Tamil Nadu Experience : Gender

The efforts in Tamil Nadu focused mainly on the health care delivery system until 1986, when a conscious effort was made to involve women's groups in leprosy work, especially among women. Considerable progress was made from 1991-93. Priority committees set up in 1990 launched the Intensive Health Education-cum-Case Detection Campaign in 1991, to focus on case detection among women and to involve more women in leprosy detection and treatment.

The move for gender equity in health received a fillip when NLEP in Tamil Nadu took up this as a priority issue and women from educational institutions were involved in the effort. In 1995, a state-level workshop was held in Ootacamund on Gender Issues in Leprosy, and at a state-level leprosy conference at Tiruchi in 1996, DANLEP tried to bring the issue to the forefront. The gender concept gradually started percolating downwards from the state level.

Large number of women were involved under MLEC in 1997-98. The data showed an increase in the detection of female cases and in voluntary reporting by women. With the Government's move to integrate leprosy services with the PHC system in 1997, DANLEP made efforts to incorporate gender in the training of PHC staff on leprosy.

The latest more in this direction was the pilot project for gender training of health workers in 1998-99. Implemented jointly by the state government and DANLEP, the project covered 8 blocks. It aimed at sensitizing health workers on gender, developing and implementing gender-sensitive action plans, identifying gender-sensitive indicators, and incorporating gender in all PHC programmes to ensure mainstreaming of gender in the day-to-day work of health personnel.

Training was imparted at the district, block and periphery levels. A gender-training kit was developed for block training team members. By the end of 1999, a total of 1838 personnel, 1531 of them women, had received training.

The project has had a positive impact on the approach of the health workers, who are beginning to recognize the need to change the situation. This, in turn, has had a small but significant impact on the community.

Some lessons learnt are:

• the gender perspective must be incorporated in the health workers' day-to-day activities rather than in the training curriculum alone.
• the use of the mass media to promote awareness is important
• co-ordination between the efforts of all agencies involved is a must.
• the identification of nodal persons to provide leadership in the planning of gender-sensitive programmes would be useful.
• follow-up training and refresher courses are a must
• training NGOs and officials of local administrative bodies would help create a more conducive atmosphere.