Gender

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.

Sex and gender: how data disaggregation is central to improvement

Elizabeth Romanoff Silva

USAID ASSIST Project/WI-HER

What is the best way to integrate gender effectively into an improvement program? Taking gender considerations into account in the program design, monitoring and evaluation aspects of a program is critical to integrating gender.

A Gender Lens across the Health Sector; Reflections from the CORE Group Spring Meeting

Elizabeth Romanoff Silva

USAID ASSIST Project/WI-HER
Dr. Taroub Harb Faramand, President of WI-HER, LLC, presents at the CORE Group Spring 2014 Conference

Last week marked the semi-annual CORE Group Spring 2014 Global Health Practitioner Conference, hosted in Silver Spring May 6-9, 2014. My biggest take-away from the CORE Group meeting is that there is an obvious interest in gender integration across programs, and practitioners must have a gender lens to everything they do in the health sector. Our USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project’s gender team had the opportunity to present in three sessions specifically about our gender work through ASSIST at the CORE Group Spring Meeting.

Is female participation in voluntary medical male circumcision of any value? Experiences from Uganda

John Byabagambi

Improvement Advisor, USAID ASSIST Project/URC

Uganda adopted voluntary medical male circumcision (VMMC) as part of its comprehensive HIV prevention strategy in 2009. From its inception, the service was designed to target males and most of the efforts were focused on ensuring that as many males as possible were circumcised. In December 2012, a PEPFAR interagency team conducted an external quality assessment for the Uganda program and found several quality gaps. One of the major gaps was the lack of a system for continuous quality improvement.

The Potential of m/eHealth to Improve Systems, Care, and Gender Relations

Elizabeth Romanoff Silva

USAID ASSIST Project/WI-HER

“Every system is perfectly designed to achieve exactly the results it achieves.” USAID Applying Science to Strengthen and Improve Systems (ASSIST) Deputy Director Kathleen Hill shared this quote from Deming with an audience of more than 40 leading experts in technology, health care, and international development that gathered on January 31st in Washington, D.C. for an m/eHealth Health System Strengthening technical working group meeting.

International Women’s Day: What I Celebrate

Taroub Faramand

Founder and President, WI-HER, LLC

March 8th marks International Women’s Day, and it offers an excellent opportunity to reflect on contributions and progress made to improve the lives of women and girls in the past year, identify where inequalities still prevent women and girls from realizing their full potential, and advocate for further changes to increase equal opportunities for women and girls.

Bringing Women on Board in Safe Male Circumcision in Uganda

Jude Thaddeus Ssensamba

Quality Improvement Officer, Uganda, USAID ASSIST Project/URC

As part of our discussion with facility health workers during a technical support visit to eastern Uganda Nankoma Health Centre IV, Bugiri District, I asked for some experiences on cases where women have not been involved in Safe Male Circumcision. One of the health workers in the group had this experience to share:

Viewing Healthcare Locally Through a “Gender Lens”

Caitlyn Lutfy

WI-HER LLC
URC Uganda staff in the gender integration training

URC Uganda staff in the gender integration training, Taroub Faramand April 2013

“You’re breaking a ‘gender rule’ right now by eating chicken,” said one of the male participants during the lunch break at our Gender Integration training in the URC Uganda office. In a murmur of laughter and banter, the Ugandan staff members explained that for some, it is taboo for a Ugandan woman to eat chicken. For the most part, Ugandans no longer practice the rule, though some say older relatives and a few tribes still observe the gender-related chicken restriction.

The roles, expectations, behaviors and interactions between men, women, boys and girls are intimately tied to local people and change with time. “Gender” is a social construct shaped by these customs and perceptions. In the previously mentioned example, the male-exclusive entitlement to eat chicken as a sign of reverence interacts with other customs to shape sex disparities of power and capabilities in the society. If  the women at our training abided by this restriction, our catering would have been gender-blind and, in effect, we would have only been serving lunch to men. Women, men, boys and girls also differ in their healthcare needs and the ways they access, utilize and benefit from care.

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