Enabling women to be meaningful participants and leaders in rural community-based water and sanitation governance remains a challenge. While the benefits of and barriers to women's participation and leadership have been reported on, there is limited understanding of the role of empowerment in addressing these challenges. To help bridge this knowledge gap, we used a household survey to measure men and women's empowerment in water and sanitation in the rural Tupiza watershed, Bolivia, and key informant interviews with women leaders to identify barriers to leadership. Overall, among survey respondents, fewer men than women were disempowered. Community-level factors, especially those related to comfort in speaking in community meetings and reporting service problems, contributed more to women's disempowerment, as did household-level factors related to work balance and input into decisions about who participates in community water and sanitation activities. Among interviewed community water leaders, many women felt their positions were costly to their households and reported challenges in obtaining technical training and local government assistance, which not only disempowered them as leaders but also was likely tied to poor service delivery and related health outcomes in their communities. We discuss the implications of our findings for rural Bolivia and future research opportunities.
Of the millions of Community Health Workers (CHWs) serving their communities across the world, there are approximately twice as many female CHWs as there are male. Hiring women has in many cases become an ethical expectation, in part because working as a CHW is often seen as empowering the CHW herself to enact positive change in her community. This article draws on interviews, participant observation, document review and a survey carried out in rural Amhara, Ethiopia from 2013 to 2016 to explore discourses and experiences of empowerment among unpaid female CHWs in Ethiopia’s Women’s Development Army (WDA). This programme was designed to encourage women to leave the house and gain decision-making power vis-à-vis their husbands—and to use this power to achieve specific, state-mandated, domestically centred goals. Some women discovered new opportunities for mobility and self-actualization through this work, and some made positive contributions to the health system. At the same time, by design, women in the WDA had limited ability to exercise political power or gain authority within the structures that employed them, and they were taken away from tending to their individual work demands without compensation. The official rhetoric of the WDA—that women’s empowerment can happen by rearranging village-level social relations, without offering poor women opportunities like paid employment, job advancement or the ability to shape government policy—allowed the Ethiopian government and its donors to pursue ‘empowerment’ without investments in pay for lower-level health workers, or fundamental freedoms introduced into state-society relations.
more » « less- NSF-PAR ID:
- 10102720
- Publisher / Repository:
- Oxford University Press
- Date Published:
- Journal Name:
- Health Policy and Planning
- Volume:
- 34
- Issue:
- 4
- ISSN:
- 0268-1080
- Page Range / eLocation ID:
- p. 298-306
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Results Women’s prevalence of overweight and obesity increased from 22.6% and 2.4% in 2002 to 28.8% and 8.9% in 2010, respectively, and BMI increased by 0.60% ± 0.12% per year (
P < 0.001). Increases in fat‐free mass accounted for some of this observed weight gain among women. Men’s prevalence of overweight and obesity increased from 16.2% and 0.7% to 25.0% and 2.2%, respectively, and BMI increased by 0.22% ± 0.09% per year (P = 0.009). Household use of cooking oil increased and was positively associated with female BMI. Consumption of domesticated animal products did not change significantly but was positively associated with female BMI and male waist circumference.Conclusions Even small increases in energy‐dense market‐based foods can contribute to adiposity gains among a moderately active, subsistence‐based population.
