it can also reduce the time they spend in hospital after a medical problem should conventional gender roles and a lack of public alternatives continue to prevail women may find their choices to be increasingly constrained in countries with weak health services the burden often falls on caregivers working silently within the home in these circumstances people are expected to sacrifice themselves for their families and communities even putting their own wellbeing at risk traditional genderdifferentiated roles then result in a further restriction of options for women often greatest for the poor who can least afford them