Walking the Walk: Integrating Gender Key to Linking Communities to Health Systems

Walking the Walk: Integrating Gender Key to Linking Communities to Health Systems

InterAction Forum 2011 Panelists (left to right): Willow Gerber, MSH; Belkis Giorgis, MSH; Diana Prieto, USAID, Mary Ellsberg, ICRW; Reshma Trasi, ICRW. Photo credit: MSH.

Gender, gender, gender.

Everyone is talking about it, but are they really addressing it?

The International Center for Research on Women (ICRW) and Management Sciences for Health (MSH) collaborated to bring experts to the InterAction Forum 2011 to discuss gender integration in health programs.

While much is known about how gender-based constraints adversely affect health, social, and economic development, successful models that integrate gender into programs have not been widely documented or evaluated.

The goal of the panel was to not just highlight the importance of gender but to discuss real incorporation of gender into programming. The panelists presented an overview of the US government’s commitment to integrating gender into health systems as well as examples of successful models of integrating gender into national and community health system responses.

In recognition of gender inequality as a driver of poor health outcomes, technical agencies and donors are issuing guidelines for integrating gender into programs and proposals. Diana Prieto, Senior Gender Advisor for the US Agency for International Development (USAID) and member of the Intergovernmental Gender Taskforce, shared the importance of gender for US government programs.

One of the Global Health Initiative's (GHI)core principles focuses on women, girls, and gender equality. Prieto explained that the women, girls and gender equality approach is a model that will empower adolescent girls, engage men and boys, use multiple community-based program approaches, and, most importantly, build the capacity of individual and institutions -- with an emphasis on women -- throughout the health system. The U.S. government and other donor organizations are expected to align their health and gender related policies to this established principle.

Integrating gender

But how are these guidelines and strategies implemented in the field? Does integrating gender in health systems transform programs and save lives in developing countries?

Panelists Belkis Giorgis of MSH and Reshma Trasi and Mary Ellsberg of ICRW shared successful ways gender can be addressed within three different areas and help to save the lives of women and their families.

“Start with the woman and her community,” Giorgis recommended. A family-focused approach leads to more comprehensive and integrated care by minimizing time away from the family, she said. In an MSH project in Ethiopia, the community and family-focused model recruited case managers (50 percent female) and Kebele-oriented (defined neighborhoods) outreach workers. This model of community mobilizing also allows women to interact in their own space and reduces the likelihood of stigmatization.

Ellsberg presented a range of models that allow for the health system to adequately respond to the needs of gender-based violence survivors. “Health service centers act as a window of opportunity to identify survivors of gender-based violence through routine inquiry,” Ellsberg said. She also called for integrated approaches to addressing gender-based violence that link health services to other institutions that provide legal services and counseling.

Trasi shared results from work in Cambodia to get gender included at the policy level. “Gender programming and integration can be complex because of deeply ingrained norms,” Trasi said. Policymakers may be resistant to integrating gender in their policies and programs due to lack of funds or evidence or the sense that gender is a women’s issue. Carefully negotiate gender integration into national HIV/AIDS responses using local evidence to make coherent arguments for gender equality while promoting country ownership, said Trasi.

The question and answer period, coordinated by panel moderator Willow Gerber from MSH, yielded more discussion on what is next for gender integration in health systems, including education of policymakers, implementers and service recipients.

More discussion and action is needed on results measurement and the inherent challenges of funding and integrating issues of equality and marginalization into a scaled, national response.

We need to document, evaluate, and scale up gender mainstreaming models and successes.

Crystal Lander is Director of Policy and Advocacy at Management Sciences for Health. 

Add new comment

Printer Friendly VersionPDF