Wong Yut Lin
Faculty of Medicine
University of Malaya

Date: 25 October 2001
Time: 4.30-5.30
 

Women suffer inequalities in health status and treatment despite the availability of modern medical technology and overall increase in life expectancy.  This is because the healthcare system remains insensitive to women's needs despite the significant gains in women's right, gender equality and reproductive health issues as a result of the 1994 Cairo Programme of  Action and the 1995 Beijing Platform for Action. Data, collected from quantitative studies, illuminating on the extent of the health inequalities and  differentials between men and women are available.  However, such data seemed inadequate to explain the reasons why, the underlying causes, women's own perceptions, attitudes and the interpersonal dynamics between men and women relevant to women's health.  Hence, the need for a detailed study on women's access to gender-sensitive health services using a mix of quantitative and qualitative methods.  ARROW, Asian Pacific Research & Resource Centre for Women thus commissioned a multi-country study towards this purpose.  Five countries participated, viz.  Bangladesh, China, Pakistan, Philippines, and Malaysia, exploring a range of healthcare services from birthing, reproductive health, and women workers' health services. The Malaysian study assessed women's access to reproductive health services.  The main objective of the study is to assess the extent to which a local non-government run family planning organisation is operationalising the aspects of accessibility, gender-sensitivity, and quality of care services for its users, majority of whom are women.  The site selected was the Kelantan Family Planning Association (KEPA) in Kota Bahru and the study was conducted from 1999-2000.  In addition, the specific circumstances and background of  Kelantan with reference to gender, politics, Islamic fundamentalism and reproductive health made the KFPA suitable to such a study. The research principles of participatory approach, action-oriented research, women-centered, and the culture of change underlie the entire study design.   Specifically, qualitative methods were used to collect information, and these include in-depth interviews and focus group discussions with both health providers and users and non-users of  the KFPA.  A situational analysis was used to provide both the  health providers' and women's perspectives on accessibility, gender-sensitivity, and quality of care in the context of reproductive health.  A total of 13 health providers, i.e. all the personnel at the KFPA, and 47 women (users and non-users) participated in the study.  The study also covered all four, or a 100 percent, of the clinics in the KFPA, with one clinic in the urban setting and the rest located in the rural districts of  Kelantan. In the workshop, some salient methodological issues, such as, reliability and validity will be highlighted particularly with regards to the local context and cultural dynamics underlying the research setting.  As the overall multi-country study aims to operationalize highly abstract concepts,  such as, gender sensitivity, accessibility, an quality of care, the workshop will discuss the complexities involved in the process of translating these theoretical constructs into practical tools and indicators, and the extent of their effectiveness