Gender Analysis for Global Health_10.15.13


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  • Welcome, Introduce the team Agenda Introductions around each table Group Survey Activity: Sector and Experience ; ChallengesKey themes among the challenges that some of you shared in the survey included:How to better engage men in FP/RH and MCH programmingIntegrating gender-transformative approaches in politically conservative or unstable environmentsStrengthening gender capacity and commitment in field officesLimited resource allocations for gender programs (both internal and external to our projects)Measurement of gender outcomes
  • Social construct that defines how women and men are supposed to act or the “social definition” of women and men, girls and boys.-- comic— illustrates how norms influence our attitudes and beliefs about appropriaterolesand behaviors for women and men. And also how we reinforce these roles in our families and in communities.In all societies, these customary rules exist. They vary from context to context, and are constantly evolving and changing, quickly in some societies and slowly in others.
  • Adherence to rigid gender roles, by individuals, by communities, by societies, by governments, mean that women and men are often excluded from opportunities perceived as gender-inappropriate. This can lead to a gender gap - that is, inequality in opportunities for women and men to access and use resources and derive benefits from policies and services. For example, in some societies laws and policies exclude women from having land rights; or parents do not allow girls to complete secondary school because that level of education is considered unnecessary for women. Likewise, men may not have access to family planning information because programs typically target women only.This inequality impacts health outcomes, and influences health programs
  • And on that last point, gender impacts health outcomes because it influences how women and men experience health. It influences their…… Exposure to risk factors.For example, In some contexts women have increased risk of contracting HIV because norms encourage her husband’s promiscuity while, at the same time, prevent her from insisting on condom use.Young boys may be at higher risk of being injured in an accident because of expectations that young men should be risk-takers.Access to & understanding of information about health„„Patterns of service useWomen may not receive needed health care because norms in her community prevent her from travelling alone to a clinic.Health decision-makingPerceptions of quality of careMen may not have accurate information about family planning because it is considered the women’s responsibility (yet in many contexts, they are in fact the key decision-maker around whether or not to use FP.
  • So gender is an important consideration when designing and implementing health programs. And we will turn now to program strategies to remove gender as a barrier to good health. This is what we refer to as gender integration or gender-integrated programs.
  • Gender integration is the process of taking account of gender norms and the differences and inequalities between men and women in programs and policies. On this slide is a picture of the Gender Integration Continuum, a framework for understanding the extent to which programs and policies address gender. As you see in the graphic, programs and policies can be either gender blind or gender aware. Gender blind programs, at the bottom of the graphic, do not explicitly articulate how gender issues are being addressed. It ignores – often unintentionally – underlying gender constraints, and carries out the program without specific consideration of gender barriers. Gender aware programs and policies, on the other hand, deliberately examine and address the environment in terms of gender, and consider how gender influences program objectives.A gender aware program may use a range of approaches to address gender constraints and opportunities. Gender transformative strategies, on the right side of the continuum, seek to address gender constraints directly by challenging inequitable gender norms. Examples of gender transformative strategies include promoting the status of women or addressing power imbalances between women and men. Gender accommodating strategies, in the middle of the continuum, also acknowledges gender constraints, however instead of challenging inequitable norms, they seek to accommodate or compensate for them. These types of strategies may design programs to “work around” the constraints in order to achieve their outcomes. Gender exploitative strategies are found on the left side of the continuum. These approaches take advantage of rigid gender norms and existing imbalances in power to achieve the health program objectives. These types of approaches can reinforce existing gender inequality and undermine program efforts in the long term. Gender exploitative approaches are not appropriate strategies for gender integration.
  • On this slide I’ve included some illustrative examples of accommodative and transformative approaches for addressing or removing gender barriers.Conducted a gender analysis and found that women do not have access or control over own income and therefore are not attending MH services. The transformative approach goes one step further to empower women to have access to their own income.Integrates FP counseling into neonatal visits – women don’t have to make a separate trip to the health clinic for FP / Engages men in FP and addresses power imbalances between women and menAddresses rigid gender rolesANY COMMENTS OR QUESTIONS SO FAR?
