Researchers analyzed data collected on female employees in Egypt's six largest family planning organizations to determine how women perceived the effects of working for a family planning program.  Researchers conducted 64 focus group discussions in Cairo, Kafr El Sheikh, Beni Suef, and Sohag, and in-depth interviews with 19 female family planning leaders.

Egypt

In Egypt, most family planning workers are women. Through their work, women say they have gained opportunities to learn new skills, improve their self-confidence, earn income, and gain respect in their communities. However, family planning work carries some disadvantages, as well, including the stress of trying to balance work and family responsibilities, and suspicion and criticism from family planning opponents.

Research Findings

Researchers analyzed data collected on female employees in Egypt's six largest family planning organizations -- the Ministry of Health and Population, the Coptic Evangelical Organization Social Services, Clinical Services Improvement, the Egyptian Family Planning Association, the Health Insurance Organization, and the Teaching Hospital Organization. Employees included physicians, nurses, social workers and raedat refiat (field workers). To determine how women perceived the effects of family planning employment on their lives, researchers conducted 64 focus group discussions in Cairo, Kafr El Sheikh, Beni Suef, and Sohag. The study also included in-depth interviews with 19 female family planning leaders.

• The Ministry of Health and Population is the nation's largest employer of family planning workers (87 percent). Among family planning workers, nurses comprise the largest category, while physicians and raedat refiat account for one-quarter of family planning employees.

• Of the 19,610 employees in Egypt's family planning program, 82 percent are female. Forty-eight percent of physicians are women, but the percentage varied by organization, from as high as 93 percent to as low as 13 percent.

• Most female family planning employees said they made household decisions jointly with their husbands, with the husband's opinion prevailing in serious disagreements. Many employees felt their work expertise gave them information which helped them make joint decisions about a daughter's age at marriage, her premarital examination, and their own contraceptive use.

• Female employees said they felt stress from the dual responsibility of performing a job and caring for a family. Women in all occupations said they had too little time to care for their own families, and they worried about sick children, housework and child care. Women also said they felt stress because of lack of material resources to perform their jobs.

• Female employees said work outside the home brought them respect inside the home. One social worker in Sohag said, "The word 'planning' does not apply to contraception only. It applies to planning in every aspect of family life. They have seen that the women can organize the family budget with very little income." Women said they had control over their income but spent it mostly on children's needs and household items.

• Employees said their work achievements helped enhance their self-esteem. A doctor in Beni Suef said, "I have developed more confidence through the trust of clients in keeping their secrets." One family planning leader said, "Working in family planning is like swimming against the tide. This is what creates a leader because it needs great effort and strong character."

• Other workers said they were hurt by criticisms, leveled at them because they stepped out of the traditional female role. Some clients' relatives blamed family planning workers for contraceptive side effects. "Some men say bad words and some husbands and mothers of clients do not meet us nicely and quarrel with us if anything happens as a result of using contraception."

• The most serious reports of job dissatisfaction came from social workers who, unlike doctors and nurses, were usually assigned to family planning through the Ministry of Labor. They expressed dissatisfaction with irregular payment and lack of training related to family planning.

• Unlike the leaders in the family planning field, most other employees did not have time for participation in community politics, although they considered it a good thing and felt no resistance from their families to participate.

• Female employees saw one of the benefits of their jobs as working with other women, and their husbands also approved of a job that involved interaction primarily with women.

Recommendations

Reproductive health programs are searching for ways to make programs more gender-sensitive for clients – to consider cultural and gender norms that affect women's access to and use of services. However, because the majority of family planning employees are women, health programs also should explore ways to make their programs more gender-sensitive for employees, taking into account women's dual responsibilities at work and at home.

Many female family planning clients say they would prefer to receive services from women. The majority of family planning workers in Egypt are women. However, there are fewer female physicians providing contraceptive services than are providing other health services. Family planning programs should work to attract more female physicians, particularly in rural areas where the needs are greatest. These efforts should go hand-in-hand with education programs in rural areas, where there is considerable opposition to contraceptive use and to women working outside the home.

Study Details

Dr. Hesham Makhlouf and Dr. Bothaina El-Deeb of the Cairo Demographic Center were responsible for this study. The research was supported by the Women's Studies Project at Family Health International (FHI), through a Cooperative Agreement funded by the U.S. Agency for International Development. Dr. Cindy Waszak was the FHI staff person responsible for technical assistance.