Research Monograph Series No. 11 BRAC

Women, workload and the women's health and development

programme: are women overburdened?

Kaosar Afsana Syed Masud Ahmed Maliha Mayeed Rita Das Roy Fazlul Karim

August 1998

BRAC Research and Evaluation Division

75 Mohakhali, Dhaka 1212 Bangladesh

Women, workload and the women's health and development

programme: are women overburdened?

Kaosar Afsana Senior Medical Officer (Research)

Syed Masud Ahmed

Senior Medical Officer (Research)

Maliha Mayeed Former Staff Geographer

Rita Das Roy Field Researcher

Fazlul Karim

Senior Research Epidemiologist

Research and Evaluation Division, BRAC

August 1998

Research Monograph Series No. 11

Research and Evaluation Division, BRAC, 75 Mohakhali, Dhaka 1212, Bangladesh. Fax: 880-2-883542, 883614 E-mail: bracamr@bdmail.net Phones: 988 1265, 884180, 884051(PABX)

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PREFACE The Research and Evaluation Division (RED) of BRAC provides necessary research support to BRAC programmes. BRAC, one of the largest multifaceted non-governmental organizations in the world, works for poverty alleviation and empowerment of the poor since 1972. Established in 1975, RED conducts wide range of studies including impact studies, action research, monitoring and evaluation studies, diagnostic studies, baseline survey, demographic surveillance, and some longitudinal studies. The study discipline covers health, nutrition, economics, education, social science and the environment. The erstwhile ‘Rural Study Series’ of BRAC, initiated in 1983, now renamed as ‘Research Monograph Series’ intends to disseminate BRAC’s research studies to scientists, researchers, policy makers, programme implementers, and other concerned persons both within and outside Bangladesh. Besides, RED also undertakes collaborative studies and joint research on issues of development with various research institutions at home and abroad. Women’s involvement in the community activities is imperative not only for self-empowerment but also for their significant contribution to community development. BRAC launched the Women’s Health and Development Programme (WHDP) in 1991. WHDP aimed to improve maternal and child health through health education and services. This study looked at whether the WHDP activities overburdened the rural women in addition to their normal workload. In 1996 the project was renamed as Reproductive Health and Disease Control (RHDC).

TABLE OF CONTENTS

Preface iii Abstract 1 Introduction 2 Materials and methods 4 Findings 6 Discussion 18 Conclusion 21 Acknowledgements 21 References 21

Women, workload and the women's health and development programme: are women overburdened?

ABSTRACT

This study investigated whether different activities of Women's Health and Development Programme (WHDP) overburdened the participating women. The study was carried out in Monmothpur and Rampur areas1 of Parbatipur thana2 under Dinajpur region3 of WHDP. Data were collected through focus group discussions, in-depth interviews and daily time-use methods from women who were associated with different activities of WHDP, such as mahila shava (MS), gram committee (GC), village organization (VO) and shasthya shebika (SS). Triangulation method was applied to cross-check the findings. The findings reveal that, apart from women's enormous workload at home, the SSs among all participating women spent a considerable amount of time in WHDP activities without monetary gain. It also put a limit to their subsistence and income-earning activities. Besides, WHDP activities compelled them to finish household work hastily leading to exhaustion and fatigue by the end of the day, particularly of the women with small children. It also indirectly put pressure on the school-going girls and old mothers-in-law. The SSs involved with other non-governmental organizations (NGOs) became more exhausted due to burden of dual community activities. To reduce the burden of the SSs the following actions are recommended: a) monetary support to the SSs should be provided; b) women aged more than 35 years having no small children and who are not involved with other NGOs should be selected; and c) women belonging to extended or joint families may be preferred as SSs with the option of giving assistance (in the form of loans) from BRAC to the members of that family.

1 Area is an administrative unit of WHDP consists of 50 villages having a population of roughly 50,000. 2 Thana is the lowest administrative unit of the government at the subdistrict level having a population

of some 200,000. 3 Region is a unit at the district level consists of 3-4 thanas.

