Another common inequality is that of power, which can cause direct harm to women, particularly through gender based violence. Sadly, some women are more vulnerable than others. Young women and adolescent girls, women who are extremely poor or belong to particularly marginalised caste or ethnic groups face more challenges and even greater risk to their health than richer, better educated, urban women. One area where this can be seen is in maternal health. Depending on where a woman lives, there are huge differences between the availability and quality of services during and after pregnancy, and the ability to decide how long to wait until having another baby using modern family planning methods.
The reduction of inequalities between men and women is now central in the international development agenda. The Sustainable Development Goal 5 commits to achieve gender equality and empower all women and girls. The target is that by 2030, all women and girls will have equal rights and opportunities and will be free from violence and discrimination. The UK government’s recent strategic vision for gender equality emphasises the need to work with women’s organisations and movements, advance women’s leadership capacities and make sure that these efforts leave no one behind, especially girls and women who are most discriminated against, for example those living with disabilities, who are non-literate or who live in remote locations.
Options supports these commitments across our programmes, in many different ways. Some of our programmes help women to become actively involved in improving the situation of other women like them. For example, in Nigeria and Malawi we have made sure that community representatives including women, people living with disability, and those from hard to reach communities can lead and participate in health facility committees, which also include health workers. Through these committees, the community representatives have been able to hold health workers to account, ensuring that everyone attending the facility is treated with respect and receives the best quality services the health workers are able to provide. Over approximately 10 years, well over a thousand committees have been strengthened in this way in Nigeria. Recent work in Malawi has shown that supporting these committees is very good value for money – producing greater benefits than the cost of the inputs.
In northern Nigeria, we are also improving essential health care for pregnant women, newborns and children and, by the end of 2019, it is estimated that this will have saved the lives of 60,000 children, 42,000 newborns and 2,000 pregnant women in the six programme states.
We work with many small local civil society organisations through our social movement initiatives. The Girl Generation became the largest global collective of organisations and individuals working to end FGM in one generation. A key message we used was that no country can achieve its full political, social or economic potential when 50% of its population is held back by extreme forms of discrimination. Through The Girl Generation, we worked with over 900 organisations who, in turn reached over 1.5 million people with this message.
In Nepal, we have very recently supported the government to produce guidelines on how to implement its Gender Equality and Social Inclusion (GESI) Strategy. This means that we can now support provincial and local governments to roll out the strategy, ensuring that these issues are incorporated throughout the health sector, including making sure that health facilities are accessible to people with disabilities. We are even increasing gender equality in our health infrastructure work by increasing opportunities for young female architects and introducing women-friendly codes of practice at sites where health facilities are being repaired.
As this important issue gains more prominence on the global agenda, we will build on our experiences and look for new opportunities to apply our social change communication and movement building model to address other pernicious norms and practices that hold back women, girls and other vulnerable groups, such as violence, early marriage, and early childbearing. At the same time, we will work towards building women and girls’ self-efficacy to make healthy choices, and take up sexual reproductive health services, particularly contraception and safe abortion.
Gender equity always has been, and will continue to be at the heart of our work.
Written by Rachel Grellier, Senior Technical Specialist