  • It will be addressed through integration of gender equality and female empowerment throughout the Agency’s Program Cycle and related processes: in strategic planning, project design and implementation, and monitoring and evaluation. This integrated approach positions the Agency to address gender gaps and the constraints that hold women back.
  • Under this policy, USAID investments are aimed at three overarching outcomes. In strategic planning at the country or project level, these outcomes will be adapted and translated into specific results with associated targets and indicators. These outcomes, which are especially important for people who are marginalized or excluded due to ethnicity, gender identity, sexual orientation, lack of income, disability or other factors, reflect the gamut of activities that USAID undertakes across multiple sectors and fields.
  • Seven guiding principles underpin this policy, reflecting key features of the USAID Policy Framework 2011­2015 and the parameters of the USAID Forward reform agenda: (1) Integrate gender equality and female empower­ment into USAID’s work: This policy will be implemented by integrating approaches and actions to advance gender equality and female empowerment throughout the Agency’s Program Cycle. USAID will also make strategic investments to promote gender equality and female empowerment. (2) Pursue an inclusive approach to foster equality:This policy is inclusive of all women and men, girls and boys, regardless of age, sexual orientation, gender iden­tity, disability status, religion, ethnicity, socioeconomic status, geographic area, migratory status, forced dis­placement or HIV/AIDS status. (3) Build partnerships across a wide range of stake­holders: USAID will partner with host governments, civil society, the private sector and other donors to ensure that our efforts are coordinated and non­duplicative, build on the skills and initiatives of local actors, and reflect country priorities. (4) Harness science, technology, and innovation to reduce gender gaps and empower women and girls: USAID investments should make bold and imaginative use of new technologies to change dis­criminatory social norms and stereotypes, and empower women and girls to wield greater influence in society. (5) Address the unique challenges in crisis and con­flict­-affected environments: USAID’s work in conflict­affected and fragile states should promote women’s participation in all efforts to prevent, resolveand rebuild following conflict; prevent and respond to sexual and gender based violence; and ensure that relief and recovery efforts address the different needs and priorities of women and men. (6) Serve as a thought ­leader and a learning community: The Agency will measure performance in closing key gender gaps and empowering women and girls, learn from successes and failures and dissemi­nate best practices on gender integration throughout the Agency. (7) Hold ourselves accountable: Gender equality and female empowerment is a shared Agency responsibil­ity and depends on the contribution and collective commitment of all staff, with particular emphasis on senior managers and Mission DirectorsOther notes: 2 year phase-in, for evaluation in 2015. Additional implementation guidance is anticipated.
  • Refer to what participants have shared, and note that in short, gender analysis is the process of identifying gender inequalities and determining their programmatic and developmental implications. That is, gender analysis identifies and examines the social constructions of what it means to be a woman and girl or man or boy and how these impact the lives and health of women and girls and men and boys.
  • In general, gender analysis tools seek to help us understand the body of social interactions that are influenced by existing gender norms, roles and relationships. Consider that mass of interaction as the pie’s content—if we don’t break it down or slice it up, the complexity is to great to lead to clear understanding.Different instruments slice the pie in various ways. Our tool—the IGWG gender analysis tool—slices the pie (social interaction) into five pieces or domains, with power spilling over into the other four. As we apply the gender analysis tool today, we hope to sharpen our analytic skills, thereby sharpening the knife.
