This article is written by Myra Betron, gender director for Jhpiego, a global health NGO that works to transform gender roles and norms across the health system with health workers, clients and other influencers of health in the community and household.
Growing up in the Philippines, my mother didn’t have the same opportunities to follow whichever path she wanted as I did, growing up in the 1980s and 90s as a woman in the United States.
She excelled in high school and college, but when she met my father her life took a very different turn. He was smart, charming and persistent. On one of their dates, he forced my mother to have sex with him. She married my father, despite a gut feeling that she should not, because he took her virginity and my grandmother told her she should marry whoever did that. She never went to medical school. After marrying my father, she had four daughters, almost one after another.
When my father started to hit her, she kept it quiet at first, because it was a “private matter”. Fifteen years into the marriage, my mother continued to endure the abuse in the name of keeping the family together. Despite her academic excellence, gender norms – the unspoken rules that govern the attributes and behaviours that are valued and considered acceptable for men and women – prevailed.
To this day, her potential to be a doctor (or whatever else she might have chosen) remains in the category of “what could have been” due to gender-based violence, social norms of purity and the expectation for women to keep the family together at all costs.
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The limits of empowerment
In recent years, rhetoric around “women’s empowerment” has become mainstream and is increasingly promoted from the highest echelons of power – from Bill and Melinda Gates to Ivanka Trump.
As researcher Kathryn Moeller points out in her January 2019 essay in The New Yorker, diverse institutions such as the Gates Foundation, the World Bank and the Nike Foundation all point to data that claims investing in female education has exponential returns, as women are much more likely than men to reinvest their income into the family.
“We need to support women and their families, and we also need interventions to transform the patriarchal relations between men and women”
However, she also rightly points out that “we need to support women and their families, and we also need interventions to transform the patriarchal relations between men and women… that enable these statistics to be true”.
I wholeheartedly agree that women’s empowerment in the traditional sense is not enough. There are additional neglected variables that influence women’s engagement with the world and leadership in their community:
- Entrenched gender roles, norms and expectations about what they should and should not do in public and private spheres
- Equal opportunity and choice in roles and participation in all spheres of society, including the household, community, representation in institutions and government
- Institutions, laws and policies that promote gender equality.
My mother had a supportive family growing up, an excellent education and training. Still, gender norms made it acceptable for my father to abuse her and convinced my mother she should marry and then stay with him for many years. What would her life have looked like had these norms not constrained her?
Bringing women out of the shed
Like my mother, millions of women around the world fail to reach their full potential because they lack basic safety, or are constrained by gender norms that affect their sexual and reproductive health and labour force participation.
I have seen countless examples over the past 18 years working in international development. When I volunteered in Guatemala, my mentee often did not make it to work because her husband beat her.
While living in Tanzania, working on an HIV prevention program that addressed male norms and behaviour that drive the virus, such as gender-based violence, I was told that women in some communities believe they are not loved if their husbands do not beat them.
“Health volunteers shared stories of women being isolated in cow sheds outside their homes during menstruation, due to deeply held beliefs about religious consequences”
On a recent visit to Nepal, health volunteers shared with me stories of women being isolated in cow sheds outside their homes during menstruation, despite laws against the practice, due to deeply held beliefs about religious consequences.
By empowering women with a focus on just their individual health or economic achievement, we fail to recognise the complex social environments in which they interact with others and are impeded or influenced in their actions and decisions.
As a 2007 World Health Organization review found, programs that seek to transform gender roles and promote more equitable relationships between men and women are more effective in achieving desired changes in behaviours.
These interventions facilitate reflective dialogues in groups and community campaigns using drama, media and other organised activities. Yet few health and development initiatives are funded to integrate these approaches meaningfully.
Can we afford to wait?
The Sustainable Development Goal on gender equality calls for the elimination of all forms of discrimination against women and girls by 2030, a lofty goal we will never achieve at the abysmal rates of investment in health programs that actually seek to transform gender norms.
While global multi-agency institutions such as FP2020, The Global Fund to Fight Aids, Tuberculosis and Malaria, Gavi and Global Financing Facility have raised billions of dollars for donors to fight various health issues, there is no parallel funding body to address a key determinant of health: gender inequality.
Some of these bodies do have gender equality strategies, but without designated funding or targets specifically for transformative interventions, there are no teeth behind them.
A few months ago, as I was boarding a plane to assess one of our gender-based violence programs in Nepal, my mother sent me a text message saying, “I want to talk to you about what Serena Williams said.”
I found it a rather cryptic message, but when I called her she explained. “Serena Williams said, ‘I don’t wait to be told I can do something,’” she said in a voice of awe that sounded as if this was something very new to her. After nearly 40 years of being one of my role models, my mother now sees the new rules of what it means to be a woman in her tennis hero.
Let’s not let another 40 years pass before we make gender inequality an issue of the past. The time is now to make gender equality a reality.
To do so, we need meaningful investments in interventions that change the social norms and structures that uphold these inequalities.
Picture credit: Ninno JackJr on Unsplash