Transcript Gender, health and the MDGs Joanna Vogel Women in Health and Development EMRO-WHO World Health Organization.

Gender, health and the MDGs
Joanna Vogel
Women in Health and Development
EMRO-WHO
World Health Organization
Outline
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Gender and health
Gender analysis in health
WHO and gender analysis
Data used to inform gender analysis
WHO work in gender indicators
Proposed WHO gender indicators
Challenges of gender sensitive data collection
Recommendations
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Gender and health
• Gender in health looks at how social differences among
males and females impact health outcomes and tries to
ensure that differential needs of males and females are
reflected in health systems.
• Gender analysis in health identifies, analyses and
informs action to address inequalities that arise from the
different roles of women and men, or the unequal power
relationships between them, and the consequences of
these inequalities on their lives, their health and wellbeing.
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Gender analysis in health
• Reveals the different health needs of males & females;
• Highlights impacts on health outcomes of inequitable
gender norms;
• Facilitates gender responsive policies and programmes;
• Improves the quality of health interventions;
• Promotes enhanced health information, documentation
and use;
• Advocates for empowerment, decision-making, informed
choice, health rights and improvement of health for both
men and women
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WHO and gender analysis
• Advocate the use gender analysis by programme
managers in the Ministries of Health by provision of the
WHO gender mainstreaming for health managers
training
– Yemen, Sudan, Iraq (UAE, Oman by end 2007)
• Training comprised of 3 modules which lead participants
through the completion of a gender analysis of selected
health issues as well as the integration of outcomes from
the gender analysis into health programmes and
policies.
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Lenses of gender analysis
Health
Issue/Problem
How biological
differences
between sexes
influence:
How gender norms/values affect
men and women's (boys' and
girls'):
Health risks and
vulnerability
Utilization of
health services
Health seeking
behaviour
Compliance with
medical advice:
prevention,
treatment and
rehabilitation
Burden of health
problem
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How do access to, and
control over resources
affect men and
women's:
Data used to inform gender analysis
• Sex disaggregated data;
– Often data is collected by sex at community level but then
aggregated at national levels
• Secondary and published sources;
• Rapid appraisals using both quantitative and qualitative
methodologies such as: gathering health service-based
data, or interviewing major stakeholders;
• Participatory data gathering and analysis exercises in
relevant sites;
• NGO reports
• Data from regions / countries with similar demographic,
cultural, political and economic contexts
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WHO work in gender indicators
• Report on comparative evaluation of indicators for
gender equity and health by the World Health
Organization Centre for Health Development in Kobe,
Japan
• Department of Gender Women and Health isolation of 3
additional and alternate indicators on health and gender
in MDG 3
– Selection criteria included:
• Available data sources
• Indicate multiple impacts on health outcomes
• Reflect multiple gender issues
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Proposed indicator 1: Measure of burden
of violence against women
• Definition: Proportion of women who have ever had a
partner, 15-49 years old, who have ever experienced
physical violence by an intimate partner (Sources: DHS,
special surveys)
– Derived from WHO Multi Country Study on Women’s Health and
Domestic Violence
– ‘Intimate partner’ is variable depending on cultural context
– VAW questions offered as option in DHS but not all countries
incorporate it
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Proposed indicator 2: Early marriage
• Definition: Proportion of 20-24 year olds married before
the age of 18, by sex. (Sources: DHS, national surveys)
– Early marriage leads to early childbearing which impacts child
and maternal mortality and morbidity
– Associated with wide age gaps between partners and low status
of the wife
– Low status impacts decision making power, mobility, and right to
secure reproductive and sexual rights
– Early marriage can reduce girl's access to education and gainful
employment
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Proposed indicator 3: Son preference
• Definition: Ratio of female to male live births. (Sources:
Census data, DHS)
– Can potentially account for occurrences of female infanticide and
sex selection practices which indicate gender inequality
– Mandated within WHO data collection
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Challenges of gender sensitive data
collection
• Ministries have multiple reporting requirements to
different agencies and are stretched to human and
financial resource capacity
• MDGs not well understood. Gender even less
understood.
• Requires collection of both quantitative and qualitative
data.
• Qualitative indicators take more time, are resource
heavy, and not perceived as credible as quantitative
indicators because of generalization limitations
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Challenges of gender sensitive data
collection
• Limited capacities of developing countries where vital
records are available for 50% or less of the population
• Conflicting data between international agencies and
country official data
• Lack of statistics on emerging gender issues
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Time use
Poverty
Violence against women
Informal employment
• How to maximize existing data?
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Challenges of gender sensitive data
collection
• Requirements of retraining field data collectors
• Sex disaggregation is only the first step
• Debate on including new indicators in routine data
collection versus collecting separate research data
• Concentration of sex-disaggregated data or gender
sensitive indicators?
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Recommendations
• Include national statistics offices in any data collection
activities (central statistics institutes and health statistical
offices)
• Advocate use of gender module in DHS in countries of
the Region
• Limit addition of gender sensitive indicators to routine
data collection to 1-3 or will exceed national capacities
• Engage academic institutes as key partners in data
collection activities as they often have more national
space to address sensitive issues
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Recommendations
• Use a combination of systems to retrieve sensitive data
(i.e.-civil society to measure abortion practices in
countries where it is illegal)
• Promote inclusion of other social determinants (ethnicity
geographical locations, income) in gender sensitive data
initiatives
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