Women's Social Well-Being: A Collaborative Investigation

THE PROJECT: INTRODUCTION AND OVERVIEW

Sharon February and Ethel Manyaka

As the world operates on a more global level, governments have been pressurised to have better policies in place for individuals to give consideration to their social well- being, in particular access to health care. Media campaigns to educate the population on how to best protect themselves from infections, where to find a solution to an unwanted pregnancy, how to access contraceptives is the order of the day. However, these prove to be relatively ineffective in poorer communities where self worth, self pride and self value and the value of life of fellow human beings is not on the education agenda. 

The purpose of this group work (which is a collaborative work by the social well-being group) is to produce a project on women's health and well-being with respect to selected group topics and themes such as: knowledge and empowerment; identity; longevity, disease, illness, accountability with culture and gender roles. The social well-being group has thus far established the significance of women’s roles, responsibilities and contribution within themselves, the community and society. Additionally, the group has examined how these roles are viewed and rewarded as well as the challenges faced in these roles. Some identified challenges which include motivation, access to resources in health, political arenas, workforce and education. The group has also managed to classify and give accurate impression of social well being as that concept that allows society to view, understand and acknowledge the impact of such individual abilities – in order “to fulfill interpersonal functions from the perspective of participatory parity, e.g. access to resources and carework load”.

When one is faced with Martha Nussbaum’s capabilities abilities approach to well-being, it is evident that both developing and developed countries are in a severe state of poverty. Interviews conducted with four women from different context in South Africa on health and social well-being indicated that education is the key to access resources and while the government in Nussbaum’s view cannot be held accountable for capabilities they should be held accountable for the quality of resources such as education and health care. More people having access to these resources does not necessarily mean that the quality of these services is the same across the board. Having a monetary resource will mean that a select few in society  always has access to more, unfortunately , more opportunities, better access to knowledge and power.

In South Africa our constitution has ensured that education, health care, social and economic support is available for all who may need these resources but it has not proved to be enough. There is a systemic shift that needs to take place in South Africa and this may be a long way off. Providing second rate health care, education and security to the majority in ones society means that eventually there will be a breakdown, the people will either revolt against the system or they will turn this hurt, frustration and poverty towards themselves. The consequences of the latter are very evident in our poorer communities already. Teenage pregnancy, drug and alcohol abuse, crimes such as rape, spousal abuse, high school drop outs are on the rise. So even though we have a wonderful constitution and the government has really made an effort, they have barely scraped the surface of the problems in our country. I think that this can be said of most developing countries in our world.

How then do women develop the right balance by avoiding overwhelmed tasks? How do they conduct ongoing self examination by being honest with themselves – especially about how they feel? Taking into account their weaknesses and strengths. Isn’t time women start delegating duties and surrounding themselves with a circle of positive or like-minded individuals, who can correct them, uplift their spirit time to time; be motivated by people who can tell them the truth in love? For women to have the right balance in life is not only critical to themselves but to society as well. What happens then when their social well-being and capabilities are challenged and compromised? The whole family and society becomes challenged and everyone’s well-being gets caught up in the midst of this tragedy. Sadly, they often lack support on various areas and functions.

Viewing the interviews prepared for this paper, it is evident that the interviewees are very aware of what is possible for them to achieve with the resources available to them. We selected women who have had various difficulties in their lives but who have resolved to be stronger and to acquire more for themselves and their families.

The capabilities approach is absorbed in this project using extensive lenses to further advance the development of women and their social well-being from a cross cultural perspective – which is the overall aim of this project. Women are significant entities of society - not naïve about themselves and the world around them.  Regrettably, they are not given liberal opportunities and appropriate wings to explore this life as much as they can and want. Often enough, they need to re-examine and refashion their personal lives in order to have healthy lifestyles, live and lead the life they deserve.

Nussbaum (2000) states that women lack essential support for leading normal lives. The social well-being of women can become a successful venture if their social integration, social contribution, social coherence, social actualization, and social acceptance can be taken into consideration.  Women in much of the world lack support for fundamental functions of a human life. They are less well nourished than men, less healthy, more vulnerable to physical violence and sexual abuse. They are much less likely than men to be literate, and still less likely to have preprofessional or technical education. Should they attempt to enter the workplace, they face greater obstacles, including intimidation from family or spouse, sex discrimination in hiring, and sexual harassment in the workplace – all, frequently, without effective legal recourse. Similar obstacles often impede their effective participation in political life (Nussbaum, 2000). 

Women are in the centre of development – socially, economically, politically, culturally and otherwise. However, subordination and patriarchal attitudes remain one of the main challenges they are faced with; while on the other hand they are expected to carry out numerous tasks. Their development endeavours and aspirations are in most cases undermined or even ignored; they end up thinking less of themselves, feeling discouraged, miserable and frustrated. This affects their health and the health of the economy they are based in – further, affecting the very same people they care for, bear and raise. These negative consequences make society to view women as a liability and burden – and being declared unfit and inefficient – and at the end being regarded as inactive or sluggish members of society. In terms of what constitute social well-being – questions should be raised and interrogated to establish more obscure and concealed issues which affect women within their lives and in society – so that a balance can be achieved for women to meet both personal and economic demands – that there may be constructive and rewarding changes in areas of their lives and development.  

It is still a battle for many individuals to accomplish a better standard of living in South Africa. Social well being is seen as one’s own responsibility to attain for oneself and those close to you. I am not convinced that South African’s have enough of a social conscience to fight for equal resources’ for all its citizens. This is to be understood in terms of our new democracy, a war was won when apartheid ended but the trauma of the past system was never dealt with so it still exists in our society, how then can we even consider our society to be socially well and how can we then expect individuals to be embracing social well- being? How can social well-being be achieved? How can it be balanced? What happens if it is jeopardized? What could be best solutions and strategies to develop and enhance the well-being for women? These are some of the issues the social well-being group is dealing with.Taking Keyes assertion into account that social well-being is the appraisal of one's circumstance and functioning in society (cf: Keyes, 1998, this project proposes workable solutions that can address “the misconception of women being supporters of the ends of others, rather than as ends in their own right” (cf: Nussbaum, 2000) – and give future recommendations.

