The Impact of HIV on the Empowerment of Household Women in East Sudan - Research Proposal Example

The Impact of HIV on the empowerment of household women in East Sudan Background Life in Sudan is difficult. Constantly plagued by civil war, the Sudanese are considered as one of the most disadvantaged of all peoples in the world, ranking 171st out of 187 countries in the 2013 Human Development Index (World Bank 2013). While East Sudan has not been besieged by deadly conflict since the signing of the Eastern Sudan Peace Agreement (ESPA) in 2006, the root cause of conflict still remain (International Crisis Group 2013). More than the issue of identity, governance, wealth and power sharing, East Sudan is also plagued by severe gender inequality where women are subjected to extreme poverty, gender-specific violence, and other discriminatory practices. While women are considered at the center of family and labor force in East Sudan, they are not afforded with the same rights as men – they are prevented from participating in decision making, they are not allowed to own land and other economic assets and they are often relegated with tasks that are limited to caring for the home (Alkhaldi 2012). The inability of the government to create concrete solutions to the long-standing conflict in East Sudan, the social and economic status of women have further deteriorated, hence limiting their opportunity for education, livelihood and access to government services. Making up half of the population in East Sudan, women help sustain the power balance in the country. They have stood as household heads when the men has left their homes, earning income from agriculture, small-scale husbandry, handicrafts and food processing. And yet, despite their central role to the economy of East Sudan, women are largely forgotten. For example, only 10 to 15% of women can access health services, even less are those women who have access to reproductive health services. Access to health services is particularly important for Sudanese women as data shows that they are bound have more than four births in their lifetime, with a one in thirty chance to die from maternity related causes (Planned Parent Hood 2014). Moreover, the low rates of contraceptive use put Sudanese women at high risk for unintended pregnancy and HIV infection. The problem with HIV is that it deprives “families, communities and entire nations of their young and most productive people” (Loewenson & Whiteside 2001, p.1). It is not just a health issue, but rather, one that affects entire economic, political and social systems. The [HIV] epidemic is deepening poverty, reversing human development achievements, worsening gender inequalities, eroding the ability of governments to maintain essential services, reducing labour productivity and supply, and putting a brake on economic growth. The worsening conditions in turn make people and households even more at risk of, or vulnerable to, the epidemic, and sabotages global and national efforts to improve access to treatment and care. This cycle must be broken to ensure a sustainable solution to the HIV/AIDS crisis. (Loewenson & Whiteside 2001, p.4) The position of East Sudan is unique in that it still has very low HIV prevalence rate despite being the largest country in Africa. This provides international organizations a “window of opportunity” to test various methodologies on how to combat the disease and its socio-economic impacts. And yet, as illustrated by the discussion on the current state of institutions in East Sudan, vulnerability to HIV infection is very high. What factors have to be considered in creating policies that will effectively control the HIV epidemic? Who are the main actors to limit HIV transmission? A report published by Ockenden International states that “creating an environment that will empower and encourage communities and individuals to fight the disease themselves and that will have a positive effect on other organisations and individuals” (Lake & Wood 2005, p.7) is the most effective, and the most sustainable way of combating HIV. In the case of East Sudan, this translates to prioritization of gender development as vulnerability to HIV/AIDS is intimately connected to issues of poverty, marginalization, gender inequality and widespread discrimination. While it is impossible to say for sure what factors affect the spread of HIV/AIDS, researches show that “those who are poor, who lack a stable income and access to education and good health facilities and/or who suffer from discrimination and unequal treatment have the most difficulty: firstly, in protecting themselves from the disease; secondly, in living and dealing with the disease once they, or those around them, become infected (Lake & Wood 2005, p.27). In East Sudan, women are the most disadvantaged and require the most help in protecting themselves from oppressive practices that further increase their vulnerability to HIV/AIDS, as well coping with the consequences of HIV infection. In the same way that better education, improved access to improved access to health services and socio-economic support for marginalized groups prevents the spread of HIV infection, controlling HIV prevalence also serves to uplift the lives of women and present them with better opportunities to improve their future. Knowing the important connection between HIV and women empowerment, this paper aims to review current literature on East Sudan in order to determine the various developments made in the country in terms of women empowerment and to assess how the spread of HIV can potentially impact these developments. Moreover, this research hopes to provide various recommendations on how the government can appropriately respond to the rising challenge of HIV infection in East Sudan. Conceptual Framework Controlling the spread of HIV is important as researches show how a full-blown epidemic could cause major social and economic disruptions. This is best illustrated by the case of Africa where the epidemic is considered as the “biggest single obstacle to reaching national poverty reduction targets and the development goals agreed on at the United Nations Millennium Summit” (Loewenson & Whiteside 2001, p.1). How will nations improve its basic social services if its most productive citizens are decimated by HIV/AIDS? How will it improve quality of lives if 40 million children will grow up orphaned? How can countries deliver economic improvements when the major actors for development are burdened by disease? When HIV prevalence reaches a certain level, the rate of infection is difficult to slow down. This is apparent in Africa, where international