Gender Strategies Will Help Achieve Health Impact in South Sudan

The Sudan Health Transformation Project (SHTP II), led by MSH and funded by USAID, partners with the government of South Sudan to transition health service delivery from emergency response to a more sustainable health system. Several months after the project began, its implementing partners realized that gender issues were affecting its progress in expanding access to health services and reducing maternal morbidity. To remedy the problem, they gathered data on gender from project reports and discussed strategies for addressing gender inequity in the project area.

The project reports revealed that its implementing partners were finding it difficult to achieve gender parity in hiring for new positions (few women are qualified compared to men) and in training community leaders (most existing leaders are men). Although the partners make efforts to recruit women, they recognize that few women apply for the positions because of cultural norms and gender roles that limit their education.

The partners also recognize that women have little say in certain behaviors that affect their health and well-being, including use of family planning methods, exposure to HIV, and access to health facilities. Early marriage, polygamy, and other cultural norms such as limited inheritance rights, inability to own land or cattle, and overall lack of economic independence further compound women’s lack of agency.

Although the SHTP II partners recognize these gender issues, they were not taking steps to adapt their implementation accordingly. For example, their efforts to increase HIV & AIDS awareness overwhelmingly targeted women despite women’s limited power in negotiating sexual relationships. And they primarily conducted family planning counseling during ante- and post-natal care for women, despite the fact that most women do not use family planning because their husbands do not condone it.

In an effort to address these gender issues, the SHTP II partners met to develop strategies to reach men with health education, including training male peer-educators, holding small group health education sessions for men, and undertaking wider community education. The project’s reports showed that a few partners who had reached out to both men and women through community awareness programs were having more success than partners who only targeted women.

The SHTP II project now encourages its implementing partners to treat gender as a local stakeholder and anticipates achieving greater health impact as a result.