INTRODUCTION TO WOMEN'S SOCIAL WELL-BEING

Vivienne Bozalek

Women’s social well-being can be examined by considering the extent to which they are able to interact with others as equals, to be able to give and receive care, and flourish as human beings. Social well-being is thus dependent on the social arrangements and circumstances which would either be conducive to and facilitate participatory parity (interacting as equals, being able to give and receive care and to flourish as human beings). There are three theoretical paradigms which are pertinent to the idea of social well-being - the human capabilities approach developed by the economist Amartya Sen (1992;1999) and the philosopher Martha Nussbaum (2000; 2006), the political scientist Nancy Fraser’s (1989;1997;2000;2008a;2008b) social justice theory and the political ethics of care as developed by Eva Kittay (1997;1999), Fiona Robinson(1999), Joan Tronto (1993) and Selma Sevenhuijen(1998). I will briefly describe each one of these approaches and explain the contribution that each makes to the notion of social well-being for women. 

The human capabilities approach

The capabilities approach examines what women are actually able to do and to be in order to flourish as a person. The approach emphasises that it is not income or resources in themselves which are meaningful, but it is what one is able to do with the resources. It also takes into account how we are differently placed in relation to resources because of our different positioning and needs. Women who are differently placed would need different resources to be able to achieve human capabilities. For example, regarding education, a first generation literate woman from a rural background who has attended a rural school would need more resources to study than would a middle class student from a literate background from a privileged school. Martha The human capabilities approach is helpful with regard to ascertaining women’s social well-being in that it is able to ‘foreground and address inequalities that that women suffer inside the family: inequalities in resources and opportunities, educational deprivations, the failure of work to be recognized as work, insults to bodily integrity’ (Nussbaum, 2003:39). Nussbaum (1995; 2000) has developed the following list of capabilities which she views as criteria against which to judge whether people are able to live the good life or to flourish. She sees the list as core areas of human functioning, and if people fall below the threshold of any of these core areas, a society would, in Nussbaum’s (1995; 2000; 2003) view, be regarded as unjust, and people’s lives as not being fully human. The list is compiled from the 1995, 2000 and 2003 versions of human capabilities and appears in the textbox below. All the capabilities are regarded by Nussbaum as being of central importance, although they are related to each other in that promoting one is seen to be a means of assisting in the promotion of others. Governments cannot be held responsible for providing these capabilities, but they can be held responsible for promoting public policies which would provide the opportunities for these capabilities to be achieved.

1.	Life. Being able to live to the end of a human life of normal length, not dying prematurely, or before one’s life is so reduced as not to be worth living.
2	Bodily Health. Being able to have good health, including reproductive health; to be adequately nourished; to have adequate shelter.
3	Bodily Integrity. Being able to move freely from place to place; having one’s bodily boundaries treated as sovereign i.e. being able to secure against assault, including sexual assault, child sexual abuse, and domestic violence; having opportunities for sexual satisfaction and for choice in matters of reproduction.
4	Senses, Imagination and Thought. Being able to use the senses; being able to imagine, to think, and to reason- and to do these things in a “truly human way”, a way informed and cultivated by an adequate education, including, but by no means limited to, literacy and basic mathematical and scientific training. Being able to use imagination and thought in connection with experiencing and producing spiritually enriching materials and events of one’s own choice; religious, literary, musical, and so forth. Being able to use one’s mind in ways protected by guarantees of freedom of expression with respect to both political and artistic speech, and freedom of religious exercise. Being able to search for the ultimate meaning of life in one’s own way. Being able to have pleasurable experiences and to avoid non-necessary pain.
5	Emotions. Being able to have attachments to things and persons outside ourselves; to love those who love and care for us, to grieve at their absence; in general, to love, to grieve, to experience longing and gratitude. Not having one’s emotional development blighted by overwhelming fear and anxiety, or by traumatic events of abuse or neglect. (Supporting this capability means supporting forms of human association that can be shown to be crucial in their development.)
6	Practical Reason. Being able to form a conception of the good and engage in critical reflection about the planning of one’s own life. (This entails protection for the liberty of conscience.)
7	Affiliation. A. Being able to live for and to others, to recognise and show concern for other human beings, to engage in various forms of social interaction; to be able to imagine the situation of another and to have compassion for that situation; to have the capability for both justice and friendship. (Protecting this capability means, once again, protecting institutions that constitute such forms of affiliation, and also protecting the freedoms of assembly and political speech.) B. Having the social bases of self-respect and non-humiliation; being able to be treated as a dignified being whose worth is equal to others. This entails, at a minimum, protections against discrimination on the basis of race, sex, sexual orientation, religion, caste, ethnicity, or national origin. In work, being able to work as a human being, exercising practical reason and entering into meaningful relationships of mutual recognition with other workers.
8	Other Species. Being able to live with concern for and in relation to animals, plants and the world of nature.
9	Play. Being able to laugh, play, to enjoy recreational activities.
10	Being able to live one’s life in one’s own surroundings and context. A. Political. Being able to participate effectively in political choices that govern one’s life; having the right of political participation, protections of free speech and association. B. Material. Being able to hold property (both land and movable good) not just formally but in terms of real opportunity; and having property rights on an equal basis with others; having the right to seek employment on an equal basis with others; having the freedom from unwarranted search and seizure. (Nussbaum 1995:83-85; 2000:78-80; 2003:41-42).

