|Parallel session 20, Friday, September 1 2006, 14:00-15:30|
|Chair(s): Mary Anne Burke, Switzerland, Priscilla Daniel, India|
|Microfinance and Health Intermediation|
|K. Narendar, Chief Executive, DHAN Foundation, Madurai, India|
|Micro-credit Financing and Impact on Female Genital Mutilation|
|Berhane Ras-Work, NGO, Inter-African Committee on Traditional Practices Affecting the Health of Women and Children, Geneva, Switzerland|
|Mainstreaming Gender-Based Analysis of the Women's Hospital of Costa Rica|
|Zully Moreno Chacón, Hospital of Costa Rica, San José, Costa Rica|
The session addressed the various manners in which gender and social inequalities may negatively impact on population health and general wellbeing. It further looked at ways in which women can be empowered to allow them to develop a holistic approach to their specific health and other related needs. Examples showed that implementing gender-based analysis can produce profound changes in the treatment of women's specific problems.
Mr. K. Narendar, Chief Executive of the Development of Humane Action Foundation (DHAN), Madurai, India, presented the activities of his organization, which promotes improved health outcomes through microfinance intervention. To put his foundation's work into perspective, Mr. Narendar first reminded the audience that population health is strongly correlated with poverty. Microfinance programmes have emerged as one of the significant mechanisms to address the deep-rooted causes of poverty. There is a growing body of evidence showing that access to microfinance services is positively correlated with factors that have a positive impact on health, such as nutritional intake or contraceptive usage, he said.
The microfinance programme of the DHAN, through savings, credit and insurance, is aimed at developing appropriate savings that can be devoted to health care. Specifically targeted at women, it enables poor women to increase expenditure on the well-being of themselves and their children, which ultimately affects the health outcome at the family level. Mr. Narendar cautioned that such schemes are not appropriate to address higher health care needs, for which social security measures such as health insurance must be in place.
Mrs. Berhane Ras-Work, from the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC) addressed the problem of female genital mutilation (FGM) in Africa. FGM is a widespread problem on the continent, affecting at least 28 countries. It is rooted in and nurtured by tradition, culture, religion, far-reaching misconceptions and socio-economic circumstances. All members of the community are participants in the continuation of this most brutal form of violence and governments tend to be silent, thereby justifying this violation of Human Rights, she said.
NGOs have played a key role in giving international recognition to gender inequality and violence. The IAC has initiated action and shown that it is possible to impact positive changes of attitude through the empowerment of women along two lines. First, by offering them micro-credits aimed at curbing their economic vulnerability. Indeed, women accept gender-based violence to ensure the security of their marriage and the survival it provides. Second, by giving them education and information to erase the misconceptions perpetuating the practice of FGM and to develop women's valuation of their bodies and health. In parallel, the IAC has embarked on a micro-credit scheme with excisers themselves, to help their conversion to other income-generating activities. Such schemes have already been successful in persuading excisers to stop their traditional practices.
Mrs. Berhane noted finally that such strategies should be further developed but that their success depended on accompanying, additional measures starting with strong political commitment and investment.
Mr. Manuel Carballo, from the International Centre for Migration and Health, Vernier, Switzerland, focused on the problems faced by migrants, an ever growing population worldwide. The migrant population was officially 195 million in 1995, but certainly amounted to three times that number when illegal migrants were taken into account. The health problems of migrants are a complex issue, combining pre-migration health profiles, diseases and health problems acquired during transit and newer ones acquired in the host country. Hence, care should be specifically tailored to the migrants' health profiles, a course which is undermined in times of increased socio-political resistance to migrants.
The nature of their health problems is only one element in all those undermining migrants' health, Mr. Carballo said. Access to health care for migrants is dependent on the availability of specific services adapted to their different psychosocial, cultural and linguistic backgrounds. The availability of such existing services should be known to the migrants, but this has been shown not to be the case in almost half of those migrants surveyed in Geneva. Such services should also be legally available, for example through a scheme of health insurance, and they should be affordable, taking into consideration the overall low income of migrants.
As migration continues to increase, Mr. Carballo concluded, medical insurance coverage which includes migrants, specific training of health personnel to handle multicultural differences and outreach to the migrant population for health promotion and disease prevention is more critical than ever.
Mrs. Zully Moreno Chacon, from the Hospital of Costa Rica in San José came with a concrete example of how gender-based analysis helped the transformation of the Women's hospital in Costa Rica from a traditional one to one working with women themselves to design tailor-made strategies addressing specific needs. The transformation was a far-reaching process involving strategic planning; revision of physical infrastructure, working processes and administration; space distribution; challenge of management structures; allocation of budgets; new practices and methodologies.
The key to the success of this initiative was to empower women in the process and to develop a holistic approach to their specific health and other related needs. Active participation was fostered by the creation of associations and a health network. Employees' training was carried out to improve the sensitivity of care for women.
Mrs. Moreno noted that implementing gender-based analysis produced profound changes in the treatment of women's specific problems and that female patients demonstrated a real appreciation of the new approaches and resources that were developed.