organizations have barely made a dent despite the millions of dollars and hundreds of hours spent trying to contain the epidemic and prevent new infections. In South Africa alone, 17% of all individuals are estimated to have HIV, while Eastern and Southern Africa registers 48% of all new infections in the world annually (UNAIDS 2011). In the case of East Sudan, a full-fledged HIV epidemic will be detrimental. For one, the number of female households in the country is growing (Lake & Wood 2005). As gender discrimination is still rampant in East Sudan, most women have to contend with complex vulnerabilities preventing them from reaching their full potential. For example, women in East Sudan have very low literacy – they lack training and skills that will allow them to earn high income. Those who are unable to find work in the informal sector engage in sexual relationships in order to provide for their families, making them high risk to HIV. In the event of infection, these women are unable to pay for treatment. Women, the poorest of the poor in East Sudan succumb rapidly to the disease due to extreme poverty and lack of institutional support, leaving behind hungry and impoverished children. And so the cycle continues – unless a concrete intervention is instituted. Displacement is also considered as a major factor to HIV/AIDS proliferation (Lake & Wood 2005). Because women in East Sudan have lower social status compared to men, they have limited control over their own actions; their gender relations are often dependent on cultural norms. Women are subjected to oppressive practices such as female genital mutilation (FGM), rape and other types sexual and gender-based violence. Uprooted from their homes, women in refugee camps are doubly vulnerable as family, social connections and norms change. Increased mobility due to displacement also exacerbates the problem (Lake & Wood 2005) as interaction with different people from different areas leads to changes in lifestyle, and sexual behavior. Previous researches have also shown that the spread of HIV infection follows transport networks and routes. Major towns along the highways have higher rate of infection, and professions with high mobility such as truck drivers have higher HIV incidence. Displacement due to political unrest has led to major changes in social systems which in turn led to further spread of HIV. And women, caught in the middle of the conflict are plunged into situations which renders them powerless and helpless. Because of the central role that women play in East Sudan, improving their wellbeing is essential if any development program will have a lasting effect on the territory. Poverty eradication programs cannot work if female households are not afforded with proper training and education so they can vie better jobs. Health goals cannot be achieved if women do not have the capacity to access health services. East Sudan cannot expect to have productive citizens if its women, the main caregivers of future laborers do not understand what it takes to become a productive citizen. In short, a development program can only be successful if it prioritizes improvement in the lives of the marginalized – in the case of East Sudan, in the lives of women. Owing to the importance of providing institutional support to marginalized sectors, various international groups such as the World Food Program (WFP), the United Nations Development Program (UNDP), the World Bank (WB), and Ockenden International have come to the aid of the Sudanese government. But the world has just started. While delivery of health services has improved, only 12 to 20% of women are able to access it; while educational programs for women are now in effect, only 50% can take advantage of it. Hence, if the HIV epidemic were to become full- blown in East Sudan, all these developments towards the empowerment of women could be decimated. In order to determine the impact of HIV on the empowerment of women in East Sudan, one must first assess the level of women empowerment in the country. In this case, the theoretical framework for understanding the various components of women empowerment developed by CARE Australia can be utilized (2010). Women empowerment can be assessed in three levels: individual (which pertains to women’s own knowledge, skills and aspirations); structural (the cultures, traditions, faiths and hierarchies based on social class, caste, ethnicity and gender); and social relationships (with husbands, children, siblings, parents, neighbours, and religious, government and other types of authority). While CARE’s framework is often utilized to design gender development programs, it provides important insights into the various spheres of women empowerment. In the individual level, the framework shows that empowered women can analyze, decide, and make decisions without outside interference. They know their capabilities and can apply their skills, literacy and leadership in their own lives. Meanwhile, we know from experience that while women may have developed the strong sense of self, structures such as culture and laws can prevent them from exercising their decisions. This is very clear in Saudi Arabia where women have high literacy but are still prevented from driving or traveling without permission of male members of their family. Empowering women requires transformation of gender roles and the various institutions that promote gender norms. It requires the establishment of laws that will not prevent women from exercising their acquired life skills. The last component, relationships talks about the capability of women to relate to their husbands, children, individuals with positions of authority and other women like equals - the acceptance of gender-equitable relationships. Where women are not allowed to have eye contact with men, women may be considered as discriminated against. How does one know that women are empowered? Experience and previous research has identified five indicators of women empowerment (CARE Australia 2010, p.15): 1. Women make important decisions within the household, alone or with other adults. 2. Women participate meaningfully and visibly in the public sphere. 3. Women make decisions and take action regarding their own bodies, their own sexual and reproductive health. 4. Women confidently control productive assets such as capital, farmland or microenterprises. 