The above list is a universal set of criteria against which the detailed and concrete particularities of people’s social circumstances can be judged in order to assess the quality of life that is being led.

Fraser’s three dimensional view of social justice

As a complement to the capabilities approach, it is also useful to use Nancy Fraser’s (1997; 2000; 2008; 2009) ideas on social justice to examine women’s social well-being. Fraser, in addition to recognising the importance of redistributing resources to attain participatory parity as full partners in women’s interactions with others, brings in a second type of claim for social justice – that of the politics of recognition. Initially, she advocated a dual consideration of redistribution of resources and recognition of status, which she terms a bivalent or bifocal view of justice (Fraser 1997; 2000). Recognition has to do with how people – women in this instance, are regarded in relation to the social markers or distinctive attributes that are ascribed to them. Being recognised as a woman implies that one is regarded as a full member of society and is able to interact on an equal footing with other members of society. Misrecognition in terms of a lack of respect for one on the basis of one’s social markers (gender in this instance) prevents people from being able to interact as full partners or in an equitable manner with others. Recognition is an important concept in considering how norms in relation to race, gender and generation in the case of women either value or devalue practices and social statuses. For example, because caring is related to women as their work, it is devalued as a practice in society generally. Rather than assuming that one has to conform to dominant norms, a social justice perspective aims to redress misrecognition by replacing, in a range of ways, including institutional and policy changes, values that impede parity of participation with ones which foster or enable it (Fraser 2000). In other words, if institutional practices have led to institutional harms, these require redress. In some cases, the distinctiveness of practices or attributes needs to be emphasised (for example, the practices which are normalised and appear to be universalised should be exposed for their distinctiveness, as in the case of women doing all the caregiving work in the family) and in others, their distinctiveness requires de-emphasis, (for example those who have been otherised and marginalised, as for example the way in which immigrant women are regarded as different). In Fraser’s later writings (Fraser 2008; 2009), she has introduced a third dimension of social justice which she refers to as the political, which refers to social belonging and determines who counts as a social member. This notion has to do with inclusion and exclusion in relation to distribution and recognition – who is entitled to resources and whose attributes are regarded as valuable. It also has to do with whose voice will be heard as legitimate. All of these factors will impact on whether a woman will be able to interact on an equal footing or as a peer in society. 

The Political Ethics of Care Approach

In addition to who is able to do what, who is entitled to be what, who has access to resources, who is afforded recognition or respect, who is excluded or included, it is also necessary to ask who gets assigned to what work, i.e. what responsibilities do women have in terms of paid work and in terms of unpaid care of dependents. The political ethics of care approach enables one to ask questions about the distribution of caregiving work in society, the relations of power which affect this work and are affected by it, and the sort of practices engaged in to ensure the care of family members. It thus raises questions about care, dependency and vulnerability in relation to women’s participation in society and their ability to flourish as human beings. 

From the lens of a political ethics of care, one cannot assume that the world consists of independent, self-sufficient, equally placed humans – we are all dependent at different times of our lives and dependents all need to be cared for. Recognition that dependency is an inevitable condition in human life and that it is usually assumed to be a familial obligation is important for women’s social well-being and for their ability to engage in activities which would be beneficial to them. In terms of the ethics of care, dependency is seen as a normal part of human life, and one which should be considered in social sharing of burdens, just as education, health services and road maintenance are (Kittay, 2002). 

The ethic of care allows us to see equality and participation as relational and connection-based rather than in terms of atomised individuals, in that care is dependent on a caregiver and a care receiver. This connection-based equality is useful in that it foregrounds people’s responsibilities towards each other in ensuring that they can both care for others and be cared for by others (Held, 2006). The political ethics of care locates practices of care in both the public and private spheres, destabilising notions of what people’s ‘natural’ responsibilities are in terms of gender and generation, and making moral claims for societal responsibility to ensure that care can be both given and received with some amount of choice and without prejudicing those involved in the caring practices. Joan Tronto’s (1993) delineation of the four phases of care, and the value associated with each phase, is useful in that it distinguishes the different processes in the practice of care:

· Caring about – noticing people’s needs (attention)

· Caring for – taking responsibility to ensure that people’s needs are met (responsibility)

· Care-giving – the actual hands-on physical work of caring for people (competence)

· Care-receiving – responding to the care that is given by the care-giver (responsiveness)

These four phases of care, with their values of attentiveness, responsibility, competence and responsiveness have important implications for participation. These four phases should lead to integrity of care if it is to be viewed as a well-accomplished caring practice. 

Women’s social well-being then, would have to incorporate what they are able to do and to be as human beings, whether they have access to resources, whether they are recognised or misrecognised, included or excluded and whether they are able to both give and receive care.

THEMES ACROSS THE INTERVIEWS

Kim-Lisa Styer and Edwina Smith

The members of our group were, Kim Lisa Styer, Sharon February, Ethel Lefentse Manyaka, Edwina Wilhelmina Smith and Nocolette Johannes. The interviews took place in different geographical locations that were conducive for the interviewees. Kim Lisa Styer interviewed a thirty nine year old woman from Delft, a place allocated by the government for people with low incomes. Kim Lisa called her Jacky.  Sharon February interviewed Lameez from Mitchell’s Plain, a place constructed for the “coloured” community.  Ethel Lefentse Manyaka interviewed Rendani from Venda in Limpopo, but now resides in Cape Town. Her interview took place at the University Western Cape. Edwina Wilhelmina Smith interviewed Nina from Sarepta in Kuils River and Nicolette Johannes interviewed Gabbi, a twenty six year old, “coloured” woman. The interview took place in Gabbi’s dining room.

BASIC NOTIONS ABOUT HEALTH AND WELL-BEING THAT EMERGED FROM THE INTERVIEWS:

The women interviewed generally viewed health and well-being as a holistic approach relating to women’s social, psychological, mental, spiritual, physical and emotional well-being. For most of the interviewees, health also meant taking responsibility for your own self image and well-being.

