Empowerment is classically defined as “granting or giving authority” weather it is by physical or financial means. However the term has been more recently applied in the context of health care policy and the improvement of the quality of healthcare. This broader meaning has expanded to include a focus on self – realization and self help (Loukanova and Bridges, 2008). Mental health and physical health are linked; this is why problems such as anxiety and depression are treated with exercise and dietary regimens in the treatment plans for patients suffering from these problems, which in fact is many in the worldwide population (Ruddick, 2013). The Department of Health (DH, 2009, 2011) recently published that there needs to be a shift towards the promotion of mental health to promote the health and well being of a nation.
Women have long been a population that is at greatest risk for disempowerment (Bhengu, 2010). While women in western societies have overcome some of the disadvantages many women in other countries have not over come them. Theories for the reasons for the disempowerment of women in society include: feminization of poverty, as well as female submission, educational deprivation, privacy of domestic violence, exploitation, domination of men and cultural oppression (Bhengu, 2010). In a study from Pakistan by Karmaliani, et al. (2012) the contributing factors of sexual violence towards women include: the acceptability of violence amongst men and women, internalization of deservability, economic disempowerment, lack of formal education, joint family systems, and the lack of legal and other support systems. Disempowerment has shown to increase the risk of health related problems (Karmaliani, et al., 2012).
A study by Corroon, et al. (2013) studied the effects of empowerment of women in urban areas of Nigeria and their use of family planning methods and reproductive health outcomes. In Nigeria, less then 10% of the population uses modern methods of family planning; due to the higher number of pregnancies there is an increased maternal morbidity and mortality. Two – thirds of the population is poor and lives in slums another factor that diminishes empowerment. Their study showed that women’s empowerment in the household and their daily life as well the relationship she has with her partner had a profound effect on a women’s likelihood to use a modern method of contraceptive as well as try to locate a safe place to give birth, suchas a free clinic or if possible a fully functioning hospital, with trained professionals at hand. The outcome deduced by this study was replicated by several other studies across Asia and other parts of Africa.
According to Van de Merwe (1996) for a person to be empowered they must be aware of their own powerlessness, be unhappy with it, and be willing to change their situation. The steps to empowerment were described by Vlasoff (2001) and include:
- Teaching the meaning of equality within the home, i.e. Brothers and sisters are equal.
- Creating groups for women to talk, share knowledge, and gain information and confidence.
- Non – formal education such as basic education and literacy programs.
- Incorporation of skills learned into every day life.
“Operation HOPE” Small Business Empowerment Program is an example of a community based empowerment program whose function is to help people that want to be entrepreneurs that come from low-income communities. Another example of a community based program is the “Sanctuary for Families Economic Empowerment program”, which aids women coming from abusive relationships to be economically independent. These programs lead to financially stable households, so that people feel empowered and control of their future, making them more likely to eat healthy and exercise, leading to better mental health.
Another example of empowerment is the Wellness Recovery Action Plan, which lets people suffering from mental illness to create their own self-help plan. The aim of the program is to let the patient feel empowered and in some sort of control, by promoting self management; they create coping strategies to deal with their problems, or they may develop new methods to promote their own well being. This means that even people who society deemed incapable of caring for themselves are now able to be in control of their lives, and might not need to rely on the family or their community for help nearly as much.
A socially just society is a society based on equality amongst its people. It is rather a process, to build strong communities, rather then a desired outcome. A socially just society distributes its resources, opportunities, and responsibilities amongst all people; it also stands together against social injustices and oppression. Finally it builds a sense of community through collaborative action (UCB- school of social welfare, 2013). Due to these reasons and definitions social justice within a community adds to the empowerment of its people, and in no way could lead to the disempowerment of them.
If governments, health insurers, and healthcare professionals provide healthcare to all, it is also the individuals responsibility to promote their own health, such as eating well, taking part in physical activity as well as complying with their own medical treatment. Yet, the problem comes back full circle because if a person is required to make healthy food choices as well as take part in physical activity, the government must give affordable access to these things. The problem in many societies is that government officials do not agree on what should be considered a health priority, such as women’s health, children’s health, social assistance for the mentally and physically disable, and thus consider their own self-interest and that of their friends and family, rather then the interest of the community as a whole (Ruger, 2010).
