SIHI Uganda Hub
continent: africa | country: uganda
Gender dimensions and access to healthcare in Uganda:
Using an intersectional gender lens on social innovation in health projects
This project explores how gender and intersecting social stratifiers affect the vulnerability and experience of disease among rural communities in Uganda. It also highlights how social innovations respond to these multiple vulnerabilities.
BACKGROUND
With the aim of understanding and exploring the gendered aspects and dimensions of social innovations in health at community level, we worked with a total of seven social innovation projects in Uganda.
These social innovation projects predominantly work in rural communities, namely: (a) Action for Women Awakening in a Rural Environment (AWARE) Uganda; (b) Amani Family Center; (c) Bwindi Mothers’ Waiting Hostel; (d) Kyaninga Child Development Centre (KCDC); (e) Opit Kic Widows’ Group; (f) Innovation for Development; and (g) Change Development Initiative.
methods and approaches
The overall objective of our work was to investigate and understand the key gender dimensions and intersectional social stratifiers that influence the health of communities in Uganda, particularly within the seven social innovation health projects, in order to draw lessons for improvement.
We utilized a mixed methods approach with 28 key informant interviews with the staff of the social innovation projects, and 30 in depth interviews with the beneficiaries of the social innovation projects. We conducted a cross-sectional survey as well, with 500 beneficiaries of the social innovation projects.
insights
Gender-based discrimination remains a crucial challenge in the achievement of equitable health.
While different vulnerable populations experience various intersecting social stratifiers, there, our research identifies the predominance of gender-based discrimination against women, as well as the high prevalence of sexual and physical violence among women. Finally, disabled persons and refugee populations have poorer health indicators than the host and non-disabled counterparts.
Factors that exacerbate exposure and experience of disease include gendered societal structures and norms.
Specific factors that contribute to the vulnerability and exposure to illness, and poor response to illness relate to the highly patriarchal structure of society, further exacerbated by the low autonomy of women especially in health care decision making. Other identified challenges include harmful beliefs about diseases, as well as poverty which leads to the de-prioritization of health care needs.
Social innovations in health purposefully respond to gender and its intersecting inequities.
Social innovations in health recognize the various inequities that vulnerable populations face, especially that of women. Embedded within social innovation projects are principles of gender empowerment, human-rights advocacy, and holistic approaches to health care.
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Recommendations and implications
for further research, policy and practice
Upon reflection on the implications for policy and practice, we recommend:
01
Gender and social norms, roles as well as relations continue to impact individual and community health. It is therefore important to work towards attitudinal change through sensitization of communities to positively perceive professional health services.
02
Disproportionate expectations of women to maintain family and individual health puts a heavy burden on married women. It is necessary that a holistic approaches be used to involve both men and women in health care maintenance.
03
Poverty affects decision making and consequently wellbeing and survival negatively. Children, women and men are all affected by inability to access even available services. We recommend income generation projects to be initiated within the area based on skills and communally sustainable resources.
04
Long term interventions to address gender and social inequity and to challenge harmful norms and practices are needed. These include a focus on family (not just individual) health care, male involvement in domestic duties, positive family relations, and economic empowerment.