THEMES THAT EMERGED FROM THE INTERVIEWS

• Formal and informal education to improve the quality of lives of women.
• The lack of family and community support, which is a barrier for growth and development of women.
• The need for women to become actively engaged in decision making processes that affects their lives.
• The importance of accessing resources and information.
• The Empowerment of women provides women with the skills to take control of their lives, and become independent and vocal.
• Poverty alleviation
• Power relations
• The ability to fight diseases and illnesses.
• Maintaining emotional well being and experiencing happiness.

DIFFERENCES

In the interviews, there were both differences and similarities. The pertinent difference that emerged was the interview in Mitchell’s Plain. The interviewee was very critical about her location and the disintegration of her community. In other interviews, the Interviewees mentioned their locations, but did not allude to their locations as the interviewee of Mitchell’s Plain. She elaborated widely about the influences the inability of women to better their lives.

“It, you know, I think I have spoken about this about a thousand times, I mentioned things. It really, it, it upsets me. It upsets me that because you come from, or you come from a certain category of, I mean social wealth now, I am talking about, is like you are caste away there in that corner but what irritates me about it is that people don’t, majority of people in these communities who are in these communities don’t get out there and show the world that we are, we are, we respect ourselves. We deserve better than the way you treat me.”

Education was raised in all interviews, but interviewees had different views about education. In one interview, education was a barrier.

“Education was the only barrier that kept us back a bit."

Education was also the vehicle to enable women to improve their quality of life.

“Education is key. I believe with education, you are able to ensure that you live a better life. You can eat healthy and afford a good life.”

There was a difference of opinion about the government; in some respects there was the expectation that it is the government’s responsibility to provide the necessary resources for women, but others felt that the government is performing well by providing the resources.

All the interviewees mentioned that they had heterosexual relationships, except one, who was involved in a same sex relationship. In this interview, the interviewee had strong Christian beliefs, blaming herself for her condition.

SIMILARITIES

The general perceptions of health and social well-being were similar across interviews. Women were aware of the many facets that involve their well-being, including the physical, psychological, financial, spiritual, and social. The interviewees viewed well-being as interlinked and holistic, something that cannot simply be viewed in isolation.

In the interviews, women were viewed as being more susceptible to illness and disease than their male counterparts. In other words, their bodies are more sensitive than that of men. Subsequently, these women have all compromised their health at some point in their lives and have not consciously been made aware of the different factors contributing to their health and social well-being. As an interviewee stated “My well-being was compromised as a result of the psychological experiences that I was encountered in my life. It was on the relationship that I was having with my boyfriend which was not going well, so this kind of issue really affected me not only psychologically but it also affected my physical body- leading it not to function properly. I ended up having a stroke, which was caused by me thinking too much about the problem. My health was compromised as I ended up in hospital”.

In the interviews, the importance of education was mentioned as it contributed a great deal to women’s empowerment and freedom. Interviewees felt that women in the communities are uninformed and sometimes ignorant of health risks. However, there is a lack of awareness impacting negatively on women’s health.

In the interviews, empowerment of women was also strongly emphasized as the more knowledge women gained, the more they are able to understand their strengths and their potential. Kim’s interviewee mentions how “policies have also changed where women are concerned and the awareness of women and children abuse that also help women feel more empowered”. Women can make a difference and become more independent and not as dependent on partners”.

The interviews similarly focused on access to resources which contributes to the quality of life. Ethel’s interviewee mentioned that “Africa is one of the poorest continents around the world and the health of people is affected due to their social background”. In other words people are affected by their demographic location and as we know most of the interviewees come from disadvantaged communities and therefore have a similar perspective of the many challenges that women in their communities face.

  
THEORETICAL FOUNDATIONS IN THE LITERATURE 
Sharon February and Nicolette Johannes 

Nussbaum’s view is that women are human beings, born with certain basic “capabilities”, which, if go un-nurtured, withers. If these are nurtured and strengthened through education and support of a material nature, it can develop into “higher level capabilities.” Nussbaum makes a distinction between basic, internal and combined capabilities, with basic capabilities referring to the innate, natural most basic functioning people can be born with and which can be developed into superior functioning capabilities. Internal capabilities are more specifically the condition of the person and the adequate personal state enabling expression of such capabilities. Finally, there are combined capabilities which refer to the interaction between internal capabilities and external conditions, where external conditions can either act to restrict or facilitate the expression of internal capabilities. (Nussbaum, 2000)

Nussbaum also makes a distinction between functioning and capability, stating that the latter is the ideal, “the appropriate political goal” (Nussbaum, 2000) and at the core of the difference is the ability to choose. One of the examples she uses is that of a person making the choice to fast (for religious reasons) as opposed to a person who is starving. Both persons are not nourishing their bodies, but the former is exercising a choice, while the latter has no choice and is being deprived in some way.

Using this explanation of Nussbaum, we can investigate all those factors that impact on the social wellbeing of women, and consider to which extent the women interviewed perceived these factors to have either facilitated or restricted their social wellbeing, which in this case is the combined capability in question. The connection between Nussbaum’s work and the interview content relating to health and wellbeing is demonstrated in various responses given by the women interviewed.

In one interview the interviewee spoke about measures of illness prevention, such as following a healthy diet and also refers to her avoidance of seeing any further doctors. These are both references to combined capabilities. In her case, she has the financial means as well as access to both more nutritious food and other doctors, but she has made the choice to not pursue either of the two. This interview is also a good example of the combined capability of religious expression.

