Module 2: Gender and Power Dynamics

Gender roles and the lack of power that women have in many traditional societies adversely affect the health of women in many ways. For example, reproductive roles can be emphasized, resulting in high birth rates, high maternal mortality, and this emphasis can interfere with a woman’s autonomy, limiting her decision making power and use of financial resources.(1) For example, in 2008, Nepal’s maternal mortality rate reached 830 deaths per 100,000 live births (compared to less than 15 deaths in developed nations). Though limited facilities and lack of quality of care contribute to this high maternal mortality rate, the disempowerment, low status, and restricted decision-making capacity of females also contribute. In addition, in many societies, women are valued only for their ability to produce children, and they may put themselves at risk in order to do so. As a Nepalese woman explains, “I got married when I was 14 years old and after 2 years of marriage I became a mother. I have no intention to have another baby before this one goes to school, but my husband doesn’t agree. He wanted to have at least four sons. It won’t affect him even if I die during childbirth but I have to produce them because it was his wish.” (2) For more information about child marriage and its effects on the health of women please see:

Women’s Empowerment and Increased Domestic Violence

Though many studies have recognized the benefits of empowering women, it is important to realize that, in some societies, empowering women may actually lead to increased domestic violence and familial tensions. For example, women who take out microfinance loans may serve as a conduit for loans to men, may have little control over their loans, and may be forced to repay through coercion. In addition, their forced attendance in group meetings may lead to domestic tensions. Thus, participation in microfinance programs can lead to short term increases in domestic violence. This increase in domestic violence may be a natural reaction of a patriarchy that is challenged. (3) “Women’s exercise of autonomy, through for example, participation in micro-savings and credit groups in conservation social settings may be viewed as provocative because they undertake actions that challenge prevailing norms governing women’s propriety and modesty.” (4)

A study conducted in 2006-2007 surveyed 69 Bangladeshi villages and corroborated these ideas; it found that female borrowers who had less control or no control over their credit experienced significantly more domestic violence. This led the authors of the study to hypothesize that female borrowers face more domestic violence than non-borrowers. “Anecdotal evidence suggests that due to a male dominated power structure within the family, male members use their spouse to borrow the credit from credit programs and then use the borrowed credit for their own purpose. Since the female borrowers have to pay back the weekly installments for credit, they face violence from their spouse when they pressurize them for weekly installment and their husbands are unable or unwilling to repay it.” (5) Though women in some families earn most of the money, it is often the man who controls the financial resources. Therefore, “as long as the traditional female ideals persist, increased income will not necessarily translate into increased power/control in the household (and therefore improved mental and physical health).” (6)

Studies have also found that, in general, giving women equal access to the workforce is not always positive and increases their daily work requirements. Often, when women enter the workforce, especially in families with traditional gender-role-attitudes, this action increases their husbands’ psychological distress by reducing his power in the family and threatening his self-esteem.(7) Additionally, women who enter the workforce are often confronted with the ‘triple burden of employment’ where they must take care of the housework and child care, in addition to taking on extra paid work. This extra burden leaves women with very little free time and increases their daily stresses. “Mother and Wife are the traditional roles that women have been expected to fill, but now many women are expected to fill the new role of worker; and it is this new role that has pushed many women to the psychosocial, mental, and emotional problems they are experiencing. Women are now not only involved in domestic life, but are expected to be the so-called ‘breadwinner’ of the home as well.” (8)

Women Forced Into Prostitution

As Nicholas Kristof and his wife, Sheryl WuDunn, explain in their book “Half the Sky: Turning Oppression into Opportunity for Women Worldwide”, “it’s not hyperbole to say that millions of women and girls are actually enslaved today… The term that is usually used for this phenomenon, ‘sex trafficking,’ is a misnomer. The problem isn’t sex, nor is it prostitution as such. In many countries- China, Brazil, and most of sub-Saharan Africa- prostitution is widespread but mostly voluntary (in the sense that it is driven by economic pressure rather than physical compulsion). In those places, brothels do not lock up women, and many women work on their own without pimps or brothers. Nor is the problem exactly ‘trafficking,’ since forced prostitution doesn’t always depend on a girl being transported over a great distance by a middleman. The horror of sex trafficking can more properly be labeled slavery.”(9)

