2023•03•02

What You’ll Learn

• Previously, we identified over 50 examples as potential cases of gender integration in government health programs across three regions. Of these, fewer than 20 had substantial government involvement, were active for at least three years and went beyond addressing health needs of a particular gender group to address gender inequalities.
• Although the initial list of potential case studies spanned a broad range of health-related themes, as inclusion criteria were applied, the breadth of themes was reduced with most programmes clustered around certain health areas, largely sexual and reproductive health and rights or gender-based violence. There was also a large geographical skew with many programmes located in a handful of countries/sub-regions.
• Summaries of the final shortlisted cases for Africa, South Asia and Southeast Asia including an interactive dashboard map.

About this project

The United Nations University International Institute for Global Health in partnership with Public Health Foundation of India through its Ramalingaswami Centre on Equity and Social Determinants of Health and School of Public Health at the University of Western Cape in South Africa aims to fill an important evidence gap about what worked, where, for whom, why and how when integrating gender in large scale government health programmes through a series of national case studies.

A wide net was cast to capture a broad range of government health programmes that have promising features of gender integration across three regions. Screening the initial list of over 50 programmes, spotlights the challenges faced across different geographies in achieving consistent government buy-in/leadership and sustaining successful gendered outcomes.

What did we find

Initial screening of 51 potential programmes quickly revealed that:

• Many programmes showed minimal or unclear involvement from the government (for example, government involvement was primarily an advisory or consultative role)
• Donor funding was prevalent often overshadowing government funding
• The time frame of many programmes was short, with many being active for one year or less
• Levels of gender integration were limited and information on gendered outcomes was largely absent.

Input from ten advisors across Africa, South Asia and Southeast Asia with extensive expertise in gender and/or health was sought to determine the final selection of programmes. They made three broad recommendations to guide the final selection of programmes:

• Prioritise programmes in health areas beyond SRHR and GBV as these areas have been the mainstay of gender programming. They also recommended continuing to look for cases of gender integration in disease-focused areas (e.g., non-communicable diseases or infectious diseases], and health system areas (e.g., health workforce, sector-wide planning).
• Choose programmes that capture regional diversity to balance the concentration of potential cases in a handful of countries (e.g., India, the Philippines, Ethiopia).
• Given the difficulty in finding programmes that have definitive successful gender and health outcome measures, select programmes where promising progress has been made and lessons can be drawn to address existing gaps.

Final case studies and next steps

Across the three regions, seven programmes were selected as case studies for final review and follow-up. These programmes were selected based on regional representation, program diversity, levels of gender integration, government involvement, and long-term sustainability. Geographically the programmes are located in the Philippines, Timor Leste, India, Nepal, Ethiopia and Niger and focus on gender mainstreaming in hospital systems, gender-responsive budgeting, male engagement, mainstreaming gender in primary health care, transgender health, and sexual and reproductive health.

For each case study, a critical realist approach will be used to build an evidence base for understanding what contributes to successful and sustained gender integration across government health programmes. We are also planning to host Policy Dialogues where we will engage a range of key stakeholders to discuss the nature and implications of the findings and identify opportunities for evidence-informed policy change. So be sure to stay tuned for more exciting updates as the project unfolds!

For further details of the study, please contact us