The remainder of the interviewees expressed the possibility of tertiary (or other) education as attainable in the light of legislation, societal norms, intellectual ability but yet are restricted in terms of access to education due to financial barriers. Education is thus a combined capability, in this case restricted by funds as an external factor, while it is possible in terms of intellectual ability and personal drive/motivation (internal capability). Nussbaum says that having access to resources is simply not enough, education is not enough but what one is able to achieve with the resources available to you is important. Even though government has come a long way to make education as accessible as possible, the lack of resources such as finance, access to transport, the distance between rural towns and urban Universities and institutions of learning has made it almost impossible for many women across the world to acquire education at all levels. These are only some of the challenges in South Africa. It is not only formal education that needs to be addressed in South Africa but informal education. More value needs to be ascribed to informal education such as women educating each other by relaying experiences to each other. “It would be. I still come down to education. Because I mean if we can start there and if, if one woman tells her story to another and another can you imagine the effect it can have? And I mean if you yourself and I feel if I speak about this, and doing this now, I am not just sucking this out of my thumb. I am doing this, I am working, I have a husband, I don’t have a family yet but we are a family on our own. I have priorities at home but I can have that (education) as well.”

Access to adequate health services as impacting on social well-being is also important. Most interviewees reported having access to basic health services in their immediate communities, but not necessarily to the required and desired more specialized health care, or even adequate basic health care. External factors that act as barriers include distance from either the home or work place, and financial constraints. “Yes, of course, I mean can you imagine how many women..... I mean they take their last and they go to a doctor course I can, I can think of one or two occasions when that was my last money but I refused to go to the day hospital because I felt I was going to get better treatment being at a private doctor and I was wrong. I mean I am one person and I am sure there are quite a few women who have gone through the same thing, maybe not the same condition, but something else.”

A study by Di Cooper (1992) illustrates the difficulty women have in accessing health care in a suburb in Cape Town known as Khayelitsha because of the vast area this township consists of, it is often difficult for women to commute to the government hospitals. The hospital itself is often overcrowded and understaffed and receiving medication can be problematic because of the amount of people who have to be catered to.

Another less obvious restrictive factor is the prevailing gender stereotypes and the subsequent tendency of women to act as subordinate to men in their household. While most of the participants identified women as individuals who have to endure many hardships throughout life, women are seen a very resilient beings. One participant felt strongly that “Being a woman is not easy. You are confronted with difficult challenges. Women are vulnerable as compared to men. In the issue of HIV and AIDS due to lack of education or empowerment, women cannot decide for themselves. For instance, they are unable to decide if the condom should be used or not. (PAUSE) A man decides if it has to be used or not due to lack of money and food. The issue is about our culture and morals I mean according to African people, I can say is has contributed a lot to the perception – the way women perceive themselves. They still look down upon themselves. They think they still don’t have a say. It is not everybody who is well informed.”

A scholarly article by Mini Jacobs (2006) highlights a programme in India which aims to dispel negative perceptions of women by promoting women’s health, education and employment on the grass roots level. While these programmes are useful, changing the mindsets of the men in the community proves a challenge as women have always been regarded as the other in this society.

It appears that women of the younger generation have fewer qualms about leaving a negative marriage, changing careers or practically challenging old beliefs and practices. This implies that cultural norms and practices and traditional belief systems are less of a restrictive combined capability to them than to women of an older generation. Theoretically, access to many resources is possible, but practically tenacious gender stereotypes and cultural practices act as a barrier, something which ironically could be best addressed by education.

CONTEMPORARY POLICIES AND PRACTICES
Nicolette Johannes and Kim-Lisa Styer

Since the concept of social well-being as being is perceived to be influenced by several factors, and as affecting each of these factors in return, we analysed each of these relevant factors as identified in the National Gender Policy Framework. The Policy Framework set out several principles which has gender equality as its vision, based on which long term and short term interventions (which are continually monitored and revisited) have been designed.

For the purpose of this project, we will focus on the sections: Women and Poverty, Women and Education, Women and Health, and Women and the Economy, because these are the areas identified as important themes which emerged from the various interviews with women. 

Women and Poverty

The National Gender Policy Framework refers to the feminisation of poverty which is attributed to the “gendered division of labour in the household, the low value accorded to women’s work with the concomitant clustering of women in low-paid jobs”. Combining the transformation of the education profile of women, the removal of gendered barriers in the work place and economy and effective measures of cracking prevailing gender stereotypes and female subordination are likely to improve the plight of poor women.

Women and Education

The situation analysis informing the policy indicates that unplanned pregnancy, domestic responsibilities of girls, the prevalence of gender stereotypes and women’s subordination are the areas to be addressed. The implication could be a decrease in the current high drop-out rate and low secondary pass rate among girls. The introduction of non-formal education to especially rural women could make a substantial contribution to their lives and livelihoods.

Women and Health

The two major reasons for the current health status of South African women are “the legacy of apartheid and gender discrimination”, and this document proceeds to show how this fact manifests in the lives of women in terms of their health status, health behaviours and access to health services. One proposed way of addressing this inequality which is steadily gaining popularity worldwide is the universalising of adequate health care, not only for women, but also for children and the elderly. Developing countries are showing progressive trends in especially reproductive health services, while some developed countries are doing the opposite, for example in California “a steady stream of legislation continues to be introduced…to limit access to abortion services for women and teens”. This, despite findings showing that abstinence-only programmes are failing.

Women and the Economy

Economic activity shows how women are still getting the shorter end of the stick in gendered terms. Access, control or ownership, decision-making, change in power relations, choices, participation and self reliance either on the part of women or favouring women is proposed as steps towards gender equality which would positively contribute to the social well-being of women.

Implications of the National Gender Policy

The ideal implications would be those formulated in the policy document as principles underlying the vision of achieving gender equity, and these are applicable to the areas of Women and Poverty, Women and Education, Women and Health, as well as Women and the Economy; the improvement of the condition of feminisation of poverty, the facilitation of women’s access to education, the access of women to adequate health care, and women’s key role in and adequate compensation for participation in the economy would contribute to the improvement of the social well being of women, based on the premise that all these factors impact on women’s social wellbeing.

