In many settings worldwide, health facilities fail to deal with gendered aspects of care and treatment, in terms of both the challenges that clients face in accessing care, and the actual delivery of services. Gender inequalities, unequal power dynamics and negative provider attitudes in health systems impede respectful care for clients. In part due to gender norms and the overall low status of women in society, health providers sometimes practice gender discrimination toward clients, including but not limited to: physical, sexual and emotional abuse; non-consented care; and a lack of privacy. On the other hand, health care providers in many societies also see reproductive health services as a woman’s domain and alienate men from participating. Jhpiego helps facilities take action to ensure that gender-sensitive, respectful services are provided to all clients. We are building reproductive health services that are non-stigmatizing or gender-discriminatory to adolescents, unmarried people and non-traditional gender identities and sexual orientations.
- Conducting quality assurance and quality improvement on gender-sensitive service delivery in facilities using a standards-based supervision tool in a participatory process with providers;
- Addressing gender-based discrimination, which leads to mistreatment of health workers and clients, through sensitization, skills-building and mentorship of health providers and facility managers; and
- Building reproductive health services that are non-stigmatizing or gender-discriminatory to adolescents, unmarried people and non-traditional gender identities and sexual orientations.
- Jhpiego developed the Gender Service Delivery Standards, a tool to assess and improve the quality of gender-sensitive, respectful care. This tool helps identify challenges for facilities in providing gender-sensitive care, as well as improvements that can be made such as enhanced client privacy, male engagement and improved policies regarding a women’s ability to select permanent family planning methods without their husband’s consent. Examples of how these standards are being implemented and adapted across health facilities where Jhpiego works include:
- Jhpiego Tanzania adapted and integrated the standards in the needs assessments and quality improvement processes for their reproductive, maternal, newborn, child, and adolescent health and HIV key populations projects.
- In Mozambique, the Maternal and Child Survival Program (MCSP) is applying the standards at 56 health facilities in Nampula Province and 30 in Sofala Province.
- In Nigeria, MCSP built the capacity of 41 providers to implement the standards.
- Jhpiego is also exploring implementing the standards in Myanmar and Kenya.
- The Ministry of Health in Mozambique asked MCSP to develop a Gender Strategy for the Health Sector, which was subsequently launched at a stakeholders’ workshop. MCSP will continue to provide technical assistance to the Ministry to integrate gender into its health interventions, budgets, planning processes and data collection.
- In India, MCSP worked with an Indian organization, called C3, to train more than 15,700 auxiliary nurse midwives and community health workers known as accredited social health activists, as well as 961 facility-level providers, on gender-sensitive family planning services that respect women’s autonomy, dignity and privacy. MCSP also sensitized 59 staff, government stakeholders and C3 colleagues on gender and reproductive, maternal, newborn, child and adolescent health in two workshops in Odisha and Delhi.
- In Tanzania, MCSP incorporated gender into community social and behavior change communication efforts led by community health workers. More than 10,000 community members—including over 4,000 men—participated in community-gender dialogue sessions led by these community health workers. In Mara, 91% of men who participated indicated that they are willing to educate others at community and church meetings.
A tool to assess and improve the quality of a health care facility’s provision of gender-sensitive, respectful care
A practical guide for public health professionals seeking to understand how gender can impact health outcomes, with a focus on sexual, reproductive, maternal, newborn, child and adolescent health
Gender Transformation for Health: A Participatory Toolkit
Learning materials covering Jhpiego’s 5 key priority areas, suitable for health providers and program implementers
Integrating Gender from Start to Finish, Inside and Outside
Case study of Jhpiego’s efforts to integrate gender into interventions to improve access to—and quality of—health care services for women and families in Afghanistan under the Health Services Support Project