Documento(s) 3 de 13

Gender

In most if not all societies, the socioeconomic relations between women and men are largely unequal and hierarchical. The disparity between women and men can be seen in the legitimization of a sexual division of labour beyond purely biological roles in the household and the formal work force and in the practices that are gender discriminatory in other societal institutions (Tsikata 1994). Women have fewer educational opportunities than men and receive unequal distribution of land and access to resources such as food and health care (Wee 1995).

The traditional theory explaining the emergence of separate roles for women and men posited that there were biologically determined differences between females and males. However, the belief that there are fundamental and immutable differences between women and men has been thoroughly challenged by feminist commentators. They have argued that sexuality is in fact socially constructed and historically located within a matrix of intersecting social, economic, and cultural factors (Caplan 1987).

Gender relations are not biologically determined; rather, they are based on differential relations of power in which patriarchy exerts substantial control over women in a variety of spheres (Strebel 1994). Some argue that one of the most powerful forms of social control over women's sexuality is the fear of violence from men (Smart and Smart 1978).

Gender does not mean "sex" -- although sex is determined by genes and biology, a gender perspective recognizes the socially defined, sexually differentiated roles and power relationships between women and men in society (Crawford and Maracek 1989; Balmer 1994; Cook 1994). Vlassoff (1994, p. 1249) explains "gender" as "the context of [the] behaviour [of women and men] in society, the different roles that they perform, the variety of social and cultural expectations and constraints placed upon them by virtue of their sex, and the ways they cope with societal expectations and constraints." Finally, Rathgeber (1994b, pp. 6-7) puts it this way:

Utilization of the term "gender" rather than "women" allows for a more substantive and profound analysis of the position of women vis-à-vis that of men .... Such an analysis will include a consideration of relations of power between men and women and inevitably it will lead to a questioning of basic social structures in a fundamental way.

Gender must be understood as a conditioning factor of all aspects of social life: in the work force, in the family, in political and cultural relations, as well as in ways of relating with the environment (Breilh 1994). Incorporating a gender perspective into health research is crucial if the research outputs are to lead to sustainable policy decisions.

It must also be emphasized that gender does not mean "woman." The subtitle of this book reflects the theme of most of the workshop presentations and discussions, which highlighted women's health issues. This focus on women reflects the need to "strengthen women and to redress imbalances in the power relations between women and men" (Richters 1994). In research and interventions aimed at improving the health of women, however, many participants stressed the importance of including men. In the area of sexually transmitted diseases (STD) and AIDS prevention, for example, men have much decision-making power in matters of sexuality and need to be encouraged to take the initiative for prevention. In the words of Barbara Klugman (1994), "there is increasing recognition in women's health circles [of the] need to research and address men's experiences and concerns given their power in relation to women." As well, in the distribution of childrearing and household responsibilities, men should also be persuaded to take a greater role to lessen the burden placed on women.

Gender stereotypes

Gender stereotypes are culturally shared expectations of gender-appropriate behaviours (Eagly and Steffen 1984; Eagly and Wood 1991; Garcia et al. 1994). Although gender-role stereotypes change over time and vary from culture to culture, much of the control of women by men in our societies depends on these stereotypical roles. Gender-based social roles define the nature and type of activities pursued by women and men and define the power differential in male-female relationships (Airhihenbuwa et al. 1992; Garcia et al. 1994).

As an individual grows, sex-linked attitudes and behaviours develop. Early in life, traits of passivity, dependency, and helplessness are established in women. In keeping with this gender-defined role, a woman or other family members may underplay her achievements to maintain the status quo.

-- S.A. Udipi and M.A. Varghese, sndt Women's University, Bombay, India

Traditional expectations of how males and females should behave can have severe consequences for the health and well-being of men, as well as women. Socialized expectations of men to be self-contained, emotionally controlled, and self-sufficient can lead to blocked emotions, a lack of openness, an inability to acknowledge weakness and vulnerability, and decreased capacity to receive interpersonal feedback (Pleck 1985; Werrbach and Gilbert 1987; Balmer 1994). Furthermore, "by centring maleness around a penile function and sexual prowess, society has nurtured an emotional atrophy in men that makes them all the more vulnerable to the dangers of risk-taking" (Pinel 1994, p. 67).