The extent to which contemporary social policies and practices with respect to your group topic (global, regional and /or local) contribute to the issues raised as significant to the health and well-being of women interviewed.

With respect to social well-being, contemporary social policies and practices contributed significantly by addressing the issues that emerged from the interviews. The policies focus on relevant issues pertaining to health and social well-being.  Health is one of most important issues that were addressed, especially reproduction health. In the interviews, women did not really delve into reproduction rights per say but it could be an important issue to note since it goes hand in hand with the illnesses and diseases that women are prone to. Ethel addressed HIV and AIDS in her interview and the reproduction rights has to do with having access to family planning and negotiating safe sex that impact on women’s health and social well-being.

The health policy mentions that “women’s great vulnerability to HIV infection, although partly biological, is strongly driven by the gender inequalities that pervade South African society”, (Cooper, 2004: 77). In the interviews, some women raised the issue of vulnerability and the way women have been designed is far more sensitive and emotional than men. This puts them at a greater risk of contracting viruses and therefore women suffer more. “Women with low social and economic status increase their risk of exposure to HIV impeding their ability to refuse sex” (Cooper, 2004: 77). 

There is the cultural assumption that men have the “right” to engage in sexual relations with more than one partner. Therefore the practices that occur within society can be detrimental to that of women due to lack of control of self. In the interview I conducted, the interviewee mentioned the way women have been socialized into the role of a submissive wife or girlfriend who depends on the man to approve her social activities.

Other policies focused on nutrition, health, gender- based and sexual violence, contraception,  improving quality of care, revitalization of public hospitals, maternal and women’s health, more importantly on how HIV and AIDS affects women’s ability to spend time on more incoming generating activities or education than bearing the burden of caring for those with AIDS-related illnesses. In the interviews education was raised as a way of empowering women but often women do not have access to resources, especially those who come from disadvantaged communities.

FUTURE DIRECTIONS AND RECOMMENDATIONS 

Edwina Smith and Ethel Manyaka 

FUTURE RESEARCH AND POLICY IMPLICATIONS

·        Statement of future recommendations of best practices

·       Statement of future recommendations of best policies

·       Acknowledgement of national or transnational organizations to implement such practices and policies

·       Statement of potential future research directions that might be undertaken

Policies around social well-being and health for South African women are not currently in line with global development policies. They are; however, in a better state as countries such as India, Bangladesh, Kenya, Colombo or Somalia. Policy framework(s), introduced over a decade ago have not been as fruitful as hoped for in the post-apartheid period. The capability approach of Nussbaum needs to be introduced and applied to challenge patriarchal structures, policy planners, government and their agents – in order to revive and rebuild the lives of women in particular.

To address this gap, policies affecting women’s health and their social well-being should be revisited. An open invitation must be issued to national and international development agencies, policy makers, non-governmental bodies and other relevant stakeholders to renegotiate, review and restructure fundamental functions and rights for women around their health and social well-being. Rather than having or expecting such bodies to decide on women’s health, which are male dominant in nature, women should instead be invited to participate and serve as the main role players in the forum as well as the decision making processes. 

In order to achieve effective results, these women-led groups should have employable plans and strategies that thoroughly examine and uncover the problems that hinder their health and well-being. In addition, women must also evaluate, learn and strategize ways to lobby politicians – design policies that can be merged with current ones and where necessary, assist in deconstructing those policies that are not beneficial to them. 

This exercise should not be viewed as a weakness, but rather as a move beyond transformation. This essentially allows women to take a seat at the governing table and align policy with current beliefs.  Being role players within these settings allows for candid and actionable deconstruction of existing systems that cripple and stifle women’s culture and social order.

Women should start engaging in dialogues that entails their “taxing employment and full responsibility for housework and child care (cf: Nussbaum),” which hinders time for themselves – and a platform to showcase their human capabilities and skills. Drastic steps to eradicate factors that affect their emotional and social well-being must be made so that women’s focus is re-directed. 

It is evident that culture has always been influential in health and social structures. The reviewing of existing policies and systems will explore further those categories and conceptual systems that have been designed by the West – and which are continuously globalized, but not necessarily working in various parts of Southern Africa and its settings. Women who understand culture, theirs and those of others, would have to help in the deconstruction of women’s health and well-being policies; including education and empowerment initiatives to be integrated, implemented and be measured accordingly.

This will be the beginning of resolving the representation of women as “others”. By so doing, reports and meanings of, and explanations about women’s health and social well-being is unlikely to be obscured and distorted. Women’s capabilities will also be addressed. Culture and tradition are simply the forms of social interaction accepted by particular communities as particular times, and according to their worldviews and historical experiences, such that there are several alternatives and systems of values selected for their usefulness (Akinjogbin, 1987/1990). 

It would be important and interesting to find out where women are in terms of culture and tradition; how far they’ve progressed in terms of education, empowerment and their social well-being. This would enable the future recommendation to move forward beyond transformation. On a lighter note, women should continue to conduct an ongoing self-examination and assessment of themselves, get involved with others who will give them honest feedback on wellbeing perceptions etc, - develop the supportive environment through family, friends, and external activities and for those who have been much involved to maintain their health and social well being. They need to keep their mind, body and spirit checked, revived and restored. Personal accountability and responsibility has to be one of their priorities; it can be done through exercising, eating healthy and having honest examinations. Women should constantly look within themselves to examine how and what they feed their intellect with. The following are examples of things women should consider to cultivate their well-being:

·        Get involved with motivating people.

·        Find ways to better themselves.

·        After honest self-examination, then align with others to establish solutions to address identified problems.

 ·        If they lack access to health care, then they should plan trips twice a year to places that have it.