5. Men cease to commit violence against women. Each of these five key areas involves changes in three spheres and would require comprehensive approaches in order to become successful. Approaches to gender development cannot be piecemeal, but they must be carefully planned so that changes in the three spheres – individual, structional and relational – could be simultaneously implemented. Only when changes on these three realms have been implemented can there be durable empowerment. As CARE aptly describes, “Women’s empowerment is not solely about women, nor can it be achieved only by women. Women’s empowerment also requires changes to the relationships and social structures that shape the lives of women” (CARE Australia 2010, p.10). In the context of HIV infection, only when there is real women empowerment, and essentially, a comprehensive approach to development, can there be a real hope to control the transmission of this deadly disease. In the same manner, if East Sudan hopes to sustain development in its territory and prevent the breakdown of its social systems, it must make comprehensive changes in its various institutions. : Methodology Owing to the interconnectedness of women empowerment and HIV transmission, it is important to note that purely quantitative measures cannot be utilized. As stated in the discussion of conceptual framework for this research, lasting women empowerment can only be achieved if there are simultaneous changes in three levels – individual, structural, and relational. While data on the individual can be easily accessed through various data sources, information on structural and relational changes in East Sudan has to be extracted from previous studies. As such, this study shall utilize both quantitative and qualitative methods to address the research objective. Through these methodologies, this research hopes to define gender development in East Sudan, compare it with other countries and determine how economic indicators relate to women empowerment, and how women empowerment can affected (whether positively or aversely) by HIV prevalence. Quantitative Research “Quantitative research is Explaining phenomena by collecting numerical data that are analysed using mathematically based methods” (as quoted in Muijs 2010, p.1). Quantitative research is all about providing answers to questions by manipulating data through statistics. For the purpose of this research, quantitative research can be utilized to answer these questions: 1. What is the prevalence rate of HIV in East Sudan? 2. What sectors or groups in East Sudan have the highest infection rate? 3. How is HIV transmitted in the East Sudan? 4. What is the level of empowerment of women in East Sudan in terms of decision making, political participation and control of economic assets? 5. What is the level of gender-specific discrimination in the country? To answer these questions, statistical data can be collated from the database international organizations such as the World Health Organization (WHO), International Labor Organization, UNAIDS, WB, and the UNDP. Variables such as the Gender Development Index, the Human Development Index, GDP and GNP, labor statistics, access to health and education services would be valuable for this purpose. Data analysis will be descriptive so as to set the context for further discussion. Where data permits, a regression will be applied to determine how much of HIV transmission is affected by women empowerment and gender-specific violence, and how much of women empowerment and gender-specific violence is affected by HIV prevalence. Through this approach, one can gain an insight into the gender-specific socio-economic impact of HIV in East Sudan. Qualitative Research Just like quantitative research, qualitative research seeks to address a problem by collecting evidence. The main difference is that evidence is no longer in the form of numerical data and collected evidence is specific to the involved population. “It provides information about the “human” side of an issue – that is, the often contradictory behaviors, beliefs, opinions, emotions, and relationships of individuals. Qualitative methods are also effective in identifying intangible factors, such as social norms, socioeconomic status, gender roles, ethnicity, and religion” (Mack & Woodsong 2005, p.1). When used along with quantitative measures, it can provide real world explanation to an otherwise ambiguous data. This research will not collect its own qualitative data, but will instead look at previous literature on women empowerment in East Sudan to provide clues to the following questions: 1. What sort of gender development has already been instituted in East Sudan? 2. How has this development affected the lives of women in the country? 3. What does gender development mean to the control of HIV transmission? To answer these questions, a literature review will be conducted. In order to be included in the review, sources must be peer-reviewed and must be about HIV and women empowerment in general, and East Sudan in particular. Moreover, literature search will be limited to those published in 2000 up to the present. References Alkhaldi, K., 2012. Empowering women for peace and recovery in east Sudan. International Labor Organization. Available at: http://www.ilo.org/public/english/region/afpro/cairo/projects/empowerwomen-sudan.htm [Accessed May 3, 2014]. CARE Australia, 2010. Strong Women, Strong Communities: CARE’s holistic approach to empowering women and girls in the fight against poverty, Braddon. Available at: http://www.care.org.au/document.doc?id=368. International Crisis Group, 2013. Sudan: Preserving Peace in the East. International Crisis Group. Available at: http://www.crisisgroup.org/en/regions/africa/horn-of-africa/sudan/209-sudan-preserving-peace-in-the-east.aspx [Accessed May 3, 2014]. Lake, S. & Wood, G., 2005. Combating HIV/AIDS in Eastern Sudan: The Case for Preventative Action, Surrey. Available at: http://www.cmi.no/file/HIV in Eastern Sudan.pdf. Loewenson, R. & Whiteside, A., 2001. HIV/AIDS: implications for poverty reduction, Mack, N. & Woodsong, C., 2005. Qualitative Research Methods: A Data Collector’s Field Guide, United States. Available at: http://www.ccs.neu.edu/course/is4800sp12/resources/qualmethods.pdf. Muijs, D., 2010. Doing Quantitative Research in Education, SAGE Publications. Planned Parent Hood, 2014. Sudan Country Program. Planned Parenthood Federation of America Inc. Available at: http://www.plannedparenthood.org/about-us/international-program/sudan-country-program-19030.htm [Accessed May 3, 2014]. UNAIDS, 2011. Middle East and North Africa: Regional Report on AIDS 2011, Available at: http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/JC2257_UNAIDS-MENA-report-2011_en.pdf. World Bank, 2013. Sudan Overview. The World Bank. Available at: http://www.worldbank.org/en/country/sudan/overview [Accessed May 3, 2014]. Read More