Women, on the other hand, are socialized in most cultures to be emotional, sensitive, nurturing, interdependent, and nonviolent, and such stereotypical expectations serve to stultify women.

Fluctuations in the nature of sexually defined roles throughout history and from society to society suggest that increased convergence in gender roles is possible (Balmer 1994). In the Philippines, for example, men and women inherit land equally. Where women have equal economic security to men, women also tend to have equal social and political power. Filipina women make up a significant proportion of the country's entrepreneurs, lawyers, and bank managers. Although women are expected to be quiet in many societies, Violeta Lopez-Gonzaga (1995) from the University of St La Salle (Bacolod) in the Philippines believes that it is culturally acceptable for women to talk as much as men in the Philippines and that there is no gender discrimination about a child's right to speak.

In Canada, an increasing number of women are entering traditionally male-dominated professions and more men are sharing household responsibilities with their partners. Balmer (1994) argued that genuine equality between the sexes, which can greatly contribute to improved health for both women and men, will only be achieved with the breakdown of sharply differentiated gender stereotypes.

Health

According to the widely recognized definition of health adopted by the WHO, health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The WHO concept of health "emphasizes the significance of the social welfare of populations and not merely the medicalization of disease" (Cook 1994, p. 5) and allows for the consideration of the complex set of cultural, economic, social, political, and environmental factors, as well as biological and genetic components, that influence the health and well-being of populations (Tsikata 1994). This broad definition acknowledges the role of human activities, social structures, and the environment in good health and creates the space to discuss the role of gender relations in health (Tsikata 1994).

To achieve a state of "complete physical, mental, and social well-being," a number of prerequisites for health have been identified by various commentators. To begin with, adequate shelter, nourishing food, good hygienic practices, clean and abundant water, and fuel are clearly essential. Health and well-being also requires peace, freedom from violence, access to income-earning capacity and opportunities, access to educational resources, social justice, a stable ecosystem, and sustainable resources (Cook 1994; Timoteo and Llanos-Cuentas 1994).

Actions undertaken outside the health sector can have much greater health effects than actions within the health sector. Therefore, to improve and sustain health, broad-based, intersectoral, and multisectoral activities at a number of levels are required to develop truly effective and integrative programs and policies (Milio 1986).

Sustainable development

In Our Common Future, the World Commission on Environment and Development states that to have development that is sustainable is to "ensure that it meets the needs of the present without compromising the ability of future generations to meet their own needs" (WCED 1987, p. 8). Healthy human beings are central to sustainable development. Investments in health can translate into healthier men, women, and children and increased capacity to lead socially and economically productive lives. Children who are healthy grow and learn better and have an improved chance of developing the skills necessary for employment. Incapacitation as a result of illness or the death of a household head can lead to family crisis and a vicious downward spiral of ill-health and poverty.

Women's health is a critical component of sustainable development. Although most of the world's poor suffer from poor health and nutrition, women often suffer from higher rates of malnutrition and greater burdens of illness and disability than men. Assuring women's good health means that they will be better able to perform their essential roles both inside and outside the home.

The correlation between health and sustainable development has often been overlooked because concepts of development have been traditionally associated with economic improvement. Development means more than economic growth alone. New models of development that invest in human potential and create enabling environments for the full use of human capabilities are needed. Development should focus directly on people and health as key variables and not be restricted to the increase of income and wealth.

Development that is sustainable must also be equitable. To date, however, women have been unequal beneficiaries of the forces of international development programs. In Gotarka, India, for example, despite the fact that a great deal of development money has been directed to ease the burden of the poor, women, who are the poorest of the poor, are the least likely to benefit. According to Stackhouse (1995a, p. D1):

For all the fine intentions of outsiders, it is the men who tend to benefit from development -- and the richer men at that. While women walk the dirt trails carrying headloads of wood, the wealthy men drive tractors on pukka roads. The men are paid high government wages for building water pipes; the women are expected to maintain these pipes for no wages at all. The schools are filled with male students. Even at the health centre, the ward is occupied by men because women will not allow a male practitioner to see their bodies uncovered.

Documento(s) 3 de 13