·        If they don’t have any positive friends or activities – they can start with a local women’s group, park activity, church event or function.

Women’s situations in the global marketplace are changing rapidly and they are becoming more actively engaged in leadership positions. The health and well-being of women are of paramount importance for the effective management of these positions. To assist women to improve their mental, social, physical and spiritual health, and to encourage women to live a healthy lifestyle, a booklet was compiled for women’s emotional wellness. (Bright Futures, a woman’s guide to emotional wellness.)

This booklet serves as a guideline for organizations, young women and caregivers to make use of as a tool for a change in behavior. These guidelines are specifically designed, to enable women to follow their behaviour patterns.

Australia implemented a primary health care strategy, which resulted in an excellent primary health care system.  This system serves as a benchmark to inspire and guide those who wish to have positive outcomes for primary health care. (Best Practices in Primary Health Care; David Legged, Gai Wilson, Paul Butler, Maria Wright, Tony Mc Bride, and Robyn Attewell.)

The women in Manitoba and Saskatchewan experience unequal access to unemployment and face high demands from families and societies. This puts severe pressure on women, which affects the health and well being of women and with the result, a plan of action was developed to improve the conditions of women. (Action plan for Women’s health in Manitoba and Saskatchewan: Key priorities and Strategies.2001)

 The following improvements were essential.

• “Consult with women on how heath services should be changed to meet their needs.
• Make changes based on women's input.
• Expand the range of publicly funded services.
• Place women in key positions in the health system.
• Support the development and use of the most effective practices in women's health.
• Develop women's health strategies within provincial health departments.
• Provide a full range of services to ALL women, particularly in rural and remote areas and between health districts and regions.
• Acknowledge the unique health needs of Aboriginal women, older women, younger women, lesbian and bisexual women, and immigrant and refugee women, women with disabilities and women living in rural and remote areas.
• Address women's poverty.

References from Bozalek introduction:

Fraser, N. (1989). Unruly Practices: Power, Discourse and Gender in Contemporary Social Theory. Oxford: Polity Press.

Fraser, N (1997). Justice Interruptus: Critical Reflections on the “Postsocialist” Condition. London: Routledge.

Fraser, N. (2000). Rethinking Recognition, New Left Review, 3: 107-120.

Fraser N (2008a). Reframing Justice in a Globalizing World’. In K Olson (ed). Adding Insult to Injury: Nancy Fraser Debates Her Critics. London & New York: Verso.

Fraser N (2008b). Scales of Justice. Reimagining Political Space in a Globalizing World. New York: Columbia University Press.

Kittay, E. F.(1997). Taking Dependency Seriously.In Patricia DiQuinzio and Iris Marion Young (eds.) Feminist Ethics and Social Policy. Bloomington and Indianapolis: Indiana University Press.

Kittay, E. F. (1999). Love’s Labor: Essays on Women, Equality, and Dependency. New York and London: Routledge.

   Held V (2006). The Ethics of Care: Personal, Political and Global. New York: Oxford University Press.

   Nussbaum, M. (2000). Women and human development. Cambridge, MA: Cambridge University Press.

Nussbaum, M. (2003). Capabilities as Fundamental Entitlements: Sen and Social Justice. Feminist Economics, 9(2-3):33-59.

Nussbaum, M. (2006). Education and democratic citizenship: Capabilities and quality education. Journal of Human Development, 7(3): 385_98.

Robinson, Fiona (1999). Globalizing Care. Ethics, Feminist Theory, and International Relations. Colorado: Westview Press.

Sen A K (1984). Resources Values and Development. Oxford: Blackwell.

Sen, A. K. (1992). Inequality re-examined. Oxford: Oxford University Press.

Sen A K (1995). Gender Inequality and Theories of Justice. In M Nussbaum & J Glover (eds). Women, Culture and Development. A study of human capabilities. Oxford: Clarendon Press.

Sen A K (2001). Development as Freedom. Oxford/New York: Oxford University Press.

Sevenhuijsen S (1998). Citizenship and the Ethics of Care. Feminist Considerations on Justice, Morality and Politics. London and New York: Routledge.

Sevenhuijsen S Bozalek V Gouws A & Minnaar-McDonald M. (2003). South African Social Welfare Policy: An Analysis of the Ethic of Care. Critical Social Policy 23(3):299-321.

Tronto J 1993. Moral Boundaries: A Political Argument for an Ethic of Care. New York & London: Routledge.

References: Theoretical Foundations

Cooper, Di; Mnguni, Peliwe; Harrison, Karen. “Women’s Experiences of the State Health Services in Khayelitsha.” Agenda 15 1992: 33-39.

Jacob, Mini. Community Health Programme in Rural Tamil Nadu, India: The Need for Gender Justice for Women. Reproduction Health Matters. 2006; 14(27):101-108.

Nussbaum, Martha. Women and work – the capabilities approach. The Little Magazine (2000) http://www.littlemag.com/2000/martha3.htm. 

References: Contemporary Policies and Practices

Cooper, D & Morroni, C. (2004). Reproductive Health Matters. Ten Years of Democracy in South Africa: Documenting Transformation in Reproductive Health Policy and Status.  Vol. 12(24):70-85.

Salganicoff.A. (1997). Women’s Health Issues. Women’s Health Policy. Elsevier Inc: California. Vol 17: 274-276.

South Africa’s National Policy Framework for Women’s Empowerment and Gender Equality. (2000).

Strategic Priorities for the National Health System. (2004-2009). 

References: Future Recommendations 

Action plan for Women’s health in Manitoba and Saskatchewan: Key priorities and Strategis.2001.

(Bright Futures, a woman’s guide to emotional wellness.)

David Legge, Gai Wilson, Paul Butler, Maria Wright, Tony McBride and Robyn Attewell (Australian Journal of Primary Health 2(1) 12 - 26.