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INTRODUCTION

In the predominantly rural and agrarian society of Bangladesh, management of household activities is considered to be the primary role of a woman. Micro-level studies show that rural Bangladeshi women spent 56 hours a week in different types of activity (1). Another study shows that most women worked for 14-18 hours a day in rural area (2). Besides their immense involvement in household activities and child care, women substantially participate in home-based agriculture, poultry, animal husbandry and non-farm activities, and play a crucial role in maintaining food security in the family (3). Yet women's role in productive activities is denied in the statistics of Bangladesh as their casual and seasonal involvement in income generating activities are not recognized in labour force (4,5). Women face problems with regard to culture, class, religion, race, marital status and others (6). In Bangladesh, the status of rural women is reflected in their almost non-existent role in the economy, low literacy, poor nutritional status and high rate of morbidity, mortality and fertility. Rural Bangladeshi women are regarded as the poorest of the poor because they are economically poor, socially prejudiced by customs and beliefs and traditionally secluded in Purdah4 due to patriarchal dominance of the society (7). However, women are presently forced to take part in income-earning activities outside of their home to escape from the burden of poverty. Hence, heavy demands are placed on women to maintain their participation in domestic activities as well as economic. Given the situation of women in rural Bangladesh with a view to complement government's efforts, BRAC and other non-governmental organizations (NGOs) implemented various credit, education, health and income-generating programmes to improve the status of rural women. BRAC, one of the largest NGOs in the world, launched the Women’s Health and Development Programme (WHDP) in 1991 in the northern and central regions of Bangladesh to improve maternal and child health through health education and services, and to strengthen the capacity of the community to sustain these activities (8). BRAC put much emphasis on women from the target group (TG)5 involving them in different community activities of the

4 One must keep in mind that purdah cannot be universalized. Indeed, it is not just any seclusion, but a

seclusion that has been organized by men of certain classes in favor of women of certain classes. Such classes have always been bhadras (dominant social forces), primarily geared to the task of keeping intact their identity against the o-bhadras (poor and illiterate). For further details, see I.Ahmed `On feminist methodology: can mahilas speak?’

5 BRAC defines target group that includes households having less than 50 decimals of land and a household member who sells manual labour for at least 100 days a year for survival.

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programme. As a consequence, women indeed are put in a better position in the society, but concurrently their lives are severely constrained by the burden of their triple roles - reproductive, productive and community management (9). Women who participate in WHP activities also perform domestic and other activities; a question may be raised whether WHDP activities in any way lead to overburdening of the participating women. The specific objectives of the study, therefore, were to determine how much time women used in household, income earning and WHDP activities, and to look into women's views about their involvement in various activities of WHDP. The study is expected to provide useful information to policy makers to change or improve strategies aimed at raising women's participation in BRAC’s programme. Women in BRAC activities The WHDP has directed attention towards women of reproductive age. Of the 10 thanas of WHDP, women from the target group are involved in different activities of WHDP, such as mahila shavas (MSs), gram committees (GCs), traditional birth attendants (TBAs), and shasthya shebikas (SSs). As the credit programmes have been introduced, women as members of village organizations (VOs) also get involved with income-generating activities. In this study we included women from the MSs, GCs, VOs and the SS groups. Their activities in relation to the programme are discussed below: Mahila shava (MS): All women in the WHDP areas are included in the MSs. An MS is an education forum of 5 to 6 target women. A meeting of the MS is organized in every three months to raise women's awareness on the issues of health, nutrition and family planning. Gram committee (GC): A GC is a village health organization comprises 9 to 11 women selected from the target population. In the monthly meeting, GC members discuss the health problems of their village and at the same time not only they disseminate their knowledge but also take some actions within the village. Village organization (VO): The VO is a primary organization of the rural development programme (RDP) with 20 members selected from the target population. Besides the weekly meetings for savings and credits, an issue-based meeting of the VO, held once a month, discusses socioeconomic and health problems of the villagers. Shasthya shebikas (SSs): The SSs are the health cadres, selected one for each village. They are the nucleus of the health programmes. They are trained in preventive,

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promotive and curative aspects of health, and are responsible for various health activities of WHDP.

MATERIALS AND METHODS The study was carried out in September 1993 in Monmothpur and Rampur area of Parbatipur thana under Dinajpur region of WHDP. Seventy-four women involved with MSs, GCs, VOs, and SSs activities aged 20−44 years constituted the study population. Women were grouped into four categories according to their involvement in different activities: a) Group I consists of women involved only with MSs; b) Group II includes women who were primarily GC members but also VO members; c) Group III comprises only VO members; and d) Group IV includes women who were SSs and at the same time were also members of GCs and VOs. Purposive sampling procedure was applied to draw respondents for daily time-use and in-depth interview in Rampur area and for focus group discussion (FGD) in Monmothpur area. Four women from each of the four groups were selected for in-depth interviews and daily time-use methods, and eight to nine women from each group for FGDs. Three female investigators collected the data. Six FGDs with the first three groups and two with the fourth group were carried out in Monmothpur area. The moderator guided the group discussion based on previously pre-tested discussion guide. One observer took notes of the whole procedure and also of non-verbal signs. Another one recorded the whole verbal material on tape and also helped in smooth running of FGD sessions. It took about 1½ hours for each FGD sessions. Everyday the discussion was transcribed from the tape at night. For in-depth interview, one of the investigators interviewed the women using a checklist and the other took notes. Each in-depth interview took about 1½ hours. Time spent in daily time-use method was also about 1½ hours. The investigator recorded various types of activities performed by the women from morning to sleeping time at night sequentially, and asked the respondents to put one seed against the activity, which consumed the least time, and twenty seeds against the activity, which consumed the maximum time. Further, women were asked to put 2-19 seeds against other activities using their own judgment. Soon afterward the investigators again went through the whole sequence of activities with the woman to check how far the time consumed by each activity conform with the total time. The amount of time consumed in each activity was calculated by converting total numbers of seeds into 24 hours and then the total time was divided into different proportions based on the number of seeds used by the women for each of their daily activities. Relative time was also judged according to the two indicator values. In all cases, Azan

