Women and ICT in Africa and the Middle East: Changing Selves, Changing Societies
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Women and ICT in Africa and the Middle East: Changing Selves, Changing Societies
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Product Details
| ISBN-13: | 9781783600458 |
|---|---|
| Publisher: | Bloomsbury Publishing |
| Publication date: | 10/09/2014 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 336 |
| File size: | 1 MB |
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Women and ICT in Africa and the Middle East
Changing Selves, Changing Societies
By Ineke Buskens, Anne Webb
Zed Books Ltd
Copyright © 2014 Ineke Buskens and Anne WebbAll rights reserved.
ISBN: 978-1-78360-045-8
CHAPTER 1
Healthy women, healthy society: ICT and the need for women's empowerment in Yemen
AHLAM HIBATULLA ALI, HUDA BA SALEEM, NADA AL-SYED HASSAN AHMED, NAGAT ALI MUQBIL AND ABEER SHAEF ABDO SAEED
When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied. (Herophilus)
Introduction
The state of women's health in Yemen is deeply worrying. Reproductive health studies have shown that Yemen's maternal mortality ratio is among the highest in the Middle East and North Africa region (World Bank 2012). According to the Yemeni National Strategy for Reproductive Health (Republic of Yemen 2011), 'Yemen has a high maternal mortality rate of 365 deaths per 100,000 live births so that amounts to approximately seven to eight women dying each day from childbirth complications'. Ranking as the country with the highest overall gender gap among 136 countries, Yemen also has the highest gender gap in the Middle East and the highest in the lower-middle income category (Haussman et al. 2013: 12, 13, 17, 20). With an adult male literacy rate of 81.18 per cent and an adult female literacy rate of 46.79 per cent, the gender inequality in terms of education is striking (Index Mundi n.d.).
As professional Yemeni women working in the fields of science and medicine, we, the Yemen GRACE Health Research team, all firmly believed that women's reproductive health problems could be resolved by raising awareness among Yemeni women about more effective forms of health care. We were aware of studies that suggested that information and communication technologies (ICTs) could contribute to improving women's health, and we saw in these a ray of hope. We assumed that ICTs, such as radio, television, mobile phones, computers, e-mail and the Internet, could be used to disseminate valuable health information to Yemeni women and improve their health-seeking behaviour.
Inspired by both personal success with ICTs and international research about the potential of ICTs in disseminating evidence-based knowledge, empowering people and significantly improving the health of vulnerable groups (see e.g. Mechael 2005; Maitra 2007; Buskens 2010), through our research project we intended to explore and investigate possibilities of empowering Yemeni women with information through ICTs (old and new) related to their reproductive health and well-being. We focused on women's reproductive health because of risks involved with pregnancy and the high rate of mortality during childbirth, which, if appropriate measures are taken, in many instances can be prevented. We chose Aden, Yemen's economic and commercial capital, as our area of research, and did our fieldwork in the districts of Salah-al-Deen, Fuqum, Al-Buraiqa and Madinat Al-Shaab. These areas are all characterized by a culture of strict conservative beliefs as well as under-use of health services.
We hope that our findings will be useful to efforts to improve women's reproductive health care in Yemen and beyond, particularly those involving the use of ICTs for dissemination of health-care information.
Study rationale
Studies have shown that use of ICT can have a positive health impact in developing countries, especially in remote areas where long distances and poor infrastructure hinder the movement of physicians and patients (Geissuhler et al. 2003). ICTs, especially mobile phones, are emerging as powerful tools in the facilitation of health-care message delivery, knowledge-sharing and health-care service delivery (Mechael 2005). ICTs are also believed to 'play a decisive role in behavioural change communication and safe motherhood. ICTs will help in improving connectivity for individuals and communities, which in turn may provide access to critical transformational information' (Maitra 2007: 1).
Given this potential of ICTs, we felt that if adopted correctly they could also play a significant role in Yemen: raising awareness about the importance of maintaining a healthy lifestyle, clarifying misconceptions about reproductive health care and equipping women with information relevant to good reproductive health.
Research approach
In our research we posed the following questions:
• To what extent do women in these areas of Aden use ICTs as sources of reproductive health information?
• Who is/are the decision-maker(s) in the family pertaining to women's reproductive health care?
Our research respondents were women aged between fifteen and forty-nine years who attended reproductive health clinics in public polyclinics and lived in the Salahal-Deen, Fuqum, Al-Buraiqa and Madinat Al-Shaab districts.
