Women and Sexual and Reproductive Health

Swati Pongurtekar from India presented on the experiences and particular difficulties with the methods used by Auxiliary Nurse Midwives to collect data on women's sexual behaviour. Swati felt that these midwives needed to think as women first and then as health workers to enable them to effectively listen and respond as well as attempting to provide an equal distribution of power. The main difficulty was identified as the women's shyness and embarrassment, as well as their lack of vocabulary for such candid discussions about their sexual health and sambandh (sex). Issues of women's lack of power were at the forefront of this presentation. For a number of women involved in this project the conversations with the health workers resulted in some levels of empowerment. Because the project allowed the women to talk and explore their feelings about their sexuality and reproductive health, some women reported improvements in their sexual relationships and sometimes even improved communication within the marriage. Swati then cautioned that this empowerment created conflict within the family unit and therefore it is imperative that back-up support for the women is continued for some time. The speaker then concluded with a very significant and pertinent point: that sexuality education and training must include issues of desire and pleasure.

The second speaker, Salaseini Tupou, also spoke of the importance of cultural traditions in the role of women's sexual health; however, this speaker was speaking of young women in the South Pacific Islands. Cultural practices such as the insertion of pebbles into women's vaginas to make them dry and tight increase these women's vulnerability to STIs. This paper also touched on the importance of the involvement and inclusion of men and boys in reproductive health and also pointed out that it is not solely women's responsibility. The discussion after the two presentations also raised the importance of the inclusion of desire and pleasure in the sexual education of people. It was also agreed that it was very important that spaces or forums be created for women to raise their concerns and discuss issues that might otherwise be taboo. It was felt that these kinds of forums hold the power to help change perceptions of young people and help them to explore their sexuality in a way that is comfortable for them.

The session's chair, Purnima Mane, added that health care workers, particularly women, can help often this dialogue and encourage women to talk about concerns and issues and concluded by saying that in a way HIV has forced us to look at sexuality, including women, their bodies and issues of power. However, there was still a long way to go.