The document discusses sex and gender. It defines sex as the biological differences between males and females determined at birth, such as reproductive organs and ability to bear children, which do not change. Gender is defined as the social and cultural roles, behaviors, and attributes placed on males and females in a society, which can change over time and vary between cultures. The document provides examples of sex characteristics like menstruation and voice changes during puberty. Gender roles and expectations like career choices, household duties, and parenting roles are influenced by societal and cultural norms. The document outlines how gender influences health across the lifecycle from birth through adulthood and old age due to both biological and social factors.

1. Gender and
Health

2. Understanding Sex and Gender
Sex refers to the universal biological
differences between women and men
---eg only women can bear children

3. What is sex?
Sex is determined by -- the chromosomes
(determined before
birth)
 That a person is born
male or female is
pure chance

4. What is sex?
Sex is differentiated by -- the reproductive system----external genitalia
 internal reproductive organs
 secondary sex
characteristics
of men/women
 SEX does not change

5. What is gender?

Gender refers to the economic, social, and
cultural attributes and opportunities
associated with being male or female in a
particular social setting at a particular point of
time

6. 
Gender refers to roles that men and women
play and the relations that arise out of these
roles

7. 
A person is not born with gender characteristics but
develops as she/he grows up (influenced by social
factors, environment, culture, customs –different in
different settings)

8. 
Dress and appearance

play and games

Study and career

Work and occupation
promote difference between boys and girls.

9. Gender


Refers to the way of thinking and behaving of men and women
that is learned through socialization
Socially constructed, not physically determined

10. About gender




Gender roles are not constant
It changes over time
Have wide variations within and between
cultures
eg: in Canada it has become more common
to see women bus drivers and male nurse
than before

11. Characteristics of Gender
Relational
-Socially constructed
Hierarchical
-Power relations
Change
-Changes over time
Context
-Varies with ethnicity,
class, culture, etc
Institutional
-Systemic

12. Differences between Sex & Gender
Sex
The biological differences with which
men and women are born
 Fixed and unchanging over time



Do not vary between different
cultures
Are not influenced by economic
and social factors
Are the same for women as well as
for men
Gender
The socially defined roles and
responsibilities assigned to men
and women
 Changes over time



Differ from one culture to another
Are influenced by many factors—
education, income level, age,
social class, religion & others
Are different amongst women
depending on age, ethnic group,
income, culture, tradition & other
factors as well as amongst men

13. Exercise on Sex and Gender
Sort and put into boxes of Sex/Gender
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Only women can conceive and give birth
Most men are taller than women
Women are more loving and caring
Men are the best chefs
The most important role of a woman is to become a mother
Women suffer from pre-menstrual tension, men do not
Men think and act more rationally than women
Only men can supply sperm for fertilization
The most important role of the man is to be a bread-winner
Men cannot breast feed babies
Women are poor managers
Men’s voices break at puberty, women’s don’t

14. Correct grouping of statements
Sex
Gender
Only
women can conceive and give
• Women are more loving and caring
Most
men are taller than women
birth
Only
men can supply the sperm for
fertilization
Men
cannot breast feed babies
Men’s
voices break at puberty,
women’s don’t
Women
suffer from pre-menstrual
tension, men do not
• Men are the best chefs
• The most important role of the woman
is to be a mother
• Men think and act more rationally
than woman
• The most important role of the man
is to be a bread-winner
• Women are poor managers

15. Impact of Gender
on Health
In what way does gender
influence health?

16. Men & women face some specific health
problems due to biological differences
Women face health problems not only due to
biological disadvantages but also due to social
inequalities
The influence of gender is manifested at every
phase of the life cycle of women & men, it has
particular impact on the health of women

17. At pregnancy (Conception and Birth)
Prenatal sex
detection tests are
carried out.
- These tests reveal
the foetus to be a
girl, some families
resort to abortion
due to the
predominant son
preference.

18. At birth
Birth of a baby boy
• The family rejoices at the birth
of a boy
• The male child is favored
because boys are perceived as
capable of earning and adding
to family wealth, carrying on the
family name and supporting
parents in old age etc.
• Some continue bearing
children repeatedly till a son is
born great strain to the health of
women
Birth of a baby girl
• The birth of girls is not
celebrated as the birth of boys.