  • Gender Analysis for Global Health_10.15.13

    1. 1. Gender Analysis for Global Health Programs October 15, 2013 CORE Group Fall Meeting Joy Cunningham Jennifer Pendleton Elisabeth Rottach
    2. 2. Agenda  Welcome/Introductions  Gender Overview – Terminology and Approaches  USAID Policy on Gender Equality and Female Empowerment  Participant Approaches and Successes in Gender  Gender Integration in Practice  Conclusion and Resources
    3. 3. Gender Rules for how women and men should behave
    4. 4. What does “gender” mean? The roles, responsibilities, behavior and attributes that a particular society considers appropriate for women and men
    5. 5. Why does gender matter? • Adherence to rigid gender roles can create a gender gap Women Men unequal options, opportunities and realities that women and men experience • Inequality impacts health, influences health programs Source: WHO, Why Gender and Health? 5
    6. 6. Gender influences women’s and men’s experiences related to health • Exposure to risk factors • „ Access to & understanding of information about health • Patterns of service use • Health decision-making • „ Perceptions of quality of care Source: Adapted from Caro 2009 6
    7. 7. Gender Integration Developing or adapting programs to remove gender as a barrier to good health
    8. 8. Gender Integration Continuum Source: See 8
    9. 9. Gender approaches Health program area Gender barrier Accommodative Transformative Approach Approach Maternal health Women do not have access or control over own income Provide free maternal and child health services Provide free maternal and child health services AND foster women’s credit and savings groups Family planning Men are final decisionmakers regarding use of contraceptives Integrate FP counseling into neonatal visits Offer couple counseling on FP (constructive male engagement) Maternal and neonatal health Women’s heavy workload does not permit time to visit health clinic for antenatal visits Conduct antenatal home visits Conduct SBCC campaign to promote more equitable sharing of household work amongst couples 9
    10. 10. USAID Policy on Gender Equality and Female Empowerment
    11. 11. USG Policy Overview  USAID Gender Equality & Female Empowerment Policy  US Strategy to Prevent & Respond to GBV Globally  USAID Vision for Action: Ending Child Marriage & Meeting the needs of Married Children  Counter-Trafficking in Persons  National Action Plan on Women, Peace, and Secutrity  Youth in Development Policy  USG Action Plan on Children in Adversity
    12. 12. Gender Equality and Female Empowerment Policy Goal: Improve the lives of citizens around the world by advancing equality between females and males, and empowering women and girls to participate fully in and benefit from the development of their societies.
    13. 13. Overarching Objectives  Reduce gender disparities in access to, control over and benefit from resources, wealth, opportunities and services economic, social, political, and cultural;  Reduce gender-based violence and mitigate its harmful effects on individuals and communities; and  Increase capability of women and girls to realize their rights, determine their life outcomes, and influence decision-making in households, communities, and societies.
    14. 14. Operational Principles  Integrate gender equality and female empowerment into USAID’s work  Pursue an inclusive approach to foster equality  Build partnerships across a wide range of stakeholders  Harness science, technology, and innovation to reduce gender gaps and empower women and girls  Address the unique challenges in crisis and conflict-affected environments  Serve as a thought-leader and a learning community  Hold ourselves accountable
    15. 15. • Gender Analysis • A tool to help us better understand women’s and men’s lives
    16. 16. What is Gender Analysis? Examines relational differences in women’s and men’s and girls’ and boys’  roles and identities  needs and interests  access to and exercise of power and the impact of these differences in their lives and health.
    17. 17. Applying a gender lens Laws do not support men’s involvement in family planning Health Program Laws do not protect women from violence Social norms encourage men to be strong - discourage them from being nurturing fathers Community norms devalue women’s health issues FP services target women, therefore men are uninformed about contraceptives but still the key decision-maker regarding FP use Beliefs that men are weak if they seek health care Has to ask permission from her husband to leave the home Limited control over income
    18. 18. The Gender Pie Knowledge, be liefs and perceptions Power Legal rights and status Access to resources Practices, role s and participation
    19. 19. Gender Analysis In Practice Case Study: Timor Leste Small Group Activity
    20. 20. Thank You! The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. It is implemented by Futures Group, in collaboration with CEDPA (CEDPA is now a part of Plan International USA), Futures Institute, Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA). Join the discussion: Community of Practice on Scale-up and Gender, Policy and Measurement, at