Women, men, boys, and girls should have equal opportunities to be healthy and to reach their full potential. Yet differing health-related needs and different social, economic, and cultural barriers to accessing care thwart the ability of certain groups to access and benefit from health care services. Gender is a social determinant of health across all countries and cultures. Gender gaps and issues affect access to, utilization of, and quality of care for women, men, boys, and girls. To truly improve the quality of all care for all, these gender gaps and issues must be explicitly recognized and addressed by providers, facilities, and health systems, and this is especially true in quality improvement activities. In this video, watch Dr. Taroub Harb Faramand of WI-HER, LLC explain how addressing gender considerations in improvement work leads to better outcomes.

Community Quality Improvement Team in Buikwe, Uganda

We take an improvement approach to integrate gender through the USAID Applying Science to Strengthen and Improve Systems (ASSIST) project. By collecting and analyzing sex-disaggregated data and systematically identifying and analyzing gaps in outcomes among women, men, boys and girls, we evaluate what is causing poorer outcomes among one group, and design activities to respond to the needs of males or females to close the gap. We do this in improvement activities across health areas and beyond, including non-communicable diseases (NCDs) programming, HIV and ART services, OVC services, and more. We promote partner involvement in programs targeting either males or females, such as engaging male partners and fathers in ANC visits and PMTCT programs to improve outcomes for mothers and babies, and engaging female partners of males who undergo the VMMC procedure to improve follow-up and decrease adverse events. 

Our innovative and effective six-step approach to identify and close gender-related gaps improves health outcomes for all, and we utilize locally-owned, culturally-sensitive, and innovative models. We recognize that myriad factors at multiple levels of society affect gender norms that influence risk factors, access to care, utilization of care, and equality of treatment and we work to respond to these norms in concert to generate shifts in thinking and behavior. We address gender gaps and issues at the individual, household, and community levels, when necessary, though staff and community sensitization trainings, and we consider the varied contextual factors that drive outcomes for women, men, boys, and girls in the design, implementation, and evaluation of our programs.

To learn more about gender and how to integrate gender in improvement work, download A Guide to Integrating Gender in Improvement.

International Day of the Girl Child: Addressing challenges limiting girls' access to education in Bagamoyo District, Tanzania

Delphina Ntangeki

Improvement Advisor, KM and Communications, Tanzania, USAID ASSIST Project/URC

As a girl, Mariam [not her real name] believed that education was her only hope if she wanted to live a better life. The fact that her father abandoned her and her mother added to her resolve to study hard. She put more efforts into her studies and made sure she was always among the best four students in her class. Unfortunately, her plans did not come out the way she expected. Mariam did not pass her final secondary school exams in 2012; all the effort she put into her studies ended with the exam results.

Addressing the needs of vulnerable girls in Malawi to improve educational outcomes

Tiwonge Tracy Moyo

Chief of Party, Malawi, USAID ASSIST Project/URC

In Malawi, we are currently working in five communities in two districts of Balaka and Mangochi to improve the educational performance of vulnerable girls and boys in primary schools. The Child Status Index (CSI) assessment we conducted last December in five communities found that the majority of the vulnerable girls and boys were performing poorly in continuous academic assessments.

International Day of the Girl Child: Using improvement to respond to the needs of vulnerable girls

Elizabeth Romanoff Silva


October 11th marks the International Day of the Girl Child, an internationally recognized day designated by the United Nations to promote the rights of girls and to bring awareness to the unique challenges they face around the world. Globally, girls encounter many constraints that limit their ability to access education, to live a life free from violence, to delay marriage and pregnancy until adulthood, and to be involved in making important decisions that affect their lives.

Male partners play a critical role in improving retention of the mother-baby pairs in care in Ivukula, Uganda

Joyce Draru

Quality Improvement Officer, Uganda, USAID ASSIST Project/URC

Retaining HIV positive mothers and their babies in care is a key component of the Partnership for HIV – Free survival initiative. Retention contributes to the success in reduction in the number of new HIV infections among HIV exposed babies as well as keeping their mothers alive. Supporting PHFS facilities in Uganda, sites have introduced changes such as offering eMTCT services to the mother-baby pairs at one service point and keeping the pair’s care cards together.

