Background
Nepalese society is male dominated. The mobility of male
workers is high due to social and cultural factors. Women
therefore have an enlarged responsibility for the family,
because many families are separated from their working-age
male members. Patriarchy in Nepalese society manifests itself
also in legal structures (i.e. shift of a girl to a final household
in marriage and tying women’s property rights with marriage).
Women have limited access to resources like employment,
health facilities, education and knowledge, making women
more dependent on men for access to these resources (6).
Rural women tend to suffer more than rural men. Their pov-
erty and low social status are a major contributor to chronic
poverty. There is substantial evidence showing that focusing
on the needs and empowerment of women is one of the keys
to human development (7). Empowerment can be described as
a process in which an individual is taking over control over
his⁄ her own life on the basis of equality with others. Women’s
empowerment is the process (and its outcomes) in which
women – individually and collectively – become active, knowl-
edgeable and goal-oriented actors who take and ⁄ or support ini-
tiatives to overcome gender inequalities. Hence, women’s
empowerment refers to a strategy to achieve gender equality
as well as to the inherent capacity building processes (8). Pro-
grammes for women in Nepal are usually primarily directed to
fulfilling women’s basic needs rather than their empowerment.
The BBP specifically choose to add the oral health promotion
training to an existing 6-month vocational training programme
for rural women in Baluwatar, Kathmandu. This vocational
training aims to improve the harsh (living) circumstances of
rural women. Within the programme, rural women are trained
in community leadership, emergency first aid, group animation,
vocational skills, and how to budget and save money. They
learn to recognize their rights and gain confidence in speaking out for themselves (9). It is important for a successful health
care programme to provide a culturally appropriate way to
include women, to incorporate diverse local perspectives and
to promote broad-based participation, as well as to cooperate
with local organizations and to involve members of the com-
munity (2, 10). The oral health training is embedded in the
existing vocational training because it was considered that per-
forming basic oral health promotional duties required specific
competencies that these women acquired during their 6-month
training, among them are higher self-esteem, as well as a chan-
ged attitude and confidence to educate fellow villagers. Being
part of the vocational course meant the project would not only
meet local needs and interests but is also sensitive to social
and cultural contexts in which it is located.