are not receiving it and
whose sons are not residing with them. However,
this scheme is yet to be implemented.
scenario.
Our Role to Ensure the Health and Wellbeing of Elderly Women
As a family member...
3 Do not neglect the social, economic and health needs of the elderly women
3 Try to utilise the rich potential of older women in your family. They may possess a rich
knowledge regarding how to treat minor ailments, know about the importance of
food during pregnancy and lactation etc.
3 Involve them in different family activities such as childcare and actively seek
their opinion while making decisions. They have a rich experience of life.
3 They need to remain physically active; but do not overburden them with work.
3 Let them enjoy life. They are human beings, not saints.
Relevance of Small Groups
in Participate^ Training
In context of Participatory Training, groups
have special relevance. A small group is a
powerful Vehicle for Learning. The
experiential nature of participatory training makes it imperative
that learners work as part of a group. A group is able to share
experiences, to provide feedback, to contribute ideas, to
generate insights, and enable reflection for analysis of
experiences. Group discussion is a very effective learning
method. Learning is viewed as leading to change in behaviour,
attitudes, self-concept and so on. An individual needs to try out
the learning and experiment with changed behaviour in a secure
environment before applying the learning to the outside world.
The group provides a measure of support and reassurance.
Moreover, as a group, learners may also plan collectively for
changing action.
A small group is a building block of people’s organisations.
When working towards social change, every one is involved in
organising and strengthening of groups. The village ‘sanghams’,
Mahila Dais, Panchayat Samitis are all small groups. In larger
units, the decision-making bodies are also small groups like the
executive committee. By reinforcing a base of small local
groups, people’s organisations can become more effective.
We at CHETNA believe that...
Z> If you are not enthusiastic
about your subject, how can you
expect the trainees to be!
O Consciously use your eyes and
eyebrows to communicate your
enthusiasm
O Always keep a sparkle in your
voice
O Fight the boredom of repetitive
sessions by introducing new
anecdotes, examples or by
changing lesson structure
Source: The Trainers Pocketbook: John Townsend
Case study from the State of Keraia
“I am a poor illiterate woman and have four children. My husband is an
agricultural labourer. He picked up the habit of drinking during the second year of^^u
& our marriage. He started giving company to a friend and promised it would not continue.^k
J Initially he played with the children and was affectionate towards his parents and me. But later \\
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he started spending more money, came home late, stopped playing with the children and also y
ignored his parents. He started abusing me and was not regular at his work. To make ends meet, >
I was forced to work as a casual labourer in a nearby quarry. I often fell sick. One day due to his
carelessness, our thatched hut partially burnt down. The next day, two neighbours came to meet me.
They invited me to join their Neighbourhood Self-Help Groups (NHG). In the beginning I was reluctant,
fearing that they might make fun of me. Instead they consoled me and promised to help me financially.
I became a member and became aware of the terrible malady, alcoholism. Once when my husband
became violent, we took shelter with the neighbours. The next day they met my husband and
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threatened to take action against him.,I am happy now. My husband has stopped drinking
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and is undergoing de-addiction treatment. The NHG has also helped me financially as
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well as emotionally. Several other women are also troubled with the problem of
alcoholism in their family. We are planning to persuade the
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ward members to do something about this”.
“A woman from Madakkathara, Kerala
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Experiences of Master Trainers and Village Leaders
“I have conducted the Women’s Health towards Empowerment training and also compiled a nice report. I
would like to share with you my personal experience. Recently a woman in the village was beaten and
thrown out of her home by her husband and sister-in-law. With my effort I was able to take her back to
her home and solve the problem. I was successful in doing that only because I had gained a lot of
confidence in dealing with such issues during the training.
-Experience from Gujarat State
“We are proud to say that the village level women
leaders have taken up the project seriously and
they are doing tremendous work in the area of
women and health. They prefer action-oriented
activities. They organise classes and
discussions on their own. They have shed their
inhibitions and they actively involve themselves
in many of the local problems. In one or two
occasions, their success was instantaneous and
this has boosted up their self confidence and
group cohesiveness”.
“We have started using various activities during
training. Sometimes, instead of role-play, examples
are depicted through posters, flash cards and
sharing of experiences. We also carry out some
mental and physical exercises. We use these
activities to make the training more interesting and
to break the monotony”.
‘The layout of the format of the module was excellent. Each topic
was explained with clear objectives; lot of information and
participatory exercises. Group discussions, role-plays and
stimulation games gave value to the training. Certainly, women’s
empowerment can be achieved if the trainees participate whole
heartedly in the training”.
_________________ zQc -Experience from Tamilnadu State_____
References:
Books
QJ Elderly Females in India: Their Status and Suffering
Articles
Action Research to Assess, Understand and
Improve the Status of Ageing Women: A Study
Conducted by CHETNA
LU The Ageing and Development Report: Poverty,
Independence and the World’s Older People: Helpage
India
Ourselves Growing Older: Women Ageing with
Knowledge and Power
m Ageing: Genetic and Environmental Influences
A Survey of Elderly in India: A Study for
Assistance in the Development of Comprehensive
National Policies on Ageing
ARROWS for Change: Women and Gender
Perspective in Health Policies and Programmes:
Older Women’s Health: Facing The Challenges.
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Partner NGOs in this Initiative:
Andhra Pradesh- Andhra Pradesh Mahila
Samakhya Society(MSS)-Hyderabad, UNDPKurnool.
Gujarat - CHETNA-Ahmedabad, SEWA
Ahmedabad, Mahila Samakhya Society (MSS)Rajkot and Vadodara
Himachal Pradesh- SUTRA-Solan
CD
Karnataka - Community Health Cell (CHC)Bangalore
Kerala -Integrated Rural Technology CentreMundoor
Madhya Pradesh- M.P. Voluntary Health
Association (MPVHA)-lndore.
Maharashtra - The Foundation For Research in
Community Health (FRCH),(Pune).
New Delhi - MAMTA- Health Institute for Mother
and Child-New Delhi, Dipshikha-New Delhi, SHARPNew Delhi, Voluntary Health Association of India
(VHAI)-Delhi.
Orissa - National Institute of Applied Human
Research and Development (NIAHRD)- Cuttack.
Tamilnadu -Tamilnadu Voluntary Health Association
(TVHA)-Chennai, Resource Centre for Ecology,
Agriculture and Community DevelopmentKanyakumari, NATURE-Pudukkottai, Kumbakonam
Multipurpose Social Service Society-Kumbakonam,
Coimbatore Multipurpose Social Service Society
Coimbatore, READS-Tiruvannamalai
PRINTED MATTER BOOK-POST
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(For Private Circulation Only)
Uttar Pradesh - Mahila Samakhya Society(MSS) Lucknow.
West Bengal - CINI-Calcutta, Pally Unnayan Samity
-Howrah, Nivetida Community Care Centre Hooghly, Pallisthi -Parganas
CHETNA Editorial Team: Indu Capoor, Pallavi Patel & Pallavi Shah
Input provided by: Dr. Gahver Kapadia and Gayatri Giri
Design & Illustrations: Anil Gajjar, Nagji Prajapati, Pallavi Patel & Pallavi Shah
Rajasthan - CHETNA Jaipur CUTS-Chittorgarh,
IIRD -Jaipur, Seva Mandir -Udaipur.
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