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Gender responsive programming: An approach to planning and implementation
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Gender responsive programming: An approach to planning and implementation


Gender responsive programming: An approach to planning and implementation …

Gender responsive programming: An approach to planning and implementation

Elena McEwan, Catholic Relief Services

CORE Group Spring Meeting, April 28, 2010

Published in Health & Medicine
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  • Gender refers to our social and psychological identity as males and females. What it means to be masculine or feminine in the society in which we live. Gender is expressed in our behaviors, attitudes, relationships, etc. Gender is learnt through socialization, it is not innate but evolves to respond to changes in the social, political and cultural environment. UNHCR
  • This OR will be aimed at measuring if behavior change activities with men may contribute to decreasing the first barrier in recognizing and deciding to access timely obstetric and neonatal emergency care and secondly to better understand men’s attitudes about their perceived role, their perception of authority and of family well-being. On the providers’ side, the CSP will strengthen the services by providing MoH staff new skills to diagnose and treat obstetric and newborn emergencies, by re-structuring the health services to become more culturally sensitive, and by including new indicators in the MoH health’s information system to record the number of pregnant women seeking care with their partners and the number of men who asked questions regarding their wives’ health during care. The CSP will also improve the coordination between health units and community structures to improve timely referrals.
  • The KPC results for men also showed that men do not recognize the danger signs that may put the health of their wives and children at risk. When asked which danger signs would make them seek help for their wives during pregnancy,
  • KPC and FGD with volunteers baseline
  • This is based on the quality cycle: Plan, do, check, adapt/refine/ act/implement
  • Organization: 20 communities selected using pre-established criteria Training CS and MoH team in methodology Field work planning, development of guidelines and interview techniques Invitation to community members Field work 14 FGD participating 36 men whose wives were either pregnant or with children under two 32 in-depth interviews (16 men whose were in postpartum period) and 16 post-partum women. Analysis and discussion of findings: Team compiled and analyzed the information 4 session to present the results to governmental authorities in three municipalities (major office, MoH, MoEd, Police, other organizations) 35 participants 8 sessions at community level with men, women for a total of 64 participants In all the sessions participants made recommendations about strategies could be implemented to overcome barriers
  • FGD and in-depth interview with men and women
  • 25 men in three municipalities Men with pregnant women’ Men whose wives where in last two weeks of pregnancy: behavior 1,2 Anecdote about the wife didn’t want to go back and wash the baby’s clothes after one months of probing phase The husband convinced it was important to participate in the ANC came to the H/U but the doctor didn’t let him in The H/U staff brainstorming how to declare “husband friendly units”. “welcome all me who love their wives”
  • When to the health center couldn’t participate during ANC: one decided to do something else and the other one was asked by the health staff to participate in a meeting. Other men couldn’t go with wife, only had money to pay for her wife fare. Men when to the health center and was willing to stay with wife during the delivery of the baby but the doctor didn’t allow him to enter the room Two other couples participating in this behaviors, the women haven’t went into labor yet.


  • 1.
    • Gender responsive programming
    • An approach to planning and implementation
    • Elena McEwan, MD
    • Senior Technical Adviser
    • Catholic Relief Services
    • Core Spring meeting, April 2010
  • 2. What does Gender mean?
    • Gender refers to a set of qualities and behaviors expected from males and females by society.
    • Gender roles are socially determined and can be affected by factors such as education or economics. They may vary widely within and between cultures, and often evolve over time.
  • 3. What does Sex mean?
    • Sex refers to the biological differences between males and females. Sex differences are related to males’ and females’ physiology
  • 4. Catholic Social Teaching & Gender Responsive Programming
    • Integral Human Development
    • To better understand the complex world of the communities we serve and design programs that improve livelihood outcomes and increase household resiliency
  • 5. Catholic Social Teaching
    • To promote right relationships among all people by ensuring that men and women have the opportunity, capacity, voice and support they need to participate on an equal basis, to realize their full potential, and to reduce the disparities and imbalances of power including those which exist between men and women.
  • 6. Catholic Social Teaching- Guiding Principles
    • Sacredness and Dignity of the Human Person
    • Rights and Responsibilities
    • Social Nature of Humanity
    • Solidarity
    • Option for the Poor
  • 7. The use of a Gender lens in CRS programs
    • Project cycle:
      • Pre proposal:
        • Secondary data disaggregated by sex
        • Seek & analysis of information (health outcomes vs. gender issues)
        • Include both (women and men)for feasible solutions to the same problem
      • Proposal development and implementation:
        • Innovation: Changing men’s behavior regarding health care
        • How to measure and evaluate its contribution to better health outcomes
  • 8.
    • Changing men’s behaviors regarding care during partner’s pregnancy, delivery and post-partum/neo-natal periods:
  • 9. Which danger signs would make men seek help
    • During pregnancy:
    • 26% of men mentioned bleeding,
    • 15% fever or abdominal pain and
    • 33% did not know of any sign.
    • During delivery:
    • 31% mentioned bleeding,
    • 14% fever and
    • 32% did not know any sign
    • During postpartum period:
    • 29% mentioned bleeding,
    • 13% fever and
    • 17% did not know any sign
    • Danger sings in newborns:
    • 41% mentioned fever
    • 17% rapid and difficult breathing.
    • Source: CSP Baseline, 2008
  • 10. What is the problem in seeking care?
  • 11. Systematic approach for behavior change Planning and Strategy Development Developing and Pretesting Concepts, Messages, and Materials Implementing The Strategy Assessing Effectiveness and Making Refinements 3 2 4 1
  • 12.
    • Organization of targeted communities
    • Field work
    • Findings analysis and development of community strategies
    First Phase: Formative Research
  • 13. What is the problem?
    • Formative research findings:
    • Reasons why men don’t get involved in wife and children health:
    • Don’t know how to do it
    • Lack of communication with wife regarding pregnancy
    • Lack of motivation due to feeling left out by the health staff during care
    • They feel embarrassed to be seen by other women when taking care of the newborns
  • 14. Second Phase: Probing phase and development of BCC materials
    • Key behaviors /% achievement
    • Collect fire woods and water: 76%
    • Support wife with household work: 100%
    • Take care of newborn and older children day and night: 71%
    • Feed children (one snack and dinner): 98%
    • Agree with wife to stay at the maternity waiting home seven days post partum: 75%
    • Find someone to take care of the house while he goes with wife to HU: 80%
  • 15. Key behaviors, cont…
    • Go with wife to ANC, ask questions during care: 66%
    • Go with wife to HC stay in the delivery room during labor and delivery: 50%
  • 16. Conclusions:
    • Behaviors practiced during the probing phase are feasible and men were willing to try them
    • Include in the BCC strategy the health staff to change behaviors
    • Of the ten selected behaviors only 8 were practiced, but not due to men willingness but related to the program
      • Learning curve of field staff
      • A behavior related to seeking care during L&D (date of the birth was miscalculated)
      • Some behaviors couldn’t be evaluated because the man was not at home during the visit
  • 17. Thank you!