POWER & EMPOWERMENT

Power & Empowerment in Health Promotion Practice



Power & Empowerment in Health Promotion Practice

Introduction

Kenya is among the countries in sub Saharan Africa where the devastation of AIDS has had a profound effect. Although the level of awareness and knowledge has continued to be widespread and high, at 98% (NASCOP)2 there are still a number of misconceptions about modes of infection and considerably low rates of behaviour change, especially in respect to adoption of safe sex practices, persistence of unsafe cultural practices such as the dominance of men and violence over women in sex matters, Female Genital Mutilation, early debut of sexual intercourse and marriage especially of young girls with older men. (Catherine, 2002, 37-55)

Infection prevalence rates have shown a rising trend as reported through antenatal and STD clinic surveillance sites. In 1990 the rate was 5.1%, 9.5% in1995, and it rose to 13.4% in 2000 and declined to 9.4% in 2003 (NASCOP). A more dramatic drop to 7.6% was recorded by the 2003 Demographic and Health Survey (DHS). The prevalence rates also show a marked difference between urban (15-17%) and rural areas (5 10%); Men and women in age groups 15 - 49, infections being roughly in the ratio of 1:2, with girls more severely affected in the 10 - 15, 20 - 29 ages; men's rates begin to overtake women in the 30 - 49 ages. This trend has been attributed to inequality in gender power and decision making in sexual matters. (Catherine, 2002, 37-55)

The estimated numbers of those infected and dead are 2.5 million and 2.2 million with over one million orphans, who end up being cared for by economically impoverished and ailing grandparents or overstressed relatives and siblings.

The burden of the AIDS pandemic has been overwhelming on women and girls who have had to take on the roles of care for the sick as an addition to food production, house chores, and search for water, fuel wood and feeding livestock. Many young girls drop out of school, migrate to cities in search of menial jobs or resort to prostitution, ending up with unwanted pregnancies, STD and HIV infections.

At the national level the effects of the pandemic include:

I. Rising rates of poverty due to under employment, loss of jobs and agricultural labour ii. Strain on health services, workers and volunteers; around 50% of hospital beds are occupied by HIV patients. (Catherine, 2002, 37-55)

iii. Declining national average age at death (from 65 - 48 years) especially made worse by infections and under five mortality rates and a resurgence of T.B.

iv. Arising level of dependence due to deaths of economically productive young men and women.

v. Depleted and depressed economic situations of families and employers due to the cost of care for the terminally ill, burial expenses and replacement costs in training of new employees vi. Overwhelming stigma and discrimination of the infected and their family members due to fears of being infected through association or contact. (Catherine, 2002, 37-55)

vii. A burgeoning population of impoverished street families in urban ...