Abstract
Background
Gender inequality is a significant health-determining factor that has far-reaching consequences for the well-being of children. It has been associated with child mortality and poor health outcomes. The unequal distribution of resources, opportunities and power based on gender lines lead to disparities in access to healthcare, education, and nutrition. Global and national health policies ought to place emphasis on reducing gender inequality to decrease child morbidity and mortality. In South Africa gender equality, although guaranteed by the Constitution, continues to be an elusive reality at grassroots level due to cultures that are deeply patriarchal. While great strides have been made by government to improve access to basic healthcare as a strategy to reduce child morbidity and mortality and female representation in government has improved drastically, there is not much evidence of policies targeted at addressing gender inequality nor raising awareness on the issue, particularly in rural communities. The government should utilize every resource available to raise awareness on gender inequality as a health determinant in the same way it has done in addressing basic education and healthcare, access to clean water and sanitation to improve the health and livelihood of its citizens.
Primary health care (PHC) nurses are not only a readily available resource in this respect but are also a vital link to health promotion, particularly in rural settings. They can therefore play a major role in raising awareness and reinforcing gender equality in their health promotion activities. The purpose of this study was to investigate their understanding and perceptions of gender inequality and its influence on child health to provide some preliminary indication of their readiness to provide gender-related health promotion activities.
Method
A cross-sectional quantitative study was performed with a sample size of 120 participants, calculated using the EPINFO version 7.1.3. The respondents were selected using the proportional random sampling methodology from rural clinics in the Vhembe district in Limpopo province. A semi-structured questionnaire was administered to collect data on participants’ demographics, knowledge, perceptions, and health promotion practices. The data was analysed using descriptive and inferential statistics with the Social Statistical Package for Social Sciences (SPSS). Simple descriptive analysis was conducted on all four sections of the study (demographics, knowledge, perceptions, and health promotion activities). Chi-square testing was used to analyse for differences between the various categorical variables. Bivariate
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analysis was performed as well to establish the relationship between demographic, knowledge, perception, and health promotion activities.
Results
Analysis showed no statistically significant difference between participants’ demographics and addressing gender issues in their health promotion activities. However, statistically significant relationships were found amongst the following variables and addressing gender issues in the health promotion activities: nurses who received education on the Constitution during nursing training (p=0.013) and gender issues (p=0.045) believed there was gender inequality in their communities (p=0.036), received training on the protection of women’s health rights (p=0.025), believed that their cultures promoted gender inequality (p=0.025), perceived that the Department of Health addressed gender issues that affected the health of children, had at some point discussed gender issues and gender-based violence with young mothers, men and boys in their health promotion activities (p<0.001)
Conclusion
Data showed that nurses’ knowledge and perceptions about gender inequality had an influence on their readiness to address gender issues in their health promotion activities. The study also revealed strongly that demographic factors had no influence on the nurses’ readiness to address gender issues in their health promotion activities. Nurses who received education on the Constitution and gender issues during nursing training, and attended workshops on gender issues at facilities, were more inclined to address these in health promotion. The two predictors for addressing gender issues, ‘Discussing gender equality with young mothers’ and ‘Discussing gender inequality as a factor that contributes to poor child health’, were identified as predictors for addressing gender issues in health promotion activities. Therefore, nursing education should strongly incorporate gender studies and the Department of Health should increase awareness among healthcare workers through workshops, seminars, and in-service gender-specific health promotion training.