Hesperian Health Guides
Gender, power, and health
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One of the traditional qualities of masculinity is being powerful, and men usually hold the most powerful positions in a community. For example, community leaders and government officials are more often men than women. Men are often expected to make decisions without consulting women or considering how women will be affected. In a family, the man is usually expected to be the head of the household and to decide how money is earned and spent. In a couple, the man often expects to control when and how he and his partner have sex or use family planning. These power inequities are at the root of many health problems that are common among women.
Almost everyone has some power. The problem is how power is distributed and used. Discussing different kinds of power can help people see how power can be used in healthy or harmful ways.
Power over is the most harmful kind of power. People usually think of this kind of power as using threats, manipulation, violence, or punishments to force a person or a group of people to do something they do not choose.
More powerful people often use rules, customs, and laws to preserve their power and to control other people and their actions. Less powerful people, such as women, are usually excluded from making or enforcing most of the rules, customs, and laws that govern their lives, including full access to health care. Using power in these ways is sometimes called oppression.
This kind of power can be so strong, and continue for so long, that a person or group with less power accepts the inequity as "normal." When this happens, they may not believe they have any choice or any possibility of making changes, and may pass this point of view on to others.
| ||Power from within is the ability to act on feelings and ideas. This kind of power enables people to imagine a goal and to believe that reaching the goal is possible. Girls and women all over the world show this kind of power when they pursue education despite obstacles, keep their families together in difficult circumstances, and find ways to protect their health and the health of their families and communities.|
|Power with is gained by uniting with others in community, solidarity, and cooperation. Collective power strengthens people’s ability to take action for changes that bring dignity, justice, and health for all to the whole community. To further explore different kinds of power, see the activity More powerful vs. less powerful.|
Health for All
Explore the connection: Gender roles, power, and health
The following activities can help the group explore gender expectations, unequal power relationships, and how both impact women’s health. They can be done together or separately to help explore the connections among gender roles, power, and health. You can also adapt these activities to look at a specific issue of women’s health, such as safe birth, and then discuss how gender roles and power affect that issue.
Activity The balance of burdens
This activity can help a group explore how differences in power and different expectations between women and men cause unequal burdens that affect women’s health. You can do this with a group of women and girls only, or include supportive men.
To prepare: Set up a balance with 2 cans, some string, and a stick. One can is for women’s burdens and the other for men’s. Have some equal-sized beans or stones to put in the cans. Also have some cards or pieces of paper (a regular sheet of paper cut in half works well).
- Tell the story of Vanna's unsafe pregnancies or Emma’s story of Sex and the unhappy bride to help people think about how gender inequities affect women’s health.
- Ask the group to think about the story and also about their own lives and experiences. Ask them to think about how gender expectations sometimes do not allow women or men to behave in ways that protect women’s health. These limitations for men and women can be seen as burdens imposed by gender expectations.
- Ask different people in the group to give examples of "burdens" — gender roles or expectations that impact women’s health. As each person mentions a burden, ask her to add a bean to the women’s or men’s side of the balance, depending on who has the burden. Add extra beans to reflect examples where women’s health is most affected. If a burden is even more dangerous for a young woman, an immigrant, or a minority group, put extra beans in the can too. Write each burden on a card or piece of paper and tape it on a wall, with women’s on one side and men’s on another. Note that many of women’s burdens have to do with the lack of power or access to money and resources.
- Ask the group to look at the balance and which side has the most burdens. Explain that by discussing these inequalities, you are not trying to blame men but to better understand how gender expectations can harm the health of both women and men. When people are not limited by gender burdens, everyone’s lives and health are better. You may want to conclude with a reflection about how to create a better balance between men and women. The domino game that follows is a good way to continue to explore the connections between gender roles, women’s status, and women’s health.
A dominoes game to explore gender inequality and women’s health
"The balance of burdens" activity helps a group examine many of the causes of women’s unequal access to power and health, such as less schooling and more work. In the next activity, you can see the effect of these burdens on women’s health. This activity follows the same rules as a game of dominoes, except that instead of dots, each side of a domino has a cause or effect that relates to women’s health. The causes come from women’s low status or gender expectations. The effects are situations leading to health problems. The group leader’s job is to make this activity as exciting and fun as a game of dominoes while helping people have a serious conversation about how women’s low status can cause serious health problems, even death. The goal is to have a discussion, not a test.
Activity The dominoes game
To make the dominoes:
Make 15 to 20 large rectangular pieces of colored paper or cardboard (8 ½" x 14" works well). These will be your dominoes.
One end of each domino will have a cause. If you did The balance of burdens activity, you may already have made cards or papers for the cause ends of the dominoes. Tape or glue the cause papers onto one end of each of your dominoes. Make copies of the causes if you don’t have enough to put a different one on each of the dominoes.
The other end of each domino should have a woman’s health problem or effect, which you can fill in ahead of time or create as a first step in the activity. Use different colored ink or paper for the health problem end of the domino.
You can repeat causes and effects on the dominoes.
Remember, the cause on one end does not need to match the health problem on the other end of the same domino. Mix them up!
- Introduce the activity: Ask the group to brainstorm health problems that women face. As people name different health problems that affect women, write them onto cards or pieces of paper that will fit the other ends of the dominoes. Tape the health problems onto the dominoes to prepare them for the game.
- Put people into teams of 4 or 5. Give each team the same number of dominoes. Keep one out to start the game, and lay it on the ground or tape it to the wall.
- Each team takes a turn. After the first team’s turn, the next team needs to look at their dominoes and decide if they have a cause or health problem that would relate to the domino already laid out. Remember, for many causes there will be more than one possible health problem, and some health problems may relate to another health problem.
Think about it! "No power to make decisions" is the cause that can match any of these harmful effects.
The first team lays down its chosen domino. The team must explain the connection that they see. If everyone agrees with them, the domino stays. If some disagree, let people talk about it, and if there is still disagreement, the team loses a turn.
If a team has no domino that relates to any of the causes and effects on the dominoes that are already laid out, then they lose their turn.
The first team to use up all of their dominoes wins.
- To conclude, ask the group to discuss the ways in which gender roles and women’s lack of power relate to health problems that women face.