Transcript Advancements in gender statistics and health: experiences from the Western Pacific Region Anjana Bhushan, Technical Officer (Health in Development) WHO/WPRO 3rd Global Forum on Gender.

Advancements in gender
statistics and health: experiences
from the Western Pacific Region
Anjana Bhushan, Technical Officer (Health in Development)
WHO/WPRO
3rd Global Forum on Gender Statistics
Manila, 11-13 October 2010
ESA/STAT/AC.219/34
Keys to accelerating the development
and better use of gender statistics
• Strengthening vital events monitoring with causes of death, through
existing civil registration systems, demographic surveillance sites, or
hospital statistics
• Harmonizing health surveys through a country-led national plan with
increased focus on gender, equity, and social determinants for health
• Improving the timeliness, completeness and quality of facility- and
survey-generated disaggregated data
• Developing a multi-sector culture of disaggregated data collection for
deriving gender statistics and use aligned with national M&E and HIS
frameworks
• Ensuring skills and capacity available for presentation, interpretation,
dissemination, and use of gender statistics with different target
audiences
Example 1: Proposed maternal and U5
death surveillance system, Lao PDR
Background
• Based on Cambodia experience
• 2005 Lao PDR census: about 2 maternal deaths; 36 under-five child
deaths, including 26 infant deaths (71% of U5MR), every day
• Vital registration not functioning
• Routine reporting/surveillance system unreliable
• Provincial/district hospitals report deaths, but only about 13% births in
health facilities (2005)
• Mobile phone network used by 60% of rural families
Objectives (May 2010-March 2011)
• Provide timely information on maternal and child deaths, followed by
death review
• Monitor MNCH trends and strengthen achievement of MDGs 4, 5
• Inform MNCH programme planning, policy development and
interventions' targeting
Proposed approaches
(1)
Case reports
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By villagers, village health volunteers, health workers, witnesses
Report all maternal and child (under-5) deaths anywhere
Set up toll-free landline at central level for case reporting
Encourage reporting through:
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government circular to all districts, health centers and village committees
mass media campaign
incentives to reporters
(2) Case records
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Call related health center to verify report, collect more information and
enter into computer Epi-Info program
Health centers to keep copy of death confirmation sheet for regular
reporting and death audit
(3) Information utilization
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Update summary of records weekly on national map, by written report, on
MOH website
Set up maternal and child death information room in Ministry of Health
Analyze data and report monthly to MOH, provinces, districts
Conduct maternal and neonatal death review and report annually
Incorporate the surveillance system into HMIS
MOH Info Room
MCHC Team
Regular reports
MOH – HMIS website
Example 2: Understanding
gender-based violence in
the Pacific
Background
WHO Multi-country Study on Women's Health and Domestic Violence
Against Women 2005
– gathered comparable data from over 24 000 women interviewed in 15
sites in 10 countries (including Japan, New Zealand, Samoa [Polynesia])
– found that VAW is widespread, with far-reaching health consequences,
and demands a public health response
– called on governments to take concerted action, recommended actions for
health, education, criminal justice sectors
Objectives
– estimate the prevalence of violence against women, with particular
emphasis on physical, sexual and emotional violence by male intimate
partners;
– assess the extent to which intimate partner violence is associated with a
range of health outcomes;
– identify factors that may either protect or put women at risk of partner
violence
– document and compare the strategies and services that women use to
deal with violence by an intimate partner
Using the methodology in the Pacific
Socio-Cultural Research on Gender-Based Violence and Child
Abuse in Melanesia (Kiribati, 2008) and Micronesia (Solomon
Islands, 2008-09) project (funded by UNFPA, AusAID;
implemented by SPC)
Kiribati: National representative study on intimate partner
violence (Kiribati Family Health and Support Study), 2008
• Findings:
– 68% of ever-partnered women reported experiencing at least one act of physical
or sexual violence, or both, by an intimate partner; 73% of all women aged 15-49
have experienced some form of physical or sexual violence, either by a partner or
a non-partner
– VAW has a devastating impact on women, their families and communities
– Unequal power relations between men and women are the root cause
• Legal framework: no specific domestic violence/VAW and VAW not
•
addressed appropriately in existing laws
Services: Social Welfare Unit: day-to-day services, counseling; limited
capacity; few NGOs active; limited reach and capacity; Catholic Women’s
Crisis Centre: shelter and care; underutilized due to social and cultural
barriers faced by victims
Using the methodology in the Pacific
Kiribati
• Government response:
– Family Affairs and Sexual Offences Unit established in 2004 to
manage cases of domestic violence, rape, abuse and other
sexual offences
– Study endorsed by government, launched by President
– National Action Plan for elimination of VAW developed, policy
being drafted
Partners’ response:
• Support to multi-sectoral VAW action :
• AusAID/WHO Gender Health and Development Programme, 2010-11
(Solomon Islands)
• Planned Multi-year UN Joint Programme to EVAW, 2011 (Kiribati)
• Pacific UNiTE Campaign to End Violence Against Women
• Additional studies using WHO methodology: Vanuatu (nearing
completion); Fiji: (commencing)
Example 3: Gender in the national TB
programme review, Viet Nam
Findings:
• M/F ratio in TB cases
increased from 1.6 to
2.1
• Why?
– Partly: biological/
epidemiological
factors
– Partly: genderrelated barriers to
access
4000
3500
Trends in SM+
Viet Nam: 1990-1999)
3000
2500
2000
1500
1000
500
0
1990 1992 1994 1996 1998
Male
Female
Viet Nam NTP findings
• Women have longer delay before diagnosis,
because:
– they may consult less-qualified health care providers or
self-medicate
– they may face barriers to access: distance and mobility
– they are less likely to present with ‘typical’ symptoms
• Women may produce sputum of poorer
quality and quantity, decreasing their chances
of diagnosis
Example 4: Other promising
developments in Viet Nam
• General Statistics Office and line ministries, with UNDP’s
support, are developing a M&E framework for the
implementation of:
– the Law on Gender Equality
– the Law on Domestic Violence Control
• General Statistics Office, with WHO’s support, is finalizing
the first national study on violence against women
• National Strategy on Gender Equality (2011-2020) and
National Targeted Programme for Gender Equality (201115) are under development
• Joint Annual Health Review includes key indicators to
assess health sector, including some on gender and
health issues (e.g., sex ratio at birth, gender-based
violence)
Example 5: Women’s health in the
Western Pacific Region
•
Women's Health: Western Pacific Region, 2001.
– Contains country profiles
– Reviews progress and lessons learned in implementing Beijing
Declaration and Platform for Action (1995)
– Identifies constraints, priority areas, and areas of collaboration among
partners
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Women and Health: Today’s Evidence, Tomorrow’s Agenda,
2009.
– provides evidence on women's health needs and challenges over the lifecourse
– includes latest figures on health and leading causes of death in women.
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Agenda item on “Women’s health”, Western Pacific Regional
Committee Meeting, Oct 2010. Key messages:
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Women face distinct health needs through the lifecycle
There are multiple determinants of women’s health
Health systems are failing women
The unfinished agenda can—and should—be addressed, through
multisectoral action, health systems strengthening, and partnerships
Women and Health in the Western Pacific Region, planned 2011:
new regional report on women and health
Priorities for improving national HIS in
the Western Pacific Region
• Advancing
countries along
HIS continuum
• Improving data
collection,
analysis,
quality, and use
• Providing better
training, tools, and
techniques
• Improving
interoperability of
databases and
systems
Thank you