''You just look at our work and see if you have any freedom on earth'': Ghanaian women's accounts of their work and their health

Research on women's health in the developing world has focussed on reproductive issues and has defined women primarily as wives and mothers. Moreover, women's health problems have typically been defined by experts such as health care professionals and policymakers. The research reported here aimed to capture women's own views of their main health problems and how they explain them. The study was conducted in the Volta region of Ghana, West Africa and it involved interviews with 75 women of varying background and social circumstances. Reproductive health problems did not figure prominently among the problems women described -- almost three quarters of them spoke at length of psycho-social health problems such as 'thinking too much' and 'worrying too much'. These, in turn, were often linked with problems such as tiredness and not being able to sleep. Headaches and bodily aches and pains were also mentioned by many of the women. In explaining the source of these problems, one of the strongest themes in women's accounts was the importance of their work roles. Women spoke of the gender division of labor, their heavy workloads, the 'compulsory' nature of their work, their financial insecurity and the considerable financial responsibility they assumed for their children. These contributed to the worry they experienced and led them into many different work activities. They also talked about specific links between the nature of their work and the health problems they experienced, in particular, the physical toll of their work. We suggest that it is important to document the content of women's work, both paid and unpaid, showing the ways in which it influences their physical and mental health. Women in developing countries have too long been defined as childbearers and their important roles as workers have too often been neglected.