{"id":61855,"date":"2021-08-11T17:40:00","date_gmt":"2021-08-11T21:40:00","guid":{"rendered":"https:\/\/www.psi.org\/?post_type=disc-post&#038;p=61855"},"modified":"2024-05-15T17:43:37","modified_gmt":"2024-05-15T21:43:37","slug":"partnering-with-women-from-the-start-discs-efforts-to-understand-power-in-the-context-of-self-care","status":"publish","type":"disc-post","link":"https:\/\/www.psi.org\/fr\/disc-post\/partnering-with-women-from-the-start-discs-efforts-to-understand-power-in-the-context-of-self-care\/","title":{"rendered":"PARTNERING WITH WOMEN FROM THE START: DISC\u2019S EFFORTS TO UNDERSTAND POWER IN THE CONTEXT OF SELF-CARE"},"content":{"rendered":"\n<p><strong>BY CLAIRE COLE, LINDSEY REYNOLDS, AND SUSAN ONTIRI<\/strong><\/p>\n\n\n\n<p>From the outset, the World Health Organization\u2019s (WHO)&nbsp;<a href=\"https:\/\/app.magicapp.org\/#\/guideline\/Lr21gL\">consolidated guidance on self-care&nbsp;<\/a>acknowledges \u201c[t]he&nbsp;principle of\u202fautonomy, expressed through free, full and informed decision-making\u201d as particularly relevant in the context of self-care for sexual and reproductive health (SRH). In a similar vein, the theme of agency\u2014as well as power and voice\u2014emerged strongly&nbsp;in&nbsp;Delivering Innovation in Self-Care\u2019s&nbsp;(DISC)&nbsp;insight research with&nbsp;women&nbsp;as a key factor in their&nbsp;contraceptive&nbsp;use experiences.&nbsp;Yet,&nbsp;how we define and measure concepts&nbsp;like&nbsp;autonomy, agency,&nbsp;or&nbsp;empowerment is&nbsp;hard to pin down.&nbsp;Specific to&nbsp;empowerment,&nbsp;Demographic and Health Surveys (DHS) and the United&nbsp;Nations&nbsp;rely on composites, made up of assessments of economic autonomy, attitudes towards domestic&nbsp;and&nbsp;gender-based violence, and an individual\u2019s role in household decision-making, amongst others.&nbsp;There\u2019s&nbsp;no one universally accepted way to measure&nbsp;this construct. And that\u2019s&nbsp;appropriate. Experiences of power are&nbsp;highly subjective, varying&nbsp;from&nbsp;person to person&nbsp;and&nbsp;across contexts.&nbsp;&nbsp;<\/p>\n\n\n\n<p>So, what&nbsp;does&nbsp;empowerment mean in the context of self-care?&nbsp;And&nbsp;how should we measure and understand it?&nbsp;<\/p>\n\n\n\n<p>One&nbsp;common&nbsp;survey&nbsp;question&nbsp;used in&nbsp;some of the existing&nbsp;and&nbsp;validated&nbsp;reproductive empowerment&nbsp;metrics&nbsp;asks women to identify who is responsible for making decisions about contraception.&nbsp;There is an implied logic, in how responses are scored,&nbsp;that&nbsp;a woman&nbsp;whose&nbsp;independent decision-making&nbsp;power&nbsp;is upheld by others in her life&nbsp;is a woman with&nbsp;optimal&nbsp;empowerment. Whereas&nbsp;those&nbsp;with&nbsp;less power&nbsp;make decisions with others, and women with the least power have decisions made for them by others.&nbsp;But what if a woman can act on her own agency to self-inject even when she lacks support from others? Is she experiencing power or empowerment then? If yes, is that sufficiently transformative? There are legitimate arguments to be made on both sides of this. And while we\u2019re at it, if a woman&nbsp;<em>wants<\/em>&nbsp;shared&nbsp;decision-making with her partner and she can&nbsp;achieve&nbsp;that, is that not&nbsp;power? There\u2019s lots to unpack here\u2026&nbsp;&nbsp;<\/p>\n\n\n\n<p>In the context of self-care, understanding how power operates and how women experience their power is important\u2014and somewhat new territory from an evidence standpoint.&nbsp;Thankfully, we do have some guardrails to help us navigate this new road. There has been an immense amount of research on how to measure empowerment in differing contexts and domains. This research has shown us that&nbsp;participatory&nbsp;approaches to measuring empowerment are important.