The research process had the following phases:
• pre-intervention, where we administered a baseline questionnaire to 201 women;
• intervention (six months), with delivery of health messages through television and radio: these messages focused on issues of reproductive health such as family planning and contraception, negative consequences of early marriages, advantages of regular visits to health centres, etc.;
• post-intervention, where we reintroduced the same questionnaire to four hundred women;
• interviews, where thirteen women were interviewed to obtain a better insight into issues;
• closure, with a final follow-up with health professionals who had administered the questionnaire at the health clinics.
Health professionals at the targeted clinics, who were trained by the research team for that purpose, administered both the pre-intervention and post-intervention questionnaires. From among the women visiting the targeted health clinics, 201 women selected through convenience sampling participated in the pre-intervention phase.
During the following six-month intervention period, we sent out health messages through the local radio station and Aden television channel. Our messages had a special design so that they could be easily identified from others sent out by the Ministry of Health and Population. However, our plan to send health messages via mobile phone did not work out because the mobile phone companies (we approached Yemen Mobile and Saba Phone) were not interested in collaborating with us on this issue.
After the intervention phase, the post-intervention questionnaire was administered to four hundred women visiting health clinics in the targeted areas. However, this questionnaire had a methodological flaw: the question pertaining to the mobile phone intervention that we had planned but that did not happen was not removed from the questionnaire, so when health professionals administered it this question remained.
The post-intervention questionnaire was followed by thirteen in-depth interviews, from which we hoped to gain a better insight into women's health information sources and health-seeking behaviour. Regarding the interviews it needs to be noted that we approached many women over a period of three weeks but most declined, saying that sharing personal information with a stranger would be inappropriate. We therefore included all those women who agreed to be interviewed.
To check data reliability the team leader interviewed all of the health professionals involved in the research process, both in person and over the phone, after data collection had been finalized.
Findings from the pre- and post-intervention questionnaires
Processing health information
In the pre-intervention questionnaire we asked participants which ICTs they used as information sources. In the post-intervention questionnaire we asked participants the same question as well as whether they had seen our health messages on television or listened to them on the radio. We made sure that respondents knew what we were talking about by explaining the characteristics pertinent to our messages.
Most of the women said they had not noticed our health messages. Interestingly, though, a small percentage (3.2 per cent or thirteen women) said they had received messages via mobile phone, which was puzzling because we did not have a mobile phone intervention (Table 1.1). We could not find any other source that would have sent health messages via mobile phone in that period.
What are women's sources for obtaining reproductive health information? While trends in terms of health-information-source use remained more or less the same in the six-month intervention period, women professed that they used television more than listening to health staff, relatives or friends or listening to the radio; they also used mobiles minimally. The results from the pre-intervention questionnaire differed considerably from those from the post-intervention questionnaire (Table 1.2).
Making health decisions
Who was/were the decision-maker(s) in the family pertaining to women's reproductive health care? In terms of decision-making, the trends shifted in the intervention period. In the pre-intervention stage, mothers-in-law featured more prominently as decision-makers (8.9 per cent or eighteen cases) than self-decision (5.5 per cent or eleven women); in the post-intervention phase, self-decision accounted for a much higher percentage than the mothers-in-law (20.8 per cent (83) versus 2.2 per cent (9)) (Table 1.3).
What did not change, however, was that the husband appeared to be the major decision-maker in both the pre-intervention and post-intervention stages (56.7 per cent (114 cases) and 44 per cent (176 cases) respectively), followed by the group that favoured a joint decision by both husband and wife in both the pre- and post-intervention stages (28.9 per cent (58 cases) and 33 per cent (132 cases) respectively).
Reflection on the quantitative results
As the respondents reported that they had not received our health messages, we could not explain the difference between the pre- and post-intervention results. Before drawing any conclusions we decided to contact the health professionals who had administered the questionnaire. The team leader set out to interview these health professionals both in person and over the phone to gain further insight into the process behind the data collection.
These follow-up interviews revealed some interesting information. In three of the targeted areas – Al-Buraiqa, Fuqum and Salah-al-Deen – the health professionals who administered the questionnaire stated that most of the women participants came thinking they would receive something in return for filling out the questionnaire.
Furthermore, referring to the illiterate women participants, health professionals in Al-Buraiqa, Fuqum and Madinat Al-Shaab stated that it had taken a long time to explain the questions to them. Some of these women had answered the questions positively – giving the feeling that they just wanted to be done and leave – and others had asked the health professional to fill in what they thought appropriate.
