Does volunteer community health work empower women? Evidence from Ethiopia's Women's Development Army. Issue 4 (29th May 2019)

• Record Type: Journal Article
• Authors: Closser, Svea; Napier, Harriet; Maes, Kenneth; Abesha, Roza; Gebremariam, Hana; Backe, Grace; Fossett, Sarah; Tesfaye, Yihenew
• Is Part Of: Health policy and planning. Volume 34:Issue 4(2019)
• Page Start: 298
• Page End: 306
• Publication Date: 2019-05-29
• Subjects: Ethiopia -- health workers -- health systems research -- human resources -- empowerment; Medical policy -- Developing countries -- Periodicals; Public health -- Developing countries -- Periodicals; Health planning -- Developing countries -- Periodicals; 362.1091724
• DOI: 10.1093/heapol/czz025
• Languages: English
• ISSNs: 0268-1080

Abstract

Abstract: Of the millions of Community Health Workers (CHWs) serving their communities across the world, there are approximately twice as many female CHWs as there are male. Hiring women has in many cases become an ethical expectation, in part because working as a CHW is often seen as empowering the CHW herself to enact positive change in her community. This article draws on interviews, participant observation, document review and a survey carried out in rural Amhara, Ethiopia from 2013 to 2016 to explore discourses and experiences of empowerment among unpaid female CHWs in Ethiopia's Women's Development Army (WDA). This programme was designed to encourage women to leave the house and gain decision-making power vis-à-vis their husbands—and to use this power to achieve specific, state-mandated, domestically centred goals. Some women discovered new opportunities for mobility and self-actualization through this work, and some made positive contributions to the health system. At the same time, by design, women in the WDA had limited ability to exercise political power or gain authority within the structures that employed them, and they were taken away from tending to their individual work demands without compensation. The official rhetoric of the WDA—that women's empowerment can happen by rearranging village-level social relations, without offering poor women opportunities like paid employment, job advancement or the ability to shape government policy—allowed the Ethiopian government and its donors to pursue 'empowerment' without investments in pay for lower-level health workers, or fundamental freedoms introduced into state-society relations.