Access to quality health care for women in Iraq

In the first of a series of articles around  the importance of addressing women’s health issues Hawra Abu Gulal, an Iraqi specialist in nutrition and public health, based in the UK, explores access to health for Iraq – set within a global context. Next week, Vital Voices Global Award Winner Suaad Allami will provide detailed considerations from within Iraq.

Hawra-photo-2-150x150Better health is vital to economic progress, human happiness and well-being. It leads to longer life and population productivity. Many factors influence  health status and a country’s ability to provide access to quality health services is essential. I am an Iraqi who grew up between the Netherlands and the UK. I was educated in both countries as well as the US and am a qualified Public Health Nutritionist (MPH). I have carried out extensive multiple research studies in the field of public health, global women’s health and nutrition, and I have worked in different settings of the National Health Service (NHS) in the UK, including local authorities. I am currently working for a UK based organisation which produces guidance for health and public health care and I have an immense interest in supporting and improving women’s access to quality health care, particularly in Iraq. My mission is to improve health outcomes for populations through preventing disease and  health promotion, as well as ensuring the public’s access to quality health care services.

I am honoured and delighted to support Iraqi women’s economic empowerment by sharing my experience and knowledge  in health care with you.

Background

The lack of women’s empowerment in Iraq represents a significant public health issue as it potentially has a negative impact on women’s health. There is every indication that this will lead to a negative impact on Iraq’s long-term socio-economic development. The link between the empowerment of women and improved national economic outcomes has been recognised by many global institutions. For women to be truly empowered, areas around improving health, nutrition and education need to be addressed. This needs to be done in terms of the general population of course, but must be considered in direct relation to gender also.

Currently, the most significant barriers to health care in Iraq include:

  • The deterioration in the security situation in Iraq ( including psychological and social impacts)
  • Economic and geographical barriers
  • Displacement
  • Cultural factors
  • The deterioration in health care services and out-dated standards

In order to see improvements in access to quality health care, consideration must be given to making health services affordable, with health care facilities being within safe physical reach for all sections of the Iraqi population ( i.e. accessible to vulnerable women and people with disabilities). In short, healthcare facilities must be accessible to all without discrimination.

Interventions

Several factors must be considered when addressing the particular challenges women face. Firstly, we must take a rights-based approach to health – health is a human right for all people, women and men. Interventions must focus on a human rights framework that values participation, empowerment and equality. Secondly, removing financial barriers to health care, whether by eliminating user fees or providing transport stipends, makes it easier and safer for women to get care. Thirdly there must be a focus on the development of programs and health services that address specific health care needs of women. Moreover, intervention programs must address and raise awareness to harmful social practices such as early marriages and early pregnancy, preferential treatment for men in access to healthcare and food; and the traditional practice whereby women must obtain permission from a male relative before seeking medical care.

Overall, in order for an intervention to be successful, it is important to be aware of the specific obstacles to women’s access to healthcare services in Iraq. Therefore, it is important to raise this awareness starting with local communities by educating and engaging both men and women in local communities. Most importantly, awareness must be enhanced with reference to the risks to women’s health and the importance of equal treatment for all members of the household. Thus, in order to prevent a backlash in the community, it is important to engage men in these local community interventions as well. This will change their attitudes on rigid gender roles while supporting women in seeking and accessing health care services.

Currently, projects around the empowerment of young Iraqi girls (with reference to life skills to cope with growing up, and information about their basic human rights including reproductive health rights) are limited. Moreover, there appears to be a gap in involving boys/men in other interventions. I have recently developed a Research Proposal for advancing women’s health and empowerment. This initiative focuses on empowering young Iraqi girls (aged 12-18) living in Baghdad to more effectively make life choices and gain life skills through a skills training program. This involves trained teachers and nurses providing groups of girls with information about health, communication skills, planning, saving, budgeting and negotiation skills with the aim of building confidence levels. The primary objective is to change their attitudes and knowledge about rigid gender roles starting with the very basics. Boys will also be included, as it is important to change their attitudes about rigid gender roles in a way that encourages positive partnerships. This intervention is expected to have a positive impact on the health of both female and male participants. The aim is to create an intervention which can be applied on a larger scale throughout Iraq.

An initiative by the World Association of Girl Guides and Girl Scouts is an excellent example of working directly with girls and young women to deliver educational programmes. Their work provides girls and young women with training in life skills, decision making and leadership, in order to catalyse potential. Another great example is the Iraq Health Aid Organization (IHAO), based in Iraq. The IHAO focuses on health issues with regard to maternity care, family planning, pregnancy and health referral.

Finally, it’s not just about treatment, prevention is key. Therefore Iraq must emphasise on the importance of protecting the public against disease and tackling health inequalities. My call here, with this article for Nina, is to ensure priority is given to making health care accessible to all. This can only be achieved if governments, organisations, communities and individual households collaborate.

 

Editor’s Comment:  Please let us know what your thoughts are. Do you have any stories to share? We would love to hear your ideas for improvements and also practical personal examples of your experiences in Iraq. Get in touch at [email protected]. You can also leave a comment below.

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