<\/p>\n\n\n\n<p>DISC&nbsp;strives&nbsp;to heed this&nbsp;good advice, and&nbsp;not select our empowerment metrics \u2018off the shelf\u2019 without first understanding what power looks like to the women we aim to serve. So, in June 2021, we&nbsp;launched a series of participatory workshops in the two countries where DISC is implementing. The workshops\u2019 participatory methods have created space for Nigerian and Ugandan women in DISC\u2019s key segments\u2014urban youth,&nbsp;urban young mothers, and&nbsp;urban adult moms&nbsp;to explore their own\u202funderstandings and\u202fexperiences of\u202f \u2018power\u2019 and \u2018empowerment\u2019 in their lives. This encompasses SRH, contraceptive use, self-care, and beyond.\u202fOur&nbsp;goal&nbsp;is to see power as these women&nbsp;see it, so that&nbsp;we&nbsp;can select the most relevant validated metrics to measure empowerment in the context of our self-care focus and meaningfully interpret our findings.&nbsp;<\/p>\n\n\n\n<p>Getting this right matters for more reasons than just DISC\u2019s own concern with ensuring we have useful program data. In truth, it matters for our sector. And it matters for women. Going back to the WHO\u2019s guidance, there is a clear responsibility we take to heart: \u201cWhere self-care is not a positive choice but is prompted by fear or lack of alternatives, it can increase vulnerabilities.\u201d<\/p>\n\n\n\n<p>If we recognize that technological innovations in self-care have great potential to change the face of SRH, then as an evidence community we have an even greater need to proceed responsibly. In the context of DISC, we can\u2019t know whether the change self-inject brings will be for better or for worse, unless we take care to generate the evidence that will help us see (and understand) the full picture of women\u2019s experiences.&nbsp;&nbsp;<\/p>\n\n\n\n<p>The participatory process we\u2019ve undertaken to select and interpret empowerment metrics is our first step towards this broader goal. For the steps on this path to follow, we\u2019re looking forward to continuing to learn with our incredible community of self-care technical peers about the promises (and perils) of self-care interventions.&nbsp;<\/p>\n\n\n\n<p>Footnote on the word empowerment:&nbsp;&nbsp;<\/p>\n\n\n\n<p><a href=\"https:\/\/www.psi.org\/2019\/05\/editors-note-why-were-breaking-up-with-empowerment\/\">PSI has broken up with the word empowerment.<\/a>&nbsp;Any use of the word empowerment in this piece is a direct reference to the DHS survey and does not reflect our stance on the term.&nbsp;<\/p>\n","protected":false},"featured_media":50584,"template":"","disc-resource-type":[],"disc-language":[2488],"disc-country":[2492,2490,2491],"disc-page-type":[2494],"class_list":["post-61855","disc-post","type-disc-post","status-publish","has-post-thumbnail","hentry","disc-language-english","disc-country-malawi","disc-country-nigeria","disc-country-uganda","disc-page-type-stories-updates"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/disc-post\/61855","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/disc-post"}],"about":[{"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/types\/disc-post"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/media\/50584"}],"wp:attachment":[{"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/media?parent=61855"}],"wp:term":[{"taxonomy":"disc-resource-type","embeddable":true,"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/disc-resource-type?post=61855"},{"taxonomy":"disc-language","embeddable":true,"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/disc-language?post=61855"},{"taxonomy":"disc-country","embeddable":true,"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/disc-country?post=61855"},{"taxonomy":"disc-page-type","embeddable":true,"href":"https:\/\/www.psi.org\/fr\/wp-json\/wp\/v2\/disc-page-type?post=61855"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}