19. At Childhood
•There are marked differences in
the child rearing practices for boys
and girls.
• School enrolment and retention
are lower in the case of girls.
• The nutritional intake of girls is
lower than that of boys.
• Girls start participation in work at
a younger age. Physical abuse &
child neglect prevail more
commonly for girls
•Aggressive & risk taking behaviour
is tolerated and encouraged in
boys, leading to more injuries and
accidents

20. - Nutritional deficiency diseases like IDA
are common among adolescent girl.
- Movement and social interaction of girls is
curtailed with the onset of menarche
- Education is discontinued and access to
information is reduced. Adolescent girls
share a great deal of domestic work
- Early marriage of girls makes them
vulnerable to malnutrition and incomplete
physical and mental development.
- Early marriage places heavy
responsibility and burden on girls beyond
their age and maturity.
- Teenage pregnancy places girls at high
risk of morbidity and mortality.
- Prone to violence eg rape, STI, HIV/AIDS
- Prone to trafficking (for sex, for labour)
Adolescent Girls

21. Adolescent Boys
- Alcohol, drug abuse and
tobacco use are more common
in boys.
- Accidents, homocide and
violence associated with stereo
typed masculine attitudes are
common in boys.
-Exploration into sexual
behavior before marriage is
more common among boys
placing them at risk of STDs
and HIV/AIDS placing their
partners after marriage also at
risk

22. Women suffer a greater burden related to
reproductive health system & gender
inequalities.
- Double burden of productive and
reproductive life.
-Prone to Anemia, obstetrical &
gynaecological diseases and lack of
access to MCH care
-Prone to domestic violence (physical and
mental)
- Depression is also frequent.
-Prostitution and exposure to STDs and
HIV/AIDS is more likely in women.
-Breast cancer, ovarian cancer and cervical
cancer are specific.
- Women have very little choice and
control over family planning methods.
Adult Female

23. Adult male
- Domestic violence, accidents and
injury are more common in women.
- Violence in the street and
occupational injuries are more
common among men.
- Men are more exposed to
smoking , alcohol and suffer
specific conditions like lung cancer,
heart diseases and liver diseases.
- Men engaged in practices that
are harmful to them and their
families

24. Adequate attention is not being
paid to problems of the aged-both
of men and women.
- Women in general live longer
than men. But this does not mean
that they lead healthier lives
because of economic dependence
and low social status.
- Osteoporosis is eight times more
common in women than men.
Elderly

25. Old suffer due to biological and social decline
Male
Female
Biological
- Cancer of prostate
- Diseases of male genital
tract
- Hernia
Biological
- Osteoporosis is 8 times than in
male
- UVP , Ca Cervix, Ca
endometrium
Social
- neglect, depression
Social
- Depression is 2 or 3 times than
in men
- neglect, abuse mentally

26. Gender Equity and Gender Equality

27. Gender Equity and Equality
Socio-cultural, economic and political context
Structure
(Resources)
Process
(Activities)
Outcome
(Product)

28. Gender equality
… absence of discrimination on the basis of a person’s sex.
… equal rights in social, economic, civil, and political life.
The concept of gender equality deals with equality of
opportunity and the allocation of resources or benefits or in
access to services :
eg:
• females as well as males should be able to go to school at
school going age;
• females and males enjoy adequate health care and shelter;
• and females and males be able to access economic
resources.

29. Gender equity
… the quality of being fair, just and right to men and women.
… includes fairness and justice in the distribution between
women and men of responsibilities, access to resources,
control over resources and access to benefits.
The concept of gender equity deals with how men and
women are able to use these opportunities to achieve a fair
and just balance between them.
What constitutes a fair and just outcome once equality of
opportunity is achieved?
Guaranteeing fair outcomes depends on the balance of
power and the ability to transform the structures and
processes which buttress inequality.

30. Gender Equity ensures FAIR TREATMENT of both sexes

31. Gender Equity ensures EQUAL OPPORTUNITIES to boys and
girls

32. Framework to measure Women’s
Access to Quality, Gender Sensitive
Health Services

33. Framework to measure Women’s Access to Quality, Gender
Sensitive Health Services
Indicators to measure women’s human rights and gender, are integrated into
each component of this framework.
The five components are:
1. Comprehensiveness of information
2. Comprehensiveness of women’s health services
3. Respect of women’s human rights
4. Technical competence of providers
5. Infrastructure and facilities

34. 1. Comprehensiveness of Information
1. Adequacy of the content of information given to resolve or
prevent the health problem… eg: Gender and TB
Causes, S/S
Preventive measures
Risks of woman
getting infection
Delay in
getting
treatment
by women
Resolve

35. 1. Comprehensiveness of Information
2. Extent to which the information includes the recognition of the
promotion of the rights of clients to information and quality health care
eg: Gender and pregnancy
“This labour room can be used only if the toilet is
repaired. Let us repair this toilet for the women
in labour”
Eg: in HIV/AIDS
Counseling services
VCCT to pregnant woman

36. 1. Comprehensiveness of Information
3. Adequacy of information given recognizing and promoting
women’s self health care measures
Body mapping exercise
Eg: ARH

37. 1. Comprehensiveness of Information
4. Adequacy of pamphlet or written information content and promotion of
pamphlet.
Condom promotion for prevention of premarital sex and prevention of STDs/HIV and
AIDS
Mode of Transmission
of HIV/AIDS

38. 1. Comprehensiveness of Information
5. Extent to which women providers are available for medical
examination and childbirth.

