Why Kajiado women skip, delay seeking medical care

Many women in Kajiado County delay seeking medical care until their conditions become critical and emergency services are required, a new study has shown.

The findings from the study titled “Documentation of unpaid care and domestic in Kajiado County’  indicated that unless there is a medical emergency, women admitted that seeking medical services voluntarily is almost a dream.

In the study, women reported that walking to a health facility for family planning services, antenatal care, or seeking treatment for common flu or backache is not considered important. 

“You will rarely find a Maasai woman walking into a health facility to seek medical care; more so reproductive health services or antenatal/postnatal care, or for minor ailments like headache and backache, because she is expected to be taking care of others,  but not herself,” said a female focus group discussion participant from Isinya.

The study commissioned by White Ribbon Alliance Kenya to document the realities of unpaid care and domestic work in the county revealed that in many well-equipped health facilities, healthcare workers stay idle as women are not available to utilise the services.

At Enkorika Health Centre, healthcare workers noted that they have to go door-to-door asking women to seek family planning services and have their children immunised. They regretted that referrals are never honoured as most women are busy with domestic work and fear being beaten by their spouses if the household work is not completed on time.

“Healthcare services are usually treated as a last option unless there is an emergency. This has greatly affected how women access and utilise the services,” notes the study.

“High illiteracy levels among the women is a key challenge,” said Catherine Mutinda, county director of Gender.

The study carried out in all the sub-counties revealed that in addition to doing domestic work, women have minimal time for leisure and are expected to be taking care of others, especially children, the sick, the elderly and people with disabilities.

The focus group discussion participants highlighted that girls are often enlisted to take care of family members or help with domestic chores such as cooking, cleaning, or fetching water. School is considered a lower priority.

As a result, more girls are dropping out of school, putting them at risk of early marriages.   They are married off as a way of restocking livestock. “When livestock die, families try to recover by marrying off girls in exchange for dowry, which is in form of livestock,” says the study.

Even as the women complain about doing unpaid work, the study reveals that while 58 per cent of the respondents were looking for paid work, many were illiterate at 42 per cent.

“The low literacy level among women in Kajiado is contributing to lack of knowledge and skills to access income through paid work. The highest earning female respondent reported to earn less than Sh8,000, which was also similar to income from household farming and animal products,” said the study.

 “A majority of our women are illiterate and therefore unable to access income through paid jobs. This is a problem that we have been grappling with for years despite Kajiado being a host to key industries,” said a female education and gender officer from Kajiado County. The study also revealed that unpaid domestic and care work is associated with greater mental health burden and negative effects on quality of life.

Lived experiences shared by women and men during focused group discussions and programme community dialogues during data collection showed the risk of mental illness among women engaged in unpaid care and domestic work, which is expected to get worse due to a recent drought crisis that affected most households.

“Higher levels of objective stress among women may also translate into higher levels of perceived stress (burden and role strain) compared with men. Moreover, the cognitive and emotional involvement and the lack of respite (time for leisure, communication with partners or friends, and self-care) from unpaid work can eventually lead to physical and emotional distress, depression and anxiety,” the study indicated.

Climate change was indicated in the study to have intensified unpaid care and domestic work; contributing to economic crisis and family instability.

Most respondents, irrespective of gender differences, said women are primarily responsible for farming and food production. As a result, they are disproportionately affected by droughts, flash floods and locust invasions in the agricultural areas of Oloitoktok and Namanga.

Women participants cited the lack of formal opportunities outside their households due to cultural norms around their gender roles as caregivers and household workers. They mentioned that in times of food scarcity and drought, women often prioritise their husbands’ nutritional needs and those of livestock.

The study further revealed that women who have a stable source of income and live in urban areas can give more attention to and spend more quality time with their children by outsourcing more arduous household tasks—for example by using care services and domestic help. In contrast, women who lack the financial means are often burdened by repetitive, time-consuming and physically demanding domestic tasks. “This drudgery component, which makes up the largest share of poorer women’s total unpaid work burden, may cause substantial fatigue and stress, whereas the relational component of unpaid work such as playing with children may be stress-reducing and fulfilling,” says the study.

The study recommends that the national government invests in quality, affordable care-related infrastructure to reduce long and arduous working hours for women and the related negative health impacts.

“This should be delivered through national policy frameworks and resourced through a progressive taxation regime that does not further disenfranchise women. There should be established national guidelines on investment in essential services, parental leave schemes for both formal and informal sector workers, and sufficient budgetary allocation to county governments,” the study recommends.

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