Pressing for Progress on Women's Health


Grameen Foundation blog
Grameen Foundation and local partners help women in India access financial services and other resources they need to safeguard their health.
© Photo Credit: Grameen Foundation/Cassie Chandler

One of the most powerful health tools is something many of us take for granted: the power to make decisions about health care.

This is still a dream for far too many of the women I have worked with over the past 20 years. Many have no say in how their family spends money. And it is not just because of poverty; gender norms dictate that men control the cash in the household.

This marginalization has significant health consequences. When women do not participate in making household decisions and have no control over household resources, they cannot prioritize the family’s health needs. Yet, as the primary caregivers of their children, women are more intimately familiar with not only their own, but also their family’s health needs.

Understanding such social and gender norms is crucial to improving women’s empowerment and family health. Indeed, gender norms that impact health go beyond the issue of who has a say in household decision-making. They include, for example, social customs that severely restrict women’s ability to own or access land—even though women are often the mainstay of food production and providers of household nutritional security. And, in many rural areas, women still need spousal permission to leave their village, impacting their ability to access financial and health services.

Faced with these challenges, how can women ensure their families get the care they need?

Strengthen intra-household connections

Gender dynamics play a critical role in a woman’s ability to get health care for herself and her children. In homes where husbands make virtually all household decisions--even food purchases or whether to seek healthcare--gender dialogue programs can strengthen women’s positions. One program developed by Grameen Foundation and managed by our partner, Freedom from Hunger India Trust, showed remarkable results. Working through local self-help groups, we brought members and their husbands together for facilitated conversations that aimed to increase joint decision-making on issues such as household finances, health, and nutrition.

As a result, joint decisions on food purchases increased by 28 percentage points to 55 percent. The women also gained greater autonomy and could move around more freely outside the home.

Saraswathi Rao, CEO of Freedom from Hunger India Trust, noted, “With this, they began to change the crops they grew, what they ate and fed their children, how they treated common childhood illnesses like diarrhea, and when and where they sought health care.”

Create new access to financial services

Given that 1.1 billion women worldwide lack access to formal financial services, in many parts of Africa and Asia, informal savings groups provide invaluable financial and social support to women. Groups meet regularly to save into a common pool, sometimes setting aside as little as 15 cents per member each week. Strengthening savings groups can offer women greater access to funds for health, other financial services and special training. For example, in Benin, we helped savings groups build separate savings pools that are used to provide health-related loans to members. In the first year, the groups collectively granted 2,000 loans, averaging $9, to members.

In our world of health care debates it can sometimes be shocking that a woman’s access to $9 could be the difference between health and sickness for her and her child.  But with $9, a pregnant woman can buy iron tablets to combat anemia, the mother of a toddler can by oral rehydration salts to treat diarrhea.

Pressing for more progress

More people have access to essential health services today than in 2000. But health care costs still push 100 million people a year more deeply into poverty, according a recent report by the World Health Organization and the World Bank.

To strengthen the progress of the past and ensure that no one must choose between essential health care and other needs of daily life, the development community must help women in the poorest communities gain access to the financial resources they need and the power to use them. Together with our partners, Grameen Foundation is working to bridge the critical links between women’s empowerment and improved health outcomes for women and children in poor communities.