39. 1. Comprehensiveness of Information
6. Extent of provision of information during relevant women’s
health services, on the following key gender and women’s
rights issues
− Violence against women
− Contraception
− Sexual relations
− Rights and negotiation in decision-making between
women and men towards gender-equality
7. Scheduling of service time and waiting time takes into
consideration women’s and men’s gender roles in the
household (eg: child care and cooking)

40. 1. Comprehensiveness of Information
7. Scheduling of service time and waiting time takes into
consideration women’s and men’s gender roles in the
household (eg: child care and cooking)
Daily Time-Use Analysis (Daily Activity Clocks)
Female
Male
12
12
9
3
6
9
3
6

41. 2. Comprehensiveness of Women’s Health
Services
1. Adequacy of integration and provision of related health services
in areas such as
•
STDs
•
RTIs
•
cancer screening
•
Sexuality
•
HIV/AIDS
•
VAW
•
Contraception
•
MCH & emergency obstetrics and
•
mental health in order to meet the women’s total health needs.

42. 2. Comprehensiveness of Women’s Health
Services
2. Extent to which providers’ ask women if they want their men’s
partners’ involvement in resolving their health needs and
problems and extent that providers follow up by encouraging the
men partners to take responsible action

43. 2. Comprehensiveness of Women’s Health
Services
3. Extent to which the service provided do not reinforce unequal
gender roles and gender stereotyped behaviour but promote
gender equality, eg: extent that men are allowed and encouraged
to participate childbirth process, decision on contraceptive
methods and STD screening and treatment
Eg: Ignoring labour pain
Eg: Perspective towards pain because of
gender stereotyped behaviour
Eg: Involvement of male in
STD and HIV/AIDS prevention

44. 3. Respect for Women’s Human Rights
(Interpersonal Relationship)
1. Adequacy of respect shown to women (eg: absence of scolding,
rudeness and mistreatment).
2. Adequacy of care shown to women including emotional support.
3. Confidentiality principles practiced.
4. Extent to which women are allowed and encouraged to ask
questions, express suggestions and give feedback and complaints
to service providers
5. Extent to which women participate equally in decision making with
partner and/or service provider when a choice has to be made such
as family planning contraceptive method, childbirth position,
Caesarean birth, and other routine and emergency medical
procedures.

45. 3. Respect for Women’s Human Rights
(Interpersonal Relationship)
6. Extent to which women’s health decisions or agreements are based
on informed consent (ie. Up to date and accurate information on the
method and procedure is given including advantages and
disadvantages, risks and benefits, costs, etc.
7. Adequacy of service provider’s language, both appropriateness of
level of complexity of expression, and the use of local languages and
medical terms.
8. Extent of acknowledgement and respect of women’s own knowledge,
practice and experience related to the health problem including the
links to culture and religion.
9. Extent to which husband’s notification and/or consent is not required
for specific reproductive procedures (eg: ligation, abortion and
caesarean births etc) procedures on this exist and women can decide
autonomously.

46. 4. Technical competence of providers
1. Adequacy of protocols and procedures regarding health and
treatment.
2. Adequacy of technical treatment, procedures and information.
3. Adequacy of medical records.
4. Extent mechanisms exist for eliciting regular feedback from women
on the quality of services and evaluating their satisfaction with
services
5. Extent of protocols to build in women’s feedback into providerwomen interaction and service provision.

47. 4. Technical competence of providers
6. Existence and use of client suggestion or complaint boxes.
7. Capacity for conducting periodic qualitative research studies on
quality of health care from women’s perspectives.
8. Extent evaluation procedures exist to assess the women’s overall
satisfaction with the services provided.
9. Extent of provider knowledge on
poverty;
women’s rights;
gender issues in health;
sexuality and reproduction;
and on community services for referral of women who have
been abused.

48. 5. Infrastructure and facilities
1. Adequacy of quantity and quality of:
 Health facilities
 Equipment
 Drugs
 Child care areas
 Security/safety features
 Privacy for consultation and treatment
 Allocation of toilets and hospital beds according to gender needs
2. Extent of gender bias of service availability or provision made for a
particular sex (eg; allocation of hospital beds by gender)

49. Thank You