Engagement of Social Change Agents in Improving Women's Health in Egypt

One of the key questions in women's health is the degree to and ways in which community-based health and/or social interventionists impact on women's empowerment, and in particular on women's health practices and treatment-seeking behavior. In two recent World Bank projects, Social Change Agents (SCAs) were found to have had demonstrable impact on the women and families of the households with which they interacted: playing a vital role in improving health practices and treatment-seeking behavior. A qualitative study conducted by Georgetown University School of Nursing and Health Studies (GU-NHS), in collaboration with the Egyptian Smoking Prevention Research Institute (ESPRI), was carried out to explore the role that SCAs played in influencing women's health seeking behavior within the household and the community. The study included analysis of secondary data and in-depth interviews conducted with key World Bank project team members, officials from the Ministry of Health and Population and Social Fund for Development (SFD), twenty-five SCAs and 20 household members. Through household visits and other activities during which they delivered health education messages and engaged with the women and their families, they helped the women to 1) increase their use of reproductive health services; 2) increase and improve access to and appropriate use of health centers and self-care for themselves and their family members; 3) increase their, and their family's, acceptance of male physicians as caregivers for women; and 4) discuss health issues and “healthy alternatives” with their husbands and other family members, including the issue of child spacing and female circumcision. Factors that facilitated the ability of the SCAs to carry out their roles included availability of accessible health centers and MOHP mobile health units, clear and integrated project and component design relevant to needs of villages, availability of loans for income-generating projects. The study findings have implications for public policy in Egypt, for donor funding of community-level and other programs targeting women's health, and for local government engagement with community NGOs and faith communities to engender their support for strengthening women's capacity to engage in appropriate health practices and treatment-seeking behavior.