Nursing perspectives on women, health and work in the socio-cultural context of poor communities in Northeast Thailand
Women from poor communities in Northeast Thailand can be considered as a disadvantaged group who have struggled against several problems in their daily living and who have worked hard to sustain their lives through unskilled labour. In such a strong Buddhist culture these women have vital roles within the household and in earning money. The combination of which it is suggested, has had an impact on their physical and psychological health. In Thailand, there is limited data available about such women's health, life experience and work. A better understanding of their situation is required in order to inform and redesign effective health intervention programmes to promote the health and well-being of women from these communities. An holistic nursing perspective was used to inform the design of this research. Only by understanding the context, the living experiences and the understandings of the women themselves is it possible to construct effective health intervention programmes. Thus the purpose of the study was to understand women's health and work in the sociocultural context of poverty in Northeast Thailand. A combination of quantitative and qualitative techniques were used in the overall data collection process. The study was conducted in two distinct phases. Phase 1 provided an overall of baseline account of the socio-cultural context of six communities and the health of a sample of women who live therein. It involved focus group interviews (N=102) with residents and a survey (N=209) of households. Phase 2 was a more focused case study (N=49) of women's life experiences, their health and work in one selected community. Phase 1 of the study found that the majority of women had a substantial role in household economics. Coping strategies that women frequently used were `Tam Chai' (accept and not think too much about it). The majority of women in the communities were primary breadwinners and were self-employed as vendors. Regarding women's health, the findings showed a high level of musculoskeletal and psychological complaints. The study showed that nearly all of the women were optimists and felt happy. In the second phase of the study. Buddhism and the Thai way of living emerged as the major factors which influenced women's views on health and well being. The data illustrated that women struggled to survive in the community and that they had to work hard to make ends meet. Women used networks in the community as resources for coping. They saw `health in terms of being strong enough to work and earn a living'. Health per se is the lowest priority in their life. To work and earn money to support their families is the highest. Indeed, the Buddhist teaching of `self-reliance' has a great impact on them. The conclusions reached suggest that nursing interventions and health campaigns could be used to promote and maintain the optimum health of women and their families. Finally recommendations are made with regard to further research; development of services; development of nurse-education and health promotion for women in low-income communities.