The Mental Health Foundation found that good living and work conditions as well as “green” environments had a large positive effect on a person’s mental health (Mental Health Foundation 2005, Department of Work and Pensions 2008, Faculty of Public Health 2010). The enhancement of well-being is key to promoting mental and physiological health (Ruddick 2013). Poverty can have devastating effects on the mental health of people in a society. Without political change and a more adequate distribution of wealth within the community, the poor of the of the community are kept in a “poverty trap” with a lack of motivation, opportunity, aspiration, and diminished mental health (Ruddick 2013). Some causes of mental illness are beyond the control of the individual, their family or the community, and governments have a key role in promoting mental health by creating healthy living and work environments as well as in the educational system. Mental health is of greatest concern to government’s world wide, because a population that has good mental health is a successful one.
Nurses spend a lot of time with patients and therefore have a good position to exert a positive influence onto them. The relationship between the two should be positive, and the nurse must develop skills to identify and increase a person’s well being. They must be able to interact with all types of people therefore this skill is of the utmost importance. This type of relationship makes it so that information is forthcoming and trustworthy from the patient making it better and easier for the nurse and other healthcare professionals to assess their problem (Ruddick, 2013). This type of relationship is also beneficial to a nurse working with children; recognition of their individual needs and support of individuality is key to their promotion of health as well. Children and teenagers are not as forthcoming with information and therefore the nurse must also be able to recognize signs of abuse and neglect.
Mental health requires strong relationships between the nurse and the patient, and can lead to a patient’s sense of empowerment and resilience (Ruddick 2013). Empowerment is the key to ensuring well-being of the patient, as demonstrated by the studies done by Carroon and Bengu. These cases demonstrated how women, who are a group frequently disempowered in society, can become empowered and in turn affect not only their mental health, but also their physical health, and improve their lives and the lives of their family. Nurses can help a patient or a person in a community feel a sense of empowerment, by helping get information out their and educating people on the many aspects of health that effect society as a whole. However it is not only the responsibility of the healthcare professionals; responsibility is also on the patient, the community, and society and government as a whole. It is only through cooperation that proper steps can be taken to increase overall health and wellness of the people, and furthermore the betterment of society.
Works Cited
Loukanova, S., and Bridges, J. (2007) Empowerment in Medicine: An Analysis of Publication Trends 1980-2005. Central European Journal of Medicine. Available through: http://link.springer.com/content/pdf/10.2478%2Fs11536-007-0066-7.pdf
Bhengu, B. (2010). An investigation into the level of empowerment of rural women in the Zululand district of KwaZulu-Natal province of South Africa. Curationis, 33(2), 4-12.
Corroon, M., Speizer, I., Fotso, J-C., Akiode, A., Saad, A., Calhoun, L., and Irani, L. (2013).The Role of Gender Empowerment on Reproductive Health Outcomes in Urban Nigeria. Maternal and Child Health Journal. (online) Available through: http://link.springer.com/article/10.1007%2Fs10995-013-1266-1
Operation Hope. Hope Small Business Empowerment program. (online) Available at: http://www.operationhope.org/small-business
Sanctuary for Families. Economic Empowerment program (online) Available at: http://www.sanctuaryforfamilies.org/index.php?option=com_content&task=view&id=145&Itemid=168
Van Der Merweas (1996) An Epistemological study of the power as nurses- a phenomenological approach. PhD thesis. Durban University of Natal. (online) Available through:
Karmaliani, R., Pasha, A., Hirani, S., Somani, R., Hirani S., Asad, N. Cassum, L., McFarlane, J. (2012) Violence against Women in Pakistan: Contributing Factors and New Interventions. (online) (12):820-6. doi: 10.3109/01612840.2012.718046 Available through: http://www.ncbi.nlm.nih.gov/pubmed/23215983
UCB-School of Social Justice (2013) Social Justice Symposium – Home. (online) Available at: http://www.socialwelfare.berkeley.edu/sjs/
Ruddick F. (2013) Promoting Mental Health and Wellbeing (online) Nursing Standard. 27, 24 35-39. Available through: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=55342d6b-45aa-4986-80a7-361181321fcb%40sessionmgr198&vid=1&hid=123
Rugers, J. (2010) Health and Social Justice. (online) Available through: http://www.who.int/bulletin/volumes/89/1/10-082388/en/index.html
