Module 2. Analysis conducting gender analysis

Transcription

1 Module 2 Analysis conducting gender analysis

2 Slide 2.1 Learