Concept Note  
   
  3. Focal Themes  
   
 

The focal themes for deliberations at the 10th IWHM have been conceptualized to provide a wide canvas to discuss the multi-dimensional and the multi-level violations of women's well being. Discussions around these themes, in our opinion, will enable the 10th IWHM to work towards the goal of arriving at a statement on women's health - a statement that emerges from the lived experiences of women and men and that provides directions for future research, activism, struggles, advocacy and policy.

 
     
 

Focal Theme 1

 
 

PUBLIC HEALTH, HEALTH SECTOR REFORMS AND GENDER

 
 

 

 
 

Several countries have gone through a decade or two of structural adjustment programs as part of the IMF and World Bank lending conditionalities. The adverse results of these impositions have been felt most severely in the social sector, particularly health, education and food security. Nations have been asked to reorient their policies to make their economies 'competitive'. Governments in the South, in particular, have translated competitiveness to mean one or several of the following:

 
 

  • Reduced investments particularly in maintenance of existing public health institutions thereby contributing to their further deterioration
  • Privatising whole or parts of the existing public health infrastructure thereby compelling large sections of the poor and marginalized to either remain without healthcare or buy/pay for their services
  • Commercialization of medical care and education.
  • Medicalization of more and more aspects of women's lives
 
 

This large-scale transformation of the health scenario in many countries all over the world disproportionately burdens the poor and women in particular. Women are forced to cope not only with the inadequacies of the system and with the retreat of the state from the provision of basic health and other services but also bear the burden of being care givers at home under such dire circumstances. The private sector, which was always sizeable in developing countries, has acquired more legitimacy politically in the post-liberalization phase. The latter has not only grown phenomenally but has reduced health care to a profitable industry. The poor record of publicly run health care services has compounded the problem; the poor are compelled to access services since the public systems do not deliver. The increased utilisation of the private sector by the poor is further being used as an argument for legitimising the institution of 'user-fees' even in non-functioning public health care institutions.

 
 
Within this scenario women are seen as good managers, despite poverty. The feminist notions of empowerment are being appropriated to define women in micro-credit and self-help groups as 'empowered' and the small loans they borrow as holding the key to poverty elimination.
 
 
The 10th IWHM hopes to capture the complexities and nuances of the changes in the health and health care scenario across countries, in order to understand how these processes have impacted differentially across gender, class, caste, race, disability, sexuality and ethnicity. What were/are the forms of resistance or negotiations at the local and national levels? How are women and communities being mobilized to evolve alternative models of health care provision, make the state accountable and to assert their right to health care?.