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and prayers were taken as fixed point on the clock. From this information, the investigators could conclude that the women usually get up around 5-00 to 5-30 a.m. and go to bed around 9-00 to 10-00 p.m. In daily time-use method, women replaced different types of daily tasks with BRAC activities and the replaced seeds were added and converted to hour. Because BRAC activities were not regular phenomena, and time consumed by each activity differed each day, it is difficult to present the findings in tabular or graphic form. Hence the data on time spent in BRAC activities are presented in a descriptive form. Triangulation approach was used in the study to cross-check the findings (10,11). The FGD data were sorted out and a general description of the relevant points was presented. The data from in-depth interviews and daily time-use were used to confirm the findings of the FGDs. Based on FGD and in-depth interview findings, women from the four groups were found to perform similar types of household works. As a result, we considered all four groups simply as `women' and presented the data altogether in describing household work. The study had some limitations, however. The data were collected from a small sample using purposive sampling procedure; as a result, it lacked representativeness of the survey and generalizability of the findings. The participants selected for FGDs are supposed to be unknown to each other but due to natural calamities and time constraints, women were selected from the same or adjacent villages. Since women were interviewed for a lengthy period both in FGDs and in in-depth interviews, the WHDP staff at the field level informed them earlier which may affect the reliability of the data, but it was maintained by asking the same questions repeatedly in different ways by the experienced investigators. We interviewed the women in off-season and most of the seasonal day-labourers were unemployed; therefore, it was difficult to find out the actual picture of women's involvement in income-earning activities. As women perform several activities at the same time, it was hard to collect accurate information on time allocation of daily activities by any particular methods. Also, in daily time use method, we had to rely on women's judgment of using seeds against each activity.

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FINDINGS Women's profile Most of the study women were in the age group of 20-24 years (Table 1). All but two women were currently married and two were widows, one each from MS and GC. In the first three groups, most women could not read and write (15 from MS group, 12 from GC and 16 from VO), but among the SSs, seven women had the level of education up to Class VII-IX. Most women (49) were seasonal day-labourers. Among the SSs, eight had no cash income but two earned from paddy husking, and two from sewing dresses and quilts. Besides, more common were women having 1-2 children and households with 3-5 members. Household work The findings reveal that women from all the four groups undertook similar type of activity everyday. They began their days right after the Azan of the Fazr prayer (first prayer of the day before the sunrise for the Muslims). The majority of the women woke up usually around 5 o’clock in the morning, and as most did not have access to latrine, they went to pathar (open fields) for defaecation before the sunrise. Since then women began their daily activities. A typical comment from the respondents was as follows:

“After getting up I got to go for nature's call, wash myself, clean my teeth with charcoal, prepare myself and perform prayers, bring my cattle out and feed them, clean the cowshed and make ghoshi (dung cake), get the chicken out, clean and sweep the huts and courtyards, clean dishes and utensils of previous night, prepare, serve and take breakfast and again clean dishes.”

Women commonly fetched water from the tube wells located either inside or outside the houses. Besides their regular household activities in the morning, some women helped their children in preparing homework and getting ready for school. Following that the majority had a period of obsorer somoy (free time) for a while. During this period, they commonly got occupied with varieties of activities, such as home-gardening, paddy-husking, cattle and chick-rearing, cloth-repairing, quilt-sewing (Kantha-selai), woodenstick-drying (khori-khocha shukano), house-repairing, visiting neighbourhood (ghuri-ghari berai), etc. Around mid-day, women prepared meals. Most respondents were found to cook once a day and ate the same food three times - at noon, at night and at breakfast in the following morning. Before taking bath, they smeared the kitchen floor with mud-water, swept the courtyards and washed the clothes. The daily time use

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method also supports the findings that women spent a considerable amount of time in food preparation and cleaning jobs. Furthermore, they assisted their children in taking bath and soon afterward took their own bath. Women were found to allocate the least time in self-care, which was less than an hour for each day. Some Muslim women offered Johr prayers. Interestingly, women with younger children were found not offering prayers. During mealtime, women at first fed their children and then attended their husbands. A typical comment was: "I fan my husband when he eats and I eat later." Women usually ate after their husbands and thereafter cleaned the dishes. Following lunch, they all had free time. Apart from being involved in similar activities during their free time in the morning, some women gave company to their small children. With regard to child care one woman commented:

"Go and see my children, whether they live in comfort or not. How their health is, how clean they are, how our houses are, you must go and see it."

