Bilbao , Spain

Putting Women’s Health in Women’s Hands

Ayuntamiento de Bilbao, Programa Mujer, Salud y Violencia

June 28, 2012

Promoting women’s health in immigrant communities through “agents of empowerment”

How do you address immigrant women’s health and safety in hard to reach marginalized or minority communities? In Bilbao, it was through “agents of empowerment,” women trained to help each other within the comfort of their homes and without fear of discrimination or backlash.

In 2008, the City Of Bilbao was galvanized to action by the tragic death of a young woman following an abortion and evidence that this may not have been an isolated case. Research suggested that lack of information and access to services increased the vulnerability of marginalized and minority women on health-related issues. With an eye on the city’s surging population and a high birthrate among its new migrants, the city chose to focus its new health promotion strategy on women.

Developed by Bilbao’s Office of Equality, Cooperation and Citizenship, the award-winning Programa Mujer, Salud y Violencia promotes sexual and reproductive health among immigrant women, including prevention related to gender-based violence and issues related to cultural and sexual identity. The “Women, Health and Violence” program also aims to empower individual women to participate and become leaders in their own communities.

Brave New World

Bilbao is the largest city in the Basque region of northern Spain and like many cities in Spain, immigration is increasingly critical to its future. Since 2000, Bilbao has maintained its population of around 354,000 thanks only to the constant supply of foreign nationals which has offset the decline of the native population. Between 2000 and 2010, its percentage of migrants rose from 1% to 8.2% of the population, a demographic trend likely to continue towards the national average of 12%, or higher. Today, the majority of Bilbao’s foreign-born inhabitants are from Latin America, with newer communities of Romanians, Chinese, Roma, North and sub-Saharan Africans.

Agents of Empowerment

Engaging Bilbao’s diverse communities was the city’s first step. To deepen their understanding of the needs of immigrant women and for more effective outreach and dissemination, the Women, Health and Violence program partnered with community organizations. They also wanted to promote the role of local institutions as a resource.

Secondly, women who had agreed to act as “agents of empowerment” received training; five women from each group. Health agents were selected for their leadership potential and ability to connect with other women in their communities. Their responsibilities included creating a safe space for conversation, encouraging intercultural exchange, and promoting the multiplier effect of discussions about gender violence and sexual health through community forums.


In 2010, the Women, Health and Violence program successfully trained 35 empowerment agents and in 2011, 26 more women received the program’s diplomas. To date, 465 immigrant women from 38 different nationalities have participated directly. The city has also distributed over 3,000 copies of a print and online resource, Women, Health & Violence: Guide for Women, focused on sexual health among other topics. The guide was published in Romanian, Chinese, French, Arabic, Castilian and Euskera; 3,000 copies have been distributed.

Programa Mujer, Salud y Violencia was recognized by the Spanish Ministry of Labour and Immigration, as an example of city councils implementing local plans to raise awareness on equal treatment and non-discrimination (2010). The program was also recognized as a best practice by the European Network OPENCities (2011).

Making it Work for You:

  • Providing childcare at the workshops allows more women to participate and actively take part in the project.
  • Use a participatory approach to gain a needs-based perspective and the best strategies for success within your target community or service area.
  • Cultivate a safe and respectful environment to encourage participation and effective learning.
  • Choose ‘agents’ with leadership abilities who can attract others to join in and help share the message.

For this Good Idea contact:

Idoia Uriarte Ercilla, Bilbao City Council - Department of Equality, Cooperation and Citizenship
Pza Venezuela 2, 4 th PTA
48001 Bilbao, Spain,
iuriarte @

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