Women Executives: Health, stress and success. Debra I.Nelson and Ronald J. Burke the Academy of Management Executive (1993-2005) © 2000.

Annotated Sources for Further Study 

(Johannes)

ooper, Di; Mnguni, Peliwe; Harrison, Karen. “Women’s Experiences of the State Health Services in Khayelitsha.” Agenda 15 1992: 33-39. Di Cooper has done a study about the effects of urbunisation on women, spanning three years. The result of the study was the Zibonile Health Project, based in the Griffiths Mxenge area in Khayelitsha’s Town Two, which has women’s wellness as one of its foci. Cooper, Mnguni and Harrison relays basic demographic data which feeds into more specific information about which health services are available to residents of Khayelitsha, and more specifically, to women living in the area. It gives an account of how accessible the existing services are, as well as other problems that those seeking medical attention from these health facilities are encountering by means of the personal accounts given by four women living in Griffiths Mxenge. It briefly discusses problems such as overcrowding, understaffing, transport problems, inadequate information transmission and lack of alternatives that patients at the facilities experience, and links poverty and lack of education as exacerbating factors. The article concludes by  pointing out how Women’s Wellness programmes and centres can improve these women’s plight.

Diamant, Allison; Wold, Cheryl; Spritzer, Karen; Gellberg, Lillian. “Health Behaviors, Health Status, and Access to and Use of Health Care: A Population-Based Study of Lesbian, Bisexual, and Heterosexual Women”. Arch Fam Med. 2000;9:1043-1051. A lack of information about the health of lesbian and bisexual women motivated Diamant, Wold, Spritzer and Gellberg to conduct this population based study to examine “variations in health behaviours, health status, and access to and use of health care based on sexual orientation”. Health behaviours that were investigated included the use of tobacco products and alcohol consumption. Health and health status inquiry revolved around a comparative look at the incidence of similar health conditions across sexual orientation. Access to health care was gauged by investigating health insurance, the presence of a regular source of care, as well as the likelihood of having the same source of health care over a prolonged period of time. The authors also paid specific attention to barriers to health care as experienced by heterosexual, bisexual and lesbian women. While this study makes a positive contribution to existing information, the authors acknowledge its shortcomings as areas for further investigation.

Gernholtz, Liesl; Richter, Marlise. “Young Women’s Access to Reproductive Health-Care Services in the Context of HIV”. Agenda 53 2002: 99-105. Gernholtz and Richter touches on gender stereotypes and the unequal distribution of power and resources that still prevail as barriers to young women’s access to reproductive health services and emphasise how these, in addition to disparities caused by class race and geographic location are worsened by poverty, especially so in the context of the HIV/AIDS pandemic. The article briefly considers the statutory frameworks that are in place and evaluates how it either impedes or has recently been more progressively amended, in particular with reference to reproductive health programmes to facilitate services that are more supportive, effective and youth-friendly. It concludes by emphasizing the necessity for reproductive health services to be specifically aimed at young women and makes recommendation how such measures can be better implemented.

(Smith) 

Kwesiga, Joy C., “Women’s Access to Higher Education in Africa.” Uganda’s experience , Kampala (2002): 326

Joy C. Kwesiga is the Dean of the Faculty of Social Sciences at the University of Makerere and she has extensive knowledge in education. In her presentation, she argues that discrimination against women must be eradicated. She calls for women to have a basic education, to provide them with the basic skills and become independent thinkers. Throughout society, women have unequal access to health and education and they are not adequately informed about their reproductive rights. The Social order expects women to bear children and marry even at a young age. They do not receive any support, guidance or counseling and society does everything in their power to prevent women from accessing education. This article gives the reader a wealth of information about the complexities of the lives of the women in Uganda and Africa. Her observations were based on theories and concepts and the biases towards women came through strongly. I could not gain any sense of what progress they aim to institute to enable the lives of women to improve.

Mitter, S. and Rowbotham, S, ed. Women encounter technology: Changing Patterns of Employment in the Third World. London and New York: 1995. Overall status of women in Africa. Swasti Mitter is the Deputy Director of the United nations University Institute for New Technologies, and hold the Chair of Gender and Technology Studies at the University of Brighton, UK. Sheila Rowbotham has written extensively on women in history and the contemporary position of women. She is a Research Fellow in the Department of Sociology, University of Manchester and an Honorary Fellow in Women’s Studies at the University of North London.

Fassbender, M. Addressing gender in public management in MENA countries. March 2008.The evidence indicates that the lack of resources experienced by women puts massive limitations on the ability of women to retain heir health and well-being. This article claims that men are more capable of accessing opportunities than women. Women are not fully equipped to take advantage of opportunities to enable them to generate improved employment that have materialized in Africa. Although women are the prime contributors of labour, be it agricultural or otherwise, they are paid the lowest. This exploitation of women causes women to experience the extreme pressures of life. This article acknowledges that there is a gender gap in education and are of the view that the gap is wide. Furthermore, the gap in education results in women and their families, to live a life on the bread line. The statement that men are more equipped than women to access opportunities are biased. I argue that the instrument used to determine the gap in education, could not have been gender sensitive, because a conclusion have been drawn about women and their inabilities. This article assesses the affect of education in MENA (Middle East and North African Countries.) as a justification for mothering and marriage. The evidence indicates that because of the lack of education,   and incomplete education, women marry and become mothers. Those who were educated, although it is a minority, could make informed choices to control their lives, make use of their reproductive rights as they had access to information and services. The author claims that women who have limited access to resources and information, are more likely to become mothers and marry. This article encourages the empowerment of women to fulfill their aspirations, but my argument is, education cannot be a determinant to classify worn. Although statistics substantiates the inability of women to complete their education, due to marriage and mother, they lack information about their reproductive rights. I argue that education as determinant, devalues women in all facets.