Typical comment on the same issue was:

"You don't need to watch children. They can do everything."

While chatting with the neighbours, they, in fact, did not relax rather were occupied with some other activities, such as caring the cattle. A very few women only managed to take a nap. The general opinion is that only men could make time to take rest. Typical comments were as follows:

"Men can take rest but not women."

"A mother with one child can take rest, but if she has many children she can't."

"We don't have time to take rest. We are poor, we work very hard. You will be mad if I start talking about my daily work." "I love to have rest. It is the body that wants rest. But rest will spoil everything. At night when I lie down, I lose track of my body."

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Table 1. Distribution of women of four groups by age, education, occupation, number of children under 10 years and number of household members.

Types of groups

MS (n=21) GC (n=20) VO (n=21) SS (n=12) Age in years

20-24 25-29 30-34 35-39 40-44

9 7 1 4 -

7 2 7 2 2

11 - 6 1 3

1 3 4 3 1

Marital status Married Widow

20 1

19 1

21 -

12 -

Education Can not read/write Class I-III Class IV-VI Class VII-IX

15 1 5 -

12 2 6 -

16 4 1 -

1 2 2 7

Occupation Seasonal daily Labour6 Daily labour7 Paddy husking8 Nursery9 Sewing10 Others 11 No cash earning12

17 4 - - - -

-

12 1 - 2 - 5 -

20 1 - - - - -

- - 2 - 2 - 8

No. of children below 10 years None 1-2 More than 2

-

15 6

4 13 3

2 17 2

-

10 2

No. of household members 3-5 6-10 More than 10

13 7 1

18 2 -

17 4 -

6 6 -

6 Seasonal day labourers work in the post harvest period. 7 Day labourers work throughout the year. 8 Women who earn from paddy husking. 9 Women who work in the nursery in their own houses. 10 Women who sew dresses and quilts and do embroideries. 11 Women who teach the Qur'an and Bangla, weave mats and fans, rear poultry and cattle, do home-

gardening, etc. 12 Women who do not earn any cash money.

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Most of the women received help in household work from their grown-up daughters, mothers-in-law, sisters-in-law, etc. One commented:

"Daughter of a poor family can do any kind of work." "Only girls help mothers in their household work but boys attend school or madrasha."

Surprisingly, a respondent mentioned that her minor son helped in household works. Before Magreb prayer (the fourth prayer of the day just after sunset), they again swept the huts and courtyards. Some women brought the cattle back, fed them, and put them back to the cow shed, and at the same time also fed the chickens and put them in the coup. As soon as the Magreb prayer was finished, some women helped their children in homework. At the late evening, they fixed the dinner, fed the children and put them in bed. On an average, women spent less than two hours in child care but women with younger children were found to spend more than 5 hours at most. Women usually took their night meal after Esha prayer (the last prayer of the day). Before going to bed they chatted either with their family members or with the neighbours in the khuli (courtyard) for a short time. Most respondents commonly went to bed around 9-10 p.m. It is worth mentioning that during the exercise of daily time-use method, women were surprised by observing their involvement with so many activities. Participation in income earning activities Direct income earning activities13 The majority of the MS, GC and VO members were seasonal day-labourers. During the post-harvest season, they got occupied all day-long with the rice-processing. Among the daily-labourers, two MS and one GC members worked as maid in the rich families and the rest earned from earth-digging in Food for Works Programme of the government. Two GC members earned from nursery business and two from weaving fans and baskets. Out of four SSs involved in direct earning, two earned from selling rice and rice-product, such as pithas (pancakes) and muri (puffed rice) and the other two from sewing dresses and Kanthas (quilt). One GC member earned by teaching village girls the Holy Qur'an and Bangla language. Whatever job women perform

13 Women earn cash on regular basis directly from jobs or by involving in any income generating activities.

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outside of their homestead, they must take permission from their husbands. One seasonal day labourer stated:

"My husband allow me to work only in my relatives' houses but not in other houses. "

Table 2. Time spent in different activities by women in 24 hours.

Types of activities Time spent in hour

Food preparation and serving: collecting and cutting vegetables, cooking, serving and eating food, fetching water and firewood

mean = 4 h 42 min range = 1 h 57min-8 h 2 min

Cleaning: cleaning utensils, sweeping, washing clothes, smearing floor with mud-water

mean = 2 h 30 min range = 20 min-4 h 10 min

Child care: giving bath, feeding, helping in homework

mean = 1 h 49 min range = 16 min-5 h 18 min

Self care: going to toilet, taking bath and cleaning face

mean = 54 min range = 20 min-1h 52 min

Income-earning activities mean = 1 h range = 0-5 h 30 min

Religious activities mean = 1 h 26 min range = 0-3 h 54 min

Other activities: animal care, home-gardening, sewing, leisure, etc.

mean = 2 h 54 min range = 0-7 h 16min

Sleeping mean = 8 h 45 min range = 7 h 1 min-10 h 33 min

Indirect income earning activities14 Among the MS members, some earned from paddy-husking, mat-weaving, etc. One commented:

"I weave mat in the morning or in the afternoon whenever I get time and my husband sells them in the market."

14 Women earn from these activities not on regular basis and perform these in between their household work

and during free time.

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An MS member said that she did all kinds of work available to her varying from selling cow's milk and home-made cakes to day-labour. She commented:

"If I do not get out of my house, then how would I fill my stomach? If I do not sell pithas and work in other houses, how would I feed my children?"

Some GC members earned from weaving dala (basket) and mats, selling eggs and chickens, helping their husbands in small trades and fishing, etc. A seasonal day labourer commented:

"A man sticks to only one kind of work but a woman performs thousands of work. Look at me Apa, I was healthy and pretty, but day by day I am losing all my beauty and feeling exhausted."

Most of the VO members earned from home-gardening and poultry-farming. Some helped their husbands in small trades. Maleka, a seasonal day labourer engaged in paddy-husking commented:

"During the post-harvest period, I can work only in my relatives' houses. Now I husk paddy in the sunny days. My husband sells rice in the market and I save fragmented particles of rice for my family. In rainy days, I can't do paddy husking. Actually my family now lives on earnings from cow's milk. If the cow gives less milk in any day, then I sell one or two eggs."

Most SSs earned from home-gardening and poultry-farming. Some of them received loans from BRAC's credit programme which they have invested in their husband's small trade or agricultural activities. Participation in BRAC activities Members of MS The MS meetings were held once in every three months either in the morning or in the afternoon depending on the free time of the members. It usually took half to one hour, but another hour was spent to organize all the members. Some women were irregular in attending the meetings. Typical comments were:

"If I get time I attend the meetings." "I am too busy with mat weaving, I don't have time to attend the meeting."

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However, members of the MS are not expected to perform any WHDP activities but some willfully assisted the POs in organizing ante-natal care centers (ANCC) and expanded programme on immunization (EPI) and growth monitoring (GM) sessions. Members of GC As the GC members were also the members of both MS and VO, not only did they attend the monthly GC meetings but also the weekly VO meetings and quarterly MS meetings. Needless to mention that some attended monthly issue-based meetings, which were quite irregular. If held in the morning the VO meeting took an hour, but if the GC meeting followed the VO meeting, an additional hour was spent. Some respondents stated that if GC meetings were held on a separate day it usually took about two hours to organize the meeting. Apart from the meetings, the majority claimed that they played an important role in disseminating health messages and in motivating people to avail of the health services. These activities include, for instance, demonstrating women how to make lobon-gur solution (LGS), bringing women and children to ANCC and GM sessions, inspiring people to install safe latrine, etc. Some also mentioned informing the SSs of births and deaths. However, women usually performed these tasks during their free time. Members of the VO VO members were also the members of MS. Besides the weekly VO meetings of one hour, they also attended a monthly issue-based meeting and a quarterly MS meeting which were as irregular as others. Shasthya shebika In addition to attending the GC, VO and MS meetings, the SSs also attended a monthly refresher's training course in the area office that took almost half a day. For the weekly VO meetings, the SSs spent 1-2 hours. Some of the SSs said that GC meetings held after the VO meeting were continued for half to one hour. But if GC meetings were organized in the afternoon, it took 2-2½ hours for all the members to arrive, and the issue-based meetings took the same time if held in the afternoon. The SSs attended all the MS meetings within their supervision areas, and every month at least spent 15 hours in the MS meetings. On an average, a SS spent daily more than an hour in holding meetings. Apart from the meetings, the SSs were found to assist the POs to organize ANCC, EPI and GM sessions, and also were involved in motivational work and in distributing contraceptives among the eligible couples. During their free time, few SSs

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also maintained contact with the family welfare assistants (FWAs) of the government family planning programme to collect pills and condoms. Most important work of the SSs was the supervision of the tuberculosis (TB) patients. The time spent by the SSs depends upon the treatment regimen of TB and the number of the patients. The SSs visit the TB patients every alternate days during the first two months of treatment to inject TB drugs and every week for the rest of the treatment period to provide oral medicine. Most of the SSs were found to attend 1-4 patients to push the injections and 1-7 patients to give them oral medications. Moreover, the SSs were also found to collect sputum from the suspected and the identified TB patients, and to bring the sputum to the area office for laboratory tests. The SSs performed these activities during their free time and regular working hours. Views of women regarding their involvement in various activities Problems of women Although women from each group mentioned not encountering any major problems in attending the meetings, on further probing the MS members who were engaged in paddy-husking or earth-digging (Food for Works Programme), felt discouraged to attend meetings. Typical comments in FGDs were as follows:

"To attend a meeting in every three months is not a problem at all." "I attend the meetings after finishing all my household work." "If I work at the paddy field or do earth-digging, then it is hard to attend the meetings."

