Transcript Completing the Picture

Gender, Poverty,
and Health:
A Framework for Analysis
C. Mark Blackden
Office of the Sector Director
Poverty Reduction and Economic Management
Africa Region, World Bank
August 21, 2002
Gender & Poverty
Poverty is multidimensional
beyond income poverty: loss of
rights & dignity, powerlessness
inequality, vulnerability, isolation
assets: livelihood security
Gender inequality in access to and
control of assets--impact on growth
Impact of poverty different
for men and for women
Pathways to Improved Health Outcomes
Health
outcomes
Health
outcomes
Households/
Communities
Household
behaviors
& risk
factors
Household
resources
Community
factors
Health system & other
sectors
Health
service
supply
Government
policies &
actions
Health
reforms
Other
parts of
health
system
Supply in
related
sectors
Actions
in other
sectors
Roles of Men and Women
•in the market economy
•in the household economy
Gender-based asset
inequality
Implications
for policy:
CrossSectoral
TradeOffs &
Linkages
 A
Different
Poverty
Agenda =
Better
Health
Outcomes
I
Gender Roles:
Who Does What?
Gender Roles: 1
MARKET
Labor
Segmentation
Key Characteristics
MONETIZED
ECONOMY
PREDOMINANTLY
MALE
GOVERNED
BY LAW
Agriculture
Industry, Services
Informal Sector
What do men and
women contribute
to the market
economy (GDP)?
Uganda: Gender Intensity of Production
Gender Intensity
Share of
Share of
GDP
Exports
(%)
(%)
(%)
(%)
49.0
99.0
75.0
25.0
80.0
20.0
Sector
Agriculture
o/w: Food Crops
33.0
of Production
Women
Men
Traditional Exports
3.5
75.0
60.0
40.0
NTAEs
1.0
24.0
80.0
20.0
14.4
1.0
15.0
85.0
n.a.
n.a.
32.0
68.0
50.6
49.4
Industry
o/w: Manufacturing
6.8
Services
36.6
0.0
TOTAL:
100.0
100.0
Contribution to GDP:
Notes: Gender Intensity of Production - female and male shares of employment.
NTAE = Non-Traditional Agricultural Exports.
Source: Based on Elson and Evers 1997.
Gender Roles: 2
Fuel and water
provisioning
Child care & health
Food preparation
What do men and
women contribute
to the household
economy?
HOUSEHOLD
Labor Immobility
Valued at 30-50%
of GDP
Key Characteristics
UNPAID NONMONETIZED
PREDOMINANTLY
FEMALE
GOVERNED
BY CUSTOM
The “Double Workday” of Women
Benin: Weekly Work Hours by Task and Sex
Principal Activity
17.3
Men
1.3
0.1
Livestock/Anim. husb.
Women
3.6
4.6
Maintenance/Rep.
Activity
24.8
Ag. Prod. Transform.
0.6
2.5
Fetching Wood
0.5
2.9
17.7
21.5
Other Tasks
Fetching Water
0.9
Preparing Meals
0.6
7.0
11.3
50.0
TOTAL
0
10
20
30
40
Hours
Source: Benin --Time Allocation Study, UNDP, 1998
50
67.2
60
70
80
Zambia: Transport Tasks
Domestic
Domestic Travel Time (%)
Agriculture
Services & Social
Women
Men
Other
96
1
3
18%
19%
63%
2.35 hours per adult female per day
Source: Christina Malmberg-Calvo. 1994, Women in Rural Transport …
SSTP Working Paper No. 11. World Bank and ECA.
II
Asset Inequality
(or the gender dimensions
of poverty)
Source: World Development Indicators, 2001.
Country
NEPAL
SENEGAL
GAMBIA
EGYPT
INDIA
MALAWI
SUDAN
MONGOLIA
GHANA
TANZANIA
CAMEROON
NICARAGUA
60
CHINA
80
KENYA
PHILIPPINES
URUGUAY
Percent
Capability: Adult Illiteracy
90
Male
70
Female
50
40
30
20
10
0
Capability: Enrollments
Female Enrollments (as % of Male)
150
125
Percent
100
75
50
Primary: 1995-99
25
Secondary: 1995-97
Country
Source: UNICEF, The State of the World’s Children, 2001.
TANZANIA
KENYA
ZAMBIA
LESOTHO
SUDAN
UGANDA
GHANA
NIGERIA
GAMBIA
SENEGAL
TOGO
MALI
BENIN
ETHIOPIA
GUINEA
CHAD
0
Opportunity: Income Shares
Men
Burkina Faso
Zambia
Uganda
100
CAR
Côte d'Ivoire
80
60
South Africa
Women
Ethiopia
40
Swaziland
Gambia
20
0
Sierra Leone
Ghana
Senegal
Guinea
Nigeria
Guinea Bissau
Niger
Mali
Mauritania
Source: Fofack, in Blackden and Bhanu, 1999.
Source: www.unicef.org/statis (2000).
Country
EGYPT
URUGUAY
20
INDIA
40
PHILIPPINES
CHINA
MALI
NICARAGUA
GHANA
UGANDA
MALAWI
TANZANIA
CAMEROON
NIGERIA
KENYA
ETHIOPIA
Percent
Security: Access to Water
100
80
60
Rural
Total
Urban
0
Empowerment: Men and
Women in Parliament
100%
90%
80%
Men
70%
Women
Percent
60%
50%
40%
30%
20%
10%
Country
Source: International Parliamentary Union, 2001. www.ipu.org.
TANZANIA
CHINA
SENEGAL
MALI
URUGUAY
MONGOLIA
NICARAGUA
SUDAN
MALAWI
GHANA
INDIA
ETHIOPIA
NEPAL
CAMEROON
KENYA
NIGERIA
EGYPT
GAMBIA
0%
Changes in HIV/AIDS
Men 1999
HIV/AIDS
PrevalencePrevalence
Rates by Age
Women 1999
and(15-24)
Gender,
Rates(15-24)
by Age
Men 2001
Selected
SSA
Countries
and
Gender,
Selected
Women 2001
1999-2001
60
50
Percent
40
SSA Countries
30
20
Sources: For 2001: UNAIDS, Report on the Global
HIV/AIDS Epidemic, 2002. For 1999: UNAIDS Country
Data Files, June 2000. www.unaids.org
10
Source:
Source:UNAIDS,
UNAIDS,June
June2000.
2000.
Country
LESOTHO
SWAZILAND
BOTSWANA
ZIMBABWE
SOUTH AFRICA
ZAMBIA
MOZAMBIQUE
KENYA
MALAWI
CAMEROON
BURKINA FASO
SIERRA LEONE
ETHIOPIA
COTE D'IVOIRE
TANZANIA
NIGERIA
UGANDA
GHANA
0
III
Policy Implications for
Poverty Reduction and
Health Sector Strategies
Key Policy Implications: 1
 Because,
in gendered economies,
disparities persist in men’s and
women’s access to and control of
human, economic, and social
assets …
 … gender-based inequality limits
economic growth and diminishes
the effectiveness of poverty
reduction efforts.
Gender inequality and
economic growth

