8 March 2016
Gender inequalities continue to hamper women’s access to and provision of health care in lower and middle income countries (LMICs). Women continue to face incredible challenges due to patchy availability of appropriate health services. LMICs account for 99% of maternal and child deaths, with maternal mortality higher in women living in rural areas and among poorer communities.
At the same time, even though women make up around 75% of the health workforce, they are often concentrated in lower status health occupations and poorly represented among more highly trained professions such as physicians, pharmacists and managers.
The new Sustainable Development Goals (SDG) recognise the importance of both health and gender equality as crucial tools to empower women and ultimately accelerate sustainable development. Under the SDG 5, universal access to sexual and reproductive health and reproductive rights were put at the core of the mission to achieve gender equality.
At THET, much of our work focuses on trying to improve health services for women and enabling them to take up a range of professional roles within the health workforce.
Of the grants awarded to date under the Health Partnership Scheme (HPS), 26% have been to projects focused on maternal & new-born health, child health, sexual & reproductive health. 171 institutions now have new and improved services for maternal and new-born health and these have been used by 19961 women since HPS began.
Under the HPS, out of 41,200 health workers trained, 23,000 were women (data: THET 2015). This includes 1,305 female doctors, and women form the majority of medical and healthcare students trained, 5,513. These are significant figures, but we know that in order for this progress to be replicated and sustained health partnerships also need to put women at the centre of health care initiatives and support them to be health care leaders.
Somaliland has one of the worst maternal and child mortality rates in the world. The situation is particularly critical in rural, isolated areas, where many people cannot access healthcare.
When I flew to Hargeisa for the first time I could observe this dramatic reality first-hand.
To improve access of this population to basic health care services and to make sure we respond to their needs with programmes that take into consideration the local context, we train Community Health Workers (CHW) who provide frontline care to those communities. In Somaliland, through a number of programmes, we have already trained dozens of CHWs. As Amina, the lead tutor who trained CHW in Burao, explains: “The CHW were selected by the community health select committees. While explaining our selection criteria we made it clear that we were particularly looking for women. Most of the women in Somaliland would find it difficult to openly talk about pregnancy or any sort of women’s sickness if there is a man sitting there in the room. It is easier for them to talk about their issues with another woman.”
Community Health Workers provide basic medical assistance, health education and awareness, and act as a link between the community and their nearest health facility, helping to contribute to the significant reduction of maternal and child mortality. In communities that have limited or no access to healthcare, CHW might be the only thing that stands between life and death.
We have also trained nurses in Basic Emergency & Obstetric Care so they can refer or carry out caesarean sections. I’m particularly proud of the double impact this programme has on women’s lives: on one hand, it helps women deliver their babies safely and, on the other hand, it empowers women working for their community offering them an important role to play in their society. Hawa, one of the women who had a caesarean recalls the difference this is making to women’s lives: “Women used to deliver at home bleeding and suffering there. Some may have died like that. Now that we have trained workers we don’t have cases of bleeding and complication during deliveries and women do not suffer any more in Abdal.”
If you want to know more about our work in Somaliland, the training of CHW and how this is changing the life of women watch this short video.
 Described by the World Health Organisation (WHO) as, the socially constructed characteristics of women and men – such as norms, roles and relationships of and between groups of women and men, gender equality has been put firmly on the development map with the introduction of the Sustainable Development Goals (SDGs) and the UK Government’s new aid strategy.
SDG 3 states the need for the international community to ensure healthy lives and promote well-being for all at all ages, the wording of which is inclusive and implies a world where everyone, regardless of gender, has access to safe, quality care. But it is SDG 5 which puts gender centre stage: Achieve gender equality and empower all women and girls.