Health professionals in Salah-al-Deen and Al-Buraiqa pointed out that they had mentioned to the participants that health messages would be sent through radio, television and mobile phones.
Findings from the interviews
When talking about our thirteen women participants we use pseudonyms in all cases.
Roles of ICTs in women's lives
The results from the interviews showed that some women, such as Husun, lacked access to the devices themselves: 'I don't listen to radio programmes. TV is [on] all the time with my teenage kids.' Others, such as Gala, could not comprehend the television language: 'Awareness? Radio? No. TV? The programmes are difficult to be understood and nobody watches the Yemeni channels.' Some, such as Latifa, remained engrossed in household chores: 'No one listens to the radio, and I am too busy with housework to watch TV.'
A role for ICTs in obtaining health information?
Husun considered medical counselling and neighbourhood women's gatherings as good sources of health information. Gala indicated her health-information sources as (in order, from top to bottom): husband, neighbours, teenage children and finally doctors, and believed these were adequate, explaining: 'No one reads journals or watches TV as people are struggling for their needs; they need food and medicine.' Tawadodd had a similar view of ICTs:
I don't like radio. Sometimes I watch TV but I do not understand everything they say. I'm sad that I didn't go to school because if I'm educated, I will understand better and become well informed. I think it is better to ask doctors or midwives. I can ask them everything in privacy.
The other women who were interviewed did not rely on ICTs (television and radio) for information either, except Aysha, who had a university degree.
Health decision-making
Women's health-seeking decisions varied from self-made decisions to joint decisions to having no voice in the matter. Hasna'a confirmed: 'I made the decision and I cleared it to my husband! My in-laws don't have any word in it. As a family, we are taking our own decisions.' Hasna'a said: 'I made it, I told you, I don't care if he gets a new wife', indicating that making her own health decisions is not without controversy in her family. Husun mentioned that, as long her house, kids and husband's needs are taken care of, she is free to meet the neighbours or go to the doctor.
Warda explained that her mother-in-law is the decision-maker on household issues as well as family planning. Tawadodd and Mariam said they had family members make decisions for them. Asma, Fathiya, Wahida and Latifa said they made joint decisions (related to family planning).
Poverty
Poverty affected the lives of the women we interviewed in various ways. Tawadodd, a poor woman suffering from infertility, visited private clinics but money became an issue so she then came to the public clinic. For Tawadodd, both health and good food cost money – money that she did not have. She lived under the fear that, if she did not conceive, her husband would remarry and divorce her, as he could not financially support two wives.
Latifa, whose husband's income was 17,000YR ($81) per month, was pregnant with her third child and felt distressed, saying that the child was a mistake as they could hardly afford good food (meaning meat, chicken, fish, salad, fruit). Driven by poverty, some of the women we interviewed sought family planning to avoid the financial burden of having more children to take care of, and we noticed a joint decision in such cases.
Health care, self-care?
The women we interviewed realized the need for a healthy lifestyle, but their health consciousness did not seem to stem from a sense of self-love but rather as a means to an end: to take care of their family. As Warda expressed it: 'I have to put myself first sometimes or no one will take care of my children and husband.' Asma placed herself last when she told us that taking care of herself was essential for her kids and husband, and lastly for herself. Husun took care of herself because 'we need to be healthy ... Otherwise, our husbands will get new wives and our children will be taken away. Finally, we will only suffer.'
Latifa did not believe in regular check-ups, and said: 'Even when I am sick I take some medicine that my husband gives me. I go to the clinic when the kids are sick' (before this visit, her husband had seen that she was very sick so he had insisted she visit the clinic). Similarly, Fathiya ate well and took care of herself but went to see a doctor only when she felt unwell. Hasna'a, however, said: 'First my health, then my children's sake. We have to put our priorities – we are not stupid, most people are careless.'
Discussion
Our endeavour to investigate the possibility of using ICTs as a means of empowering Yemeni women living in conservative and under-resourced areas with limited reproductive health information led us to discover a complex reality that challenges the very implementation of ICTs, particularly the new ones, for this purpose.
