Gender, health, and development in post-war Sri Lanka: access to health care for resettled women in Jaffna

Abstract

ABSTRACT Health significantly supports human development, which is particularly critical in countries affected by armed conflict. Health and health care are equally important for women hoping to be effective agents of change in their post-war societies. Through a grounded case study conducted in the district of Jaffna, Sri Lanka, in 2017, we aimed to understand the challenges resettled (formerly internally displaced) women faced when accessing health services. We conducted semi-structured interviews and focus group discussions with 54 women from two villages, one predominantly Tamil and the other predominantly Muslim. To capture complex gender and health dimensions, we employed the framework of intersectionality. While the comparative nature of the participants’ cultural identity, specifically their ethnicity and religion, was a part of the analysis, the findings illuminate particular ways that income and gender affected women’s health care-seeking behaviours, regardless of ethnicity. These encompassed: (1) prioritising caretaking over health care; (2) seeking permission when leaving home; (3) travelling with companions to health facilities; and (4) discussing health-care decisions with family members. We found that the intersection of the participants’ gender with their income, and gender aspects like marital status, greatly affected their health-seeking behaviours. Findings underscore the importance of considering multiple factors, including social determinants like gender and income, in the provision of basic services that support women’s health and development following war.