The number of women who are forced into prostitution is hard to estimate. However, The Lancet calculates that 1 million children are forced into prostitution every year, and the total number of children forced into prostitution could be as high as 10 million. The problem is particularly great in South East Asia where up to a quarter million women and girls are forced into prostitution each year.(10) These girls are often raped, locked up, denied food, water, and medical care, and are drugged if they refuse to comply with the brothel owners’ wishes. Most girls are lured away by promises of jobs as domestic workers, restaurant workers, or educational opportunities only to end up in brothels.  In India, it is estimated that there are two million prostitutes, and at any one time, 20,000 girls are transported from one part of the country to another. Research also shows that around 5,000 to 7,000 Nepalese girls are trafficked yearly into India.(11) In addition to the horrendous human rights violations that these adolescent girls suffer, they are also highly susceptible to contracting HIV and other STDs. For example, in Indonesia, HIV prevalence was nearly 20 % among trafficked women who had been sexually exploited for a year or more. In Cambodia, 73 % of women and girls tested positive for sexually transmitted infections.

Sex trafficking and forced prostitution is a large economic industry. The industry has grown in recent years because it is extremely profitable and the risk of prosecution is low since most countries have weak laws on trafficking. An analysis of the Thai economy shows that earnings from trafficking Thai women are close to $3 billion annually. In addition, in the U.S., data suggest that traffickers earn about $60 million a year from trafficking women and children.(12) Thus, “the economic approach to forced prostitution indicates that, because of the profit margins at stake and the large number of beneficiaries involved, it will not wither away. Rather, its existence must be actively assailed by addressing the supply as well as the demand side.”(13)

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(1) Ay, P., Hayran, O., Topuzoglu, A., et. al. “The influence of gender roles on health seeking behaviour during pregnancy in Turkey.” The European Journal of Contraception and Reproductive Health Care. 14.4 (2009).

(2) Regmi, K., Smart, R., and Kottler, J. “Understanding Gender and Power Dynamics Within the Family: a Qualitative Study of Nepali Women’s Experience.” The Australian and New Zealand Journal of Family Therapy. 31.2 (2010).

(3) Hashemi, S., and Rojas-Garcia, E. “Microfinance and Domestic Violence.” Accessed on 26 January 2011.

(4) Rocca, C., Rathod, S., Falle, T., and et. al. “Challenging assumptions about women’s empowerment: social and economic resources and domestic violence among young married women in urban South India.” International Journal of Epidmiology. 38. (2009). Accessed on 3 February 2011.

(5) Aktaruzzaman, K., and Guha-Khasnobis, B. “Does Micro-Credit Increase Domestic Violence? Evidence from Rural Bangladesh.” Accessed on 26 January 2011.

(6) Seybolt, M. “How do household dynamics affect maternal health in developing areas of eastern Africa?” Accessed on 16 November 2010.

(7) Ross, C., Mirowsky, J., and Goldsteen, K. “The Impact of the Family on Health: The Decade in Review.” Journal of Marriage and the Family. 52. (1990):1059-1078. Accessed on 15 November 2010.

(8) Seybolt, M. “How do household dynamics affect maternal health in developing areas of eastern Africa?” Accessed on 16 November 2010.

(9) Kristof, N. and WuDunn, S. “Half the Sky: Turning Oppression into Opportunity for Women Worldwide.” (New York: Random House, 2009)

(10) Lyn, T. “Trafficked women face high HIV infection risk.” Accessed on 3 February 2011.

(11) Chattoraj, B. “Sex related offences and their prevention and control measures: an Indian perspective.” Accessed on 3 February 2011.

(12) Ibid.

(13) Kempadoo, K. “Trafficking and Prostitution Reconsidered: New Perspectives on Migration, Sex Work, and Human Rights.” Canadia Journal of Sociology Online. (2007). Accessed on 3 February 2011.