Poverty was the major impediment to the use of new ICTs in our research environment. In poverty-stricken households such as those of Tawadodd and Latifa, computers, mobile phones and the Internet were unheard of. Poor families that are trying to meet their basic needs cannot afford a mobile phone or Internet service. The monthly bills would place an insurmountable extra burden on an already inadequate income. Almost half of the women in our study were illiterate, and this emerged as another major factor impeding the use of ICTs, since both text messaging and the Internet require reading skills. It has been establishedthat factors such as poverty, illiteracy (which includes computer illiteracy) and language barriers constrict women's use of ICT (United Nations Development Programme 2005: 7).
(Continues...)
Excerpted from Women and ICT in Africa and the Middle East by Ineke Buskens, Anne Webb. Copyright © 2014 Ineke Buskens and Anne Webb. Excerpted by permission of Zed Books Ltd.
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Table of Contents
- Foreword - Matthew L. Smith
- Introduction - Ineke Buskens
- Part I: Agentic ICT Use: The Aspiration for Emancipation Versus the Power of Gender Traditions
- 1. Healthy Women, Healthy Society: ICT and the Need for Women's Empowerment in Yemen - Ahlam Hibatulla Ali, Huda Ba Saleem, Nada Al-Syed Hassan Ahmed, Nagat Ali Muqbil and Abeer Shaef Abdo Saeed
- 2. Computer Proficiency and Women's Empowerment: Gendered Experiences of ICT at the University of Khartoum - Amel Mustafa Mubarak
- 3. Towards Non-Gendered ICT Education: The Hidden Curriculum at the National University of Science and Technology in Zimbabwe - Buhle Mbambo-Thata and Sibonile Moyo
- 4. Equal Opportunities on an Unequal Playing Field: The Potential for Social Shange in the ICT Workplace - Salome Omamo and Edna R. Aluoch
- 5. Can New Practice Change Old Habits? ICT and Female Politicians' Decision-Making in Senegal - Ibou Sané
- 6. Personal Expansion Versus Traditional Gender Stereotypes: Tunisian University Women and ICT - Oum Kalthoum Ben Hassine
- 7. Hiba's Quest for Freedom: ICT and Gender-Based Violence in Yemen - Rokhsana Ismail and Radia Shamsher Wajed Ali
- Part II: Developing Critical Voice in and Through Safe ICT-Created Space
- 8. ICT in a time of Sectarian Violence: Reflections from Kafanchan, Northern Nigeria - Kazanka Comfort and John Dada
- 9. Disconnecting From and in the Public Sphere, Connecting Online: Young Egyptian Women Expand Their Self-Knowing Beyond Cultural and Body-Image Dictates - Mervat Foda and Anne Webb
- 10. Teenage Girls' Sexting in Cape Town, South Africa: A Child-Centred and Feminist Approach - Jocelyn Muller
- 11. Of Browsing and Becoming: Young Yemeni Women Enhance Their Self-Awareness and Leadership Capacities - Zahra Al-Saqqaf
- 12. ICT in the Search for Gender Freedoms: Jordanian University Students Think, Talk and Change - Arwa Oweis
- 13. Scheherazades of Today: Young Palestinian Women Use Technology to Speak Up and Effect Change - Vera Baboun
- 14. Jordanian Bloggers: A Journey of Speaking Back to the Politics of Silence, Shame and Fear - Rula Quawas
- Part III: ICT- Enhanced Relating and Becoming: Personal and Social Transformation
- 15. Sex, Respect and Freedom From Shame: Zambian Women Create Space for Social Change Through Social Networking - Kiss Brian Abraham
- 16. Ancient Culture and New Technology: ICT and a Future Free from FGM/C for Girls in Sudan - Einas Mahdi Ahmed Mahdi and Ineke Buskens
- 17. Finding New Meaning, Creating New Connections: ICT Empowers Mothers of Children with Special Needs in Egypt - Nagwa Abdel Meguid
- 18. Serving Self and Society: Female Radio Presenters in Uganda Effect Social Change - Susan Bakesha
- 19. Challenging the Silence, Secrecy and Shame: Transforming ICT's Role in Increasing Pre-Marital Sex in Sudan - Ikhlas Ahmed Nour Ibrahim
- 20. Reviving the Power of Community: How Radio Rurale Femme de Mbalmayo in Cameroon Became a Catalyst for Equality and Democracy - Gisele Mankamte Yitamben
- 21. Transforming Relationships and Co-Creating New Realities: Landownership, Gender and ICT in Egypt - Saneya El-Neshawy
- Part IV: Methodology
- 22. Research Methodology for Personal and Social Transformation: Purpose-Aligned Action Research, Intentional Agency and Dialogue - Ineke Buskens
- Notes on Contributors
- Index