Cameroon: Rice vs. Sorghum
Women do not control the income from rice
production, and prefer the less remunerative task
of sorghum production where they control the
income.
Total household income is lower than it could be.

Burkina Faso: Agricultural Production
Key inputs (fertilizer and manure) are unevenly
distributed.
IF existing resources were shifted between
men’s and women’s plots, output up by 10-20 %
Closing the gender gap in schooling
boosts economic growth
4
3
(percent)
Average annual growth in
per capita GNP, 1960-1992
Actual growth rate
Projected growth rate
2
1
0
Sub-Saharan Africa
South Asia
Source: “Engendering Development” (PRR) 2001,
in WDR 2000/01, “Attacking Poverty”.
Middle East/North Africa
Key Policy Implications: 2

Household Economy - significance
Double workday: 5+ additional hours/day
for women in domestic tasks
 Low labor productivity, highly energyintensive, inefficient


Health Implications
Head-loading, fatigue,
 Environmental factors


Interdependence with market

Trade-offs and linkages very important
Interdependent …
GENDER DIVISION OF LABOR
ACCESS & CONTROL
OF RESOURCES
MARKET
HOUSEHOLD
Labor
Segmentation
Key Characteristics
MONETIZED
ECONOMY
PREDOMINANTLY
MALE
GOVERNED
BY LAW
Labor Immobility
Valued at 30-50%
of GDP
Key Characteristics
UNPAID NONMONETIZED
PREDOMINANTLY
FEMALE
GOVERNED
BY CUSTOM
LABOR SUPPLY
Invisible?
MARKET
Labor
Segmentation
Key Characteristics
MONETIZED
ECONOMY
PREDOMINANTLY
MALE
GOVERNED
BY LAW
Key Policy Implications: 3
 Because
the poor, especially
women, have little or no voice in
decision making …
 … gender needs to be a criterion
for inclusion in poverty reduction
initiatives, and
 a criterion for prioritizing policy
and investment choices
IV
A Different Agenda for
Gender-Responsive Poverty
Reduction and Health
Sector Strategies
Engendering Priority Actions: 1

Gender as criterion for inclusive
participation in setting poverty reduction
policy and investment priorities:




“gender budget initiatives”
inclusion in policy fora (PRSP)
local-level audit & accountability
Gender as criterion for prioritizing
economic policy and investment choices:


pro-poor growth with focus on agriculture &
informal sector
reorient research/extension, financial services,
production & labor-saving technology
Engendering Priority Actions: 2

Concurrent investment in genderinclusive human development:
education, literacy, vocational skills
 health, nutrition, fertility
 grassroots management training


Concurrent investment in the household
economy -- highly relevant for poverty
reduction, growth, and for health:

water/sanitation, domestic energy,
transport (IMT), & labor-saving technology
Different Transport Burdens
(Tonne-Km/Year by Sex)
Water
Fuel
40
40
35
35
Water Women
30
Water Men
Water Other
25
20
15
Tonne-Km/Year
Tonne-Km/Year
30
25
Fuel Women
Fuel Men
Fuel Other
20
15
10
10
5
5
0
0
Ghana
Tanzania
Zambia
Ghana
Country
Source: Christina Malmberg-Calvo. 1994, Women in Rural Transport …
SSTP Working Paper No. 11. World Bank and ECA.
Tanzania
Country
Zambia
Water and fuel investments
significantly reduce collection time
Investments in water and fuel infrastructure
significantly reduce time on collection activities
Annual time savings (hours per household)
Potential average annual time savings
Potable water
within 400m
600
Woodlots within
30 mins walk
400
200
0
Lusaka Rural
Kaya
Mbale
(Zambia) (Burkina Faso) (Uganda)
Kasama* Dedougou*
(Zambia) (Burkina Faso)
* Kasama & Dedougou already within the target for water.
Source: Barwell 1996, in Engendering Development, PRR, 2001.
Engendering Priority Actions: 3
 Integrate
gender into statistics,
national accounts & poverty work
(make gender VISIBLE!)
 intra-household
modules in surveys
 gendered economic production data
 gender-based benefit incidence
analysis of public expenditures
 integrate household (care) economy
into statistics and accounts
 country-specific time surveys