Improving access to and utilization of postpartum family planning: Why gender matters

Megan Ivankovich

Senior Program Officer, WI-HER, LLC
Dr. Faramand, WI-HER Founder and President, examines a newborn at a rural health center in Tanzania

Last month, I had the privilege to travel to a rural health center in Tanzania to observe the great work of the USAID ASSIST Project. While waiting for members of the clinic’s quality improvement team to attend to patients before starting the gender integration training, we had time to explore the clinic and talk with patients.

The value of virtual forums: Promoting Kangaroo Mother Care in Latin America

Ivonne Gómez Pasquier

Chief of Party, Nicaragua, USAID ASSIST/URC

In June, the USAID ASSIST-supported Salud Materno Infantil (Maternal and Infant Health) Kangaroo Mother Care (KMC) Community of Practice hosted its second virtual discussion forum in Spanish on "Experiences in startup and early consolidation of Kangaroo Mother Care (KMC) activities in hospitals in Latin America: favorable aspects, constraints and lessons learned.” As a pediatrician and director of the USAID ASSIST Project in Nicaragua, I was honored to moderate the forum.

MCHIP Project close-out event: Lessons learned and the way forward

Elizabeth Romanoff Silva


Last Thursday, June 26th marked the end of USAID’s flagship Maternal and Child Health Integrated Program (MCHIP) with the conference, “Critical Concepts for Ending Preventable Child and Maternal Deaths.” The event in Washington DC highlighted program learning and recommendations on scale up, quality, and community from the six-year USAID project. The event was attended by more than 400 development practitioners from many countries, including 23 health ministers from USAID-supported countries. Highlights from the conference included an overview of MCHIP’s achievements and lasting impact by Project Director Koki Agarwal and a panel discussion between five African Health Ministers about acting on preventable child and maternal deaths.

The art of gender integration in non-communicable disease improvement activities

Taroub Faramand

Founder and President, WI-HER, LLC
The USAID HCI and ASSIST quality improvement teams at the 8th Learning Session held in Kutaisi, Georgia in February, 2014

The USAID HCI and ASSIST quality improvement teams at the 8th Learning Session held in Kutaisi, Georgia in February, 2014

Globally, there are disparities in the prevalence and treatment of non-communicable diseases (NCDs) among men and women, and there is still a shortage of rigorously analyzed sex-disaggregated data related to NCDs, which makes it difficult to accurately determine the influence of gender-related factors on NCD morbidity and mortality and to establish the extent to which disparities in treatment exist.

A recent two-part series by CBS’s 60 Minutes, titled Sex Matters exposed the lack of sex-disaggregated medical data as a critical issue affecting heart disease diagnosis and other NCDs. This makes the work our USAID ASSIST team is doing to integrate gender into NCD services in the Republic of Georgia all the more innovative and meaningful. This past February I had the opportunity to travel to Georgia to work with Dr. Tamar Chitashvilli, ASSIST Chief of Party in Georgia, and her team, to provide technical assistance to integrate gender into the ASSIST-supported NCD program. I participated in a learning session, led a session to train participants on gender integration in NCD improvement activities, and developed recommendations for gender integration moving forward.

Reflections from the Gender 360 Summit: The importance of gender and its critical impact on global health and development

Kathryn Krueger


Highlighting the importance of gender and its critical impact on global development, USAID ASSIST partner FHI 360 hosted the 2014 Gender 360 Summit on June 16th in Washington, DC. This exciting summit brought together close to 300 gender experts, donors from bilateral and corporate companies and foundations, national and international policymakers, research institutions and development organizations around the world. The panel presentations and the collaborative brainstorming and discussion sessions stimulated substantial conversation and interest around the work being done to programmatically integrate and mainstream gender within all sectors. The 2014 Gender Summit highlighted trends, challenges and progress facing gender integration within the development field, while truly showcasing the growing interest and understanding of gender through social and economic lenses.

Taking strides in SMC: A health worker’s experience in female partner involvement

Jude Thaddeus Ssensamba

Quality Improvement Officer, Uganda, USAID ASSIST Project/URC

The USAID ASSIST team in Uganda has developed an innovative approach which has been shown to improve outcomes and decrease adverse events for males undergoing voluntary medical male circumcision (VMMC), known as safe male circumcision (SMC) in Uganda: engaging female partners to attend educational sessions and clinic visits with male partners who undergo the procedure to improve health outcomes. I was really encouraged by the experience of a Busolwe hospital SMC team member during the second learning session held in Jinja.