Hesperian Health Guides
Working for change
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Here are some suggestions you can use to work together with health workers to improve health care services. These activities can be used to:
- raise awareness about accessibility, availability, and the attitudes that make it hard for disabled women to find and get good health care.
- identify actions that can improve health care for disabled women.
Meeting in a group to share personal experiences of health care barriers can build each woman's confidence.
- 1 STEP 1. Everyone has something to offer
- 2 STEP 2. Share experiences about health care access
- 3 STEP 3. Role plays to learn about barriers to good health care
- 4 Role plays
- 5 Role play possibilities
- 6 STEP 4. Visit a health center
- 7 STEP 5. What did you find at the health center?
- 8 STEP 6. Which problems are the most important?
- 9 STEP 7. An action plan for improvements
STEP 1. Everyone has something to offer
To help everyone feel comfortable, and to show how each person has a contribution to make, you can ask each woman to tell about something she does well or that she is proud of. (No one has to talk about herself if she does not want to.) For instance:
a good cook.
Maria keeps the peace
between her sisters.
Rania is a skilled
midwife and has
Adetoun is a good storyteller.
The children in her family and
neighborhood love to listen to her.
Ask each person to tell about something she has seen or experienced that has prevented a woman with a disability from getting good health care. Make a list, in no particular order, of the difficulties the women describe.
- no handrails or ramps
- health centers too far away
- transport will not take me
(even when I can afford it)
STEP 3. Role plays to learn about barriers to good health care
Use role plays to deepen everyone's understanding of the difficulties they have listed. Divide the group into several teams that include both health workers and women with disabilities. Ask each team to spend a few minutes preparing a role play about a disabled woman who has trouble getting good health care. Encourage everyone to participate.
Role play possibilities
Here are some role plays you can suggest if the group has trouble coming up with ideas of its own:
After each role play, ask the "actors" to return to the group. Invite the group to ask each other questions about the role plays that will help deepen their understanding of the problems disabled women have in getting good health care.
STEP 4. Visit a health center
After the group has identified some general barriers to good health care access, they can visit local health centers to take a closer look at things that can cause problems for a woman with a disability. Divide the group into 2, if there are enough people, with at least one health worker in each group, and visit one or more health centers. (If possible, do not send a group to visit a health center where the health workers in that group work.) Ask 1 or 2 women in the group to write down or make note of any problems and obstacles they find. Also ask them to note anything they find that is helpful for women with disabilities.
The trip to the health center can also be used as an example of how women can help each other and work together to use each other's strengths to overcome problems. For example, wheelchair riders can guide blind women, and blind women can support women who need help with walking.
STEP 5. What did you find at the health center?
When you return from the visits, have each group describe the problems they found and things that were helpful to women with disabilities. Also ask each group to describe how they were treated by the director of the health center and the staff. You can make a list or draw a map of the problems they found.
- no sign language
- narrow doorways
- no knowledge
have no knowledge
STEP 6. Which problems are the most important?
Discuss the problems seen during the health center visits and ask the women to decide which ones they think are the most important to change, or that they would like to change first. Making improvements to health care services can take planning and time. Your group may want to study the list to see which things you can change quickly, and which may take longer to change. Ask them to talk about why the problems they have chosen are important to work on, and what their hopes and wishes are for the change they may bring if these problems are improved.
STEP 7. An action plan for improvements
Once the group has chosen 1 or 2 problems that make it difficult for women with disabilities to get good health care, they can work on a plan to solve these problems. Ask the group to discuss different ways they can solve each problem, and ask them to think about other people who can help them make these improvements. Work out the steps that will be needed to make these improvements and decide who will be responsible for which step. Then, take action!