STRIVE’s Dr Shelley Lees addressed this key question in her presentation on the Maisha study at one of the parallel events of the 2017 session of the Commission on the Status of Women (CSW) at the United Nations in New York. Audience members and other panelists (primarily programmers delivering services, rather than researchers) were keen to know more about research methods that give women a voice, not only about their needs but about changes in their lives.
Dr Lees was invited to participate by EngenderHealth, who developed the curriculum for violence prevention that the Maisha team adapted for Mwanza, Tanzania. The day before the panel event, Dr Lees spoke about Maisha with the Engender Health team, who are exploring whether micro-finance is, in fact, a form of empowerment. The Maisha study is designed to address the same question, seeking to establish whether reductions in partner violence are associated with access to credit or gender training or both.
Ensuring sexual and reproductive health and rights is the key to women’s economic empowerment, improved agency and overall health and wellbeing. Panel theme, CSW parallel session, 17 March 2017
Poverty and SRH
Dr Lees was asked some specific questions: What have you learned from your research regarding the poverty on the lives of Tanzania women? How does this impact their sexual and reproductive health (SRH)?
“My current research in Tanzania focuses on women’s experiences of HIV and intimate partner violence (IPV), working with colleagues from the London School of Hygiene & Tropical Medicine (LSHTM) and the National Institute of Medical Research (NIMR) in Mwanza. In this large study, Maisha, we are exploring ways to reduce women’s experiences of violence. In this and other studies I am conducting across Tanzania, I have had the opportunity to talk with women about their everyday lives and especially their economic concerns, given most of them are poor.
“Firstly, these women have had lives of struggle, poverty, and for some, early marriage in their youth, which affected their ability to continue into secondary education.
“Many are married or in long term relationships with men who have low or no income. They do have aspirations, mainly to expand their businesses but also, in particular, to ensure that their children have a good education and are able to work in the formal sector, or at least have striving businesses. Poverty limits their agency.
In discussions, I find that women are aware of their rights and want to access high quality health care, especially SRH, but everyday struggles with poverty limit their capacity to do this, especially when they experience IPV or are HIV positive. Dr Shelley Lees, LSHTM
“Any threat to the existing fragile services will further limit the choices women have in their sexual and reproductive health.”
Research that supports women’s agency
In her presentation and the discussion that followed, Dr Lees said that she can see in her research that women are increasingly challenging men’s authority. However, structural barriers hamper their aspirations to be more independent, have a better life, own assets and reduce their more recent dependency on men.
Local researchers need to give voice to women in order to understand these changes. Dr Shelley Lees, LSHTM
A paper in BMC Public Health: ‘Prevalence of intimate partner violence and abuse and associated factors among women enrolled into a cluster randomised trial in northwestern Tanzania’
A brochure outlining the Maisha intervention and the RCT to evaluate it
A short video introducing the Maisha programme and study (in Swahili and English)