Women in Health, constraints and possible solutions with reference to the Nigeria context
This paper will examine the role of women in healthcare service and policy-making bodies pertaining to health service institutions. Attempt will also be made to identify the constraints and their possible solutions.
Because women represent the nucleus of the community in Nigeria, programs and successful health activities depend on them. Also because women represent half of Nigeria’s population and because health is family-centered affairs, the crucial role of health care for the society lies on their shoulders.
Like other parts of Africa, Nigeria is patriarchal in nature. Traditional, the Nigerian society has allocated the role of nurturing, and ensuring the health of the family and the community as a whole to women. From the ages of six, girls begin to work with their mothers; cleaning, sweeping and caring for the younger children, the aged and the sick. Therefore, the female child is customarily socialized as the custodian of family health. Because women are traditionally responsible for health in Africa countries and their status in society is low, the status of the health sector has received less attention than other sectors.
“Health is wealth,” unfortunately, not much recognition is given to the fact that the health of the Nigerian woman is the qualification for the creation of national wealth. Generally speaking, the health standard of Nigerians is very low, that of women is dreadful and characterized by such indicators as high maternal mortality rate, low life expectancy, high morbidity rate, low access to health facilities and ignorance of any modern method of family planning by more than 50 percent of women of reproductive age while sexual abuse and prostitution are on the increase among women.
The Involvement of Women in health policy development and Decision Making in Nigeria.
Women represent a reasonable percentage of the Nigerian population and in fact in many of the thirty six (36) states of Nigeria they now exceed more than half of the population of the states. Due to the educational opportunities and experiences attained by women they are increasing and getting involved in health policy and decision-making.
Decisions and policies are usually the results of the way a system is organized. Women help hospitals and many other kinds of health institutions, formulate and implement policies that seek to help make health care service available and affordable to everyone.
In health care issues, because of their interest and direct involvement at the family level, women are able to make decisions that are as good as those made by men. In fact a study has shown evidences that, most Nigerians believe that women are making and implementing better decisions in the health sectors than men (e.g. Dora Akunyili in NAFDAC).
The policies to expand health care service, to introduce health insurance coverage and prioritizing health facilities in states and local government in Nigeria were most initiated and pushed by women during their tenures as ministers, permanent secretaries, Director of teaching hospitals etc.
Women As Agents of Primary Health care
Women are the main agents of primary health care, they play essential role in maintaining family and community health. They are the ones who are most aware of sickness and suffering in the community because of their social role as nurtures and caretakers of the young, the old, the sick and the handicapped, and they exert an important influence on health habits in the family.
Women as Implementer of Health care Activities
Women are mostly responsible for the most of the implementation steps of a health care process in the Nigerian society. The majority of health problems does not reach the medical care system, but are dealt with informally by women, whoa act as wife, mother or adult daughter.
At the beginning of all health care program (including the well known Expanded Program on Immunization) women played a big role to enrich the program through suggesting useful and practical ideas. They have been responsible for the formation of health- related (most) community associations.
Because of their having the advantage of easily visiting homes, women have been in the forefront for most health care awareness campaigns. They are able to ask private questions that men cannot ask, thus in profiling solutions to health problems of communities, they are able to observe directly, unlike men who collect required information by asking the inhabitants. In local authorities such Local Government Health Department, Health Centers and Ministries, women have helped in preparing monitoring plan of action for health projects, because they belong to the communities and are more familiar with their community problems.
Through their involvement in NGOs, women have helped in schools, institutes and universities; studies have shown that they are the best messengers of the environmental health messages, which have been ensuring the desire behaviors across Nigeria.
In their positions as mothers, teachers, employees, housewives, health workers, social workers, nurses etc. have played important roles towards forming healthy behaviors and propagating basic health knowledge. Many programs of reinforcing or refreshing knowledge and skills such as training of trainers, women have been the vanguard, because of their capability to raise awareness among women and children (which form the large segment of the Nigerian population) more easily.
In most Nigerian communities, to sensitize community members, visiting the inhabitants and assessing their health situations, women are always involved in order to encourage and motivate the inhabitants. Also women have been participating in health communication activities, by implementing team /group discussions, and cooperating in seminars and conferences.
Being known as women has in the past led to effective rising of awareness, causing changing behaviors, improving practice and attitude towards health behavior issues such as dangerous sexual practices, drinking of alcohol smoking and solid waste management.
Women have played important role in income-generating related environmental issues, in such a manner, they identify the community needs and mobilize the housewives to help their family situation and improving their lifestyle through inviting them to participate in training workshops about health issues.
- The paradox of entrusting the woman with the responsibility of health and at the same time denying her the opportunities to influence policies remains a major obstacle.
- Education is another factor that affects adversely the role of women in Nigeria. Access to education for Nigerian women is a major problem. The impact of poorly educated mother is passed on to the daughter.
In order for communities to benefit from the knowledge which women posses, a renewed self-confidence of women has to be encouraged. Women have to learn to regard themselves as capable human beings with important contributions to make on the basis of their life experience and their accumulated wealth of knowledge. Also, a conscious effort has to be made to enable women to organized and to vocalize the information they have acquired.
More women must be made to penetrate all levels and all areas of the health care system. They have to be doctors, nurses, community development agents, educators, agricultural extension workers, public health officials, planners, legislators, and politicians. At the same time, they have to encourage the participation of people at the grass-root, including women and women organizations, in the decisions affecting individuals and community health.
Special efforts must be made to organize education, vocational and professional training in such a way that more girls and women can take advantage of them. Make more investment in primary health care programs which includes health education and the application of health promoting activities based on simple but scientifically sound measures in which women can participate at local level, is likely to provide more benefits than traditional efforts dedicated to the formation of highly skilled physicians who practice medicine in clinics and hospitals.