The VO and GC members and the SSs on their meeting or other activity days began the day much more earlier. Before going out, they tried to finish their household work hauk-dauk kori (very swiftly). Under such circumstances, if they failed to finish their household work, they left it for their daughters or mothers-in-law. Most of the GC and VO members refused to attend the meeting by causing any inconvenience to the family, although a few felt very responsible to pursue BRAC activities. But those involved directly with income-earning activities could not spare enough time to attend the meetings regularly. Even on a few occasions they lost their wages for attending the meetings. Sometimes they sent their savings or loan payments through someone else. Typical comments were:

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"Even though I have problem, I try to manage time to attend the meeting." "The meeting is already planned, so what is the problem in attending a meeting?"

The SSs involved in income-earning activities, found difficult to continue all type of programme activities. With a strong sense of integrity to their tasks, and with some hopes of being benefited from BRAC in future, they mentioned never skipping BRAC’s activities under any circumstances, and wanted to stick to BRAC for their whole life. Involving in triple kind of works, they felt really exhausted and fatigued by the end of the day. Typical comments were as follows:

"I can't just leave the household work behind. I have to finish all my work before attending the meeting." "The day we work hard, we feel exhausted." "How long do we have to wait for that day? Apa, we came here with a hope of benefits."

Women who had a less number of children, and who belonged to joint families did not feel exhausted in performing BRAC activities. On the contrary, women belonging to nuclear families and with many children had the opposite feeling. In nuclear families, women either took their children to the meetings or asked the neighbours to look after their children. If their children were sick, most of them skipped the meetings. For the SSs, in particular, child care was a genuine problem. Most of them pointed out that they had a very little time for child care. Even when a child was ill, they could not stop their tasks or meetings. Women from all four groups stated that without their husbands' consent, they could not attend the BRAC activities. Before going to a meeting, they kept everything prepared for their husbands. Earlier their husbands forbade them to attend the meetings but after the credit programme had been introduced, their attitudes were remarkably changed. BRAC's loans were seen as an incentive for the husbands to allow their wives to participate in BRAC activities. Typical comments were:

"Should I go out without my husband's permission?" "Husbands do not bother if they have their food in time."

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However, a few MS members mentioned their husband's disapproval of attending the BRAC’s activities since they had not received any economically profitable offers. Typical comments from the MS members were as follows:

"If I attend the meetings frequently my husband shouts at me and sometimes teases me." "BRAC told us that they will provide trees to plant and to watch, to provide us latrine and tubewell. All are farce. They did not give us anything. My husband told me not to go to a meeting any more. Only advice and advice." "We run after benefits. What we gained here is only advice but no money."

Benefits from BRAC activities The statement that after getting involved with BRAC, women had learnt about maintenance of good health and prevention of diseases, and availability of health and family planning services, which were more obvious among the GC members than the MS and VO members. Besides these, the SSs had learnt more about health related issues, particularly TB treatment. Women felt that their knowledge about the related issues had reduced incidence of diarrhea and tuberculosis to a great extent in the village. Peoples' awareness of safe water and latrine use was also found to be raised among the villagers. Most of the GC and VO members received loans, which were being used in income generating activities like small trades, home-gardening, poultry-rearing, cattle-rearing, etc. Some women expected more loans from BRAC. Besides being benefited from BRAC's loan, the SSs earned some money from TB treatment and selling medicines. Yet women were much more concerned with saving some money out of BRAC activities. More importantly, they stopped borrowing money from the rich money-lenders in the village. One SS commented:

"The rich are in trouble now. They can not lend money with high interest."

Future aspirations Although the MS members did not receive any loan, they hoped for some eventual monetary gains or a salaried job in future. Most of them argued that only raising awareness about health and disease prevention would not solve their economic problems. They also awaited for those days when their children would receive

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education from BRAC school. A statement of the MS member shows how frustrated she was:

"We got some health care, but now we need care for filling our stomach. Please do something for us."

Typical comments from the MS members were:

"Human being live with hopes of finding ways for better living." "If we are lucky, then the Samity (VO) will soon open up here." "We will have Samity here soon and get VGD card."

The other women who were GC and VO members expected frequent and larger loans from BRAC, and some preferred to have salaried jobs too. Sometimes women faced difficulties in repaying the loan on time. One GC member commented:

"I can’t sleep since Thursday night, because I have to pay off my loans on Saturday. I wish to have some sort of work like watching mulberry trees."

Although the SSs wanted to serve people, most of them would expect profits in cash out of BRAC activities. In spite of their great anticipation from the credit programme, a few, however, preferred salaried jobs to loans. A typical comment in a group discussion was:

"Apa (sister), you don't mind such an enormous workload because it's your job; you want to work for the people and you want to do it more, because you earn money, but what about us?" "We are working here with a hope, if one day, we get salary for our work, it will save the poor." "Apa, this is not my salaried job that I leave my household work and family back at home and stick here all day long."

Change of status Most women stated that the neighbours never showed any hostile attitudes towards them but rather women were appreciated for being involved with BRAC. Typical comments were:

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"You have become a marad (man). Monju Ara knows everything now." "Men say that women are empowered after Khaleda Zia came to power. I don't care anyone. I learned a lot."

The SSs were not only recognized by the villagers by their names but also respected as doctors. Although some neighbours, especially the well-off opposed their activities, recently it was changed. Typical comments were:

"What you have started, only an MBBS doctor can do that." "The well-off people do not like us, but how many well-off are there?"

Involvement in other organizations Some MS members were attached to Grameen Bank and CARE. They did not want to admit it for the fear of losing BRAC benefits. Yet one participant commented:

"It is not good to put your legs in two boats."

The SSs were also found to be involved with Bangladesh Rural Development Board (BRDB) and Come To Work (CTW), some GC members with Grameen Bank, and some VO with Grameen Bank and CARE. Pre-BRAC period Before starting of BRAC activities, the majority was engaged in activities inside the households. Other NGOs, like CARE, had programmes in few areas. During their free time, most of them used to do sewing, home-gardening, animal care, etc., and also had time to take rest. The SSs stated:

"We don't have time now. Before we used to gossip with the neighbours and now we can't."

Observation Many village women often wanted to talk to us during our interview with the respondents. When we asked them how they managed to spare time since they were involved with so many activities, they said:

"Apa, you are strangers to this village. I just came to see you. I can't stay here long."

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While interviewing one of the SSs, her mother-in-law stated:

"Look girls, you came here far from Dhaka, because you are being paid for this. This poor girl (SS) works so hard for you but doesn't get anything."

We faced the same question from her husband as well. Informal discussion with programme staff We talked with the POs, area managers of two areas and the regional manager about women's workload. They believed that the SSs were perhaps the most hard working community workers in the WHDP areas, but they received much more benefits from the credit programme. In addition, they had attained such a respectable position in the society that could not be compared with money and was beyond one's expectation.

DISCUSSION The study findings revealed that all women began their days immediately before or after the Fazr Azan and continued to perform different types of activities till their bed time spending as much as 15 hours in a day. Besides household works, women who were engaged in income-generating activities spent a substantial amount of time in their jobs. Another adjunct to their work was subsistence activities that they usually executed during their free time. Among the women who were involved with BRAC activities, the SSs, in particular, mostly participated in various activities of WHDP. Apart from attending the meetings, they also worked at the villages to attend TB patients, to organize ANCC sessions, to distribute contraceptives, to mobilize people, etc. In general, the SSs spent one hour on an average in attending BRAC meetings. For carrying out BRAC activities, not only they used their free time but also used their active working hours. With all these works, they practically had no free time. Excessive involvement of SSs with WHDP activities caused their own inconvenience as well as their family members'. These activities double, treble and often quadruple their workload, and hence by the end of the day the SSs became exhausted and fatigued. Moreover, WHDP activities often limit their subsistence and other income-earning activities, which in turn create food insecurity and financial loss for the family. It was found that some women were involved with other NGOs. Involvement with other NGOs added more to their workload. To avoid duplication of work and activities, BRAC should immediately liaison with other NGOs. A suggestion has already made for an annual NGO-Summit, involving national and other South Asian NGOs (12), may be explored.

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Yet the hardship that women faced for their involvement with varieties of activities depends on their size of the family, number of younger children and helping hands in the family. Women’s lives become miserable while they play a triple role - household works, reproductive activities and BRAC activities. The findings reveal that in a large nuclear family, women with more than two small children, got occupied with their household works for long hours and more importantly, spent a considerable amount of time in child care. It is quite difficult for them to skip any household work and hence they fairly curtailed their free time to perform other activities. All women except the SSs usually abandoned their activities in case of family problems, for instance, illness of their children. Yet, the very idea of child care does not exist among women of rural areas. Here life is so close to nature that child-rearing has been considered as nature's duty. In a joint family women received help from their daughters and mothers-in-law in accomplishing their household works. Assistance from the family members, which is more available in a joint family, is crucial to their participation in outside activity (13). Since women performed BRAC activities instead of subsistence activities in their free time, questions may arise as to what should women do during their free time - subsistence activities or BRAC activities? If they continue BRAC activities, then who will carry out subsistence activities? Subsistence activities, however, not only provide the family with much needed nutrition but also bring extra income to the family, and thus add to GNP (2). Furthermore, since WHDP has no provision for pecuniary gain, should women limit their indirect income by engaging themselves in WHDP activities? Taking rest during free time is considered as luxury in rural areas. Even if they had free time to rest, they would not. On their visit to neighbours during free time, they actually did not relax, rather watched cattle. Nevertheless, the notion of relaxation does not exist in traditional rural life. So the time which is called obsorer somoy (free time) is not truly obsor (free). Is the non-existence of true free time due to poor economic condition or due to lack of knowledge and education (lack of external influence?) or due to cultural reasons? In this context, further studies are needed to address the issue. Women claimed that there awareness of health and diseases were raised, but unfortunately, in most of the study villages, hygienic practices, such as safe latrines were scarcely seen. It is understandable that installing latrines at the homestead is quite difficult due to lack of space and money, but our apprehension is that people still feel free to defaecate in the pathar (open field) because of their traditional habits and the process of socialization. More programmatic attention needs to be given towards changing this behaviour.

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BRAC has been successful in changing women’s status, particularly of the SSs, as they had no position in the society previously. Now, the SSs are respected as a doctor for providing treatment of TB and some common diseases. Since these women are being accepted at large by the community, it is time to think of establishing an alternative training center for them at the village level. This centre would provide training to poor rural women not only for treating common diseases but also raising awareness of the people, using indigenous resources of the village. After the credit programme being introduced, women's status has been slightly improved among their husbands because women have started bringing cash. Surprisingly, most money has been invested in business run by men. Because the trend of involving women in business is new in the society, it will take little more time for the women to start their own business. Although the credit programme has indeed brought some changes in women's lives, their husbands have still decided women’s place of work. Whatever the shifts in views of fit work for women, the institution of Purdah and patriarchy still restricts women's earning activities outside of their household (14). Under such circumstances, the programme should direct their attention to change men's attitudes towards women by organizing different education forum for men. Moreover, the programme should also take into account the extent to which women can get involved in WHDP activities but not affecting the relationship between husbands and wives. To bring a change in patriarchal structure is not simple. BRAC must work subtly but consciously in this domain. Despite getting credit, women showed more interest in jobs rather than in loans because of their uncertainty in repaying the loans. More importantly, women's interest in monetary gains cannot be overlooked. It has also been evident in a BRAC’s study that the village health workers showed much interest in monetary gain (15). Women also believed that as the SSs were intensely involved in BRAC activities, they must be provided with some remuneration. However, SSs' concern about the monetary gain is not illogical. Time has come to ponder whether it is rational to involve an unemployed person in community activities without remuneration. Even in the United States, social work appeared as paid occupation at the end of the nineteenth century (16). However, BRAC in collaboration with the government or other NGOs, could devise some strategies for the SSs' remuneration.

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CONCLUSION It is clearly evident in the study that women's double and triple role in the society overburdened their lives. Apart from their workload at home, the following points indicate that WHDP activities lead to overburdening of the SSs: 1) spending considerable amount of time in WHDP activities without remuneration; 2) forced to finish household work hastily, which also leads to exhaustion and fatigue; 3) by using free time, subsistence activities are greatly reduced; 4) put a limit to income-earning activities; 5) skipping regular household work puts pressure on school-going girls and old mothers-in-law; 6) getting up in the early morning reduces required sleeping time; and 7) involvement with other NGOs increases their workload. Despite SSs' change in status in the society and their increasing awareness about health-related problems, some actions should be undertaken to reduce overburdening of the SSs: a) provisions of monetary support, particularly in the form of job, will give incentive to the SSs to work in WHDP, and also reduce their involvement in income-earning activities; b) women who are more than 35 years of age having no small children should be selected as SSs; c) women belonging to extended or joint families may be preferred as SSs with the option of giving assistance (in the form of loans) from BRAC to the member of that family who will look after the household when the SS is engaged in WHDP activities; and d) women who have no involvement with other NGOs should be selected as SSs.

ACKNOWLEDGMENTS

We would like to acknowledge our gratitude to Prof. Perti J Pelto, anthropologist (formerly Professor, University of Connecticut, USA), Dr. Sushila Zeitlyn, anthropologist (formerly working in ICDDR,B), Dr. Farida Akhter, Executive Director, UBINIG, and Dr. Zarina Rahman Khan of Dhaka University for their valuable comments. We are also indebted to Dr. AMR Chowdhury, Director Research, BRAC for his guidance and encouragement. The editorial support of Dr. Siraj H Khan and Mr. Hasan Shareef Ahmed of the Research and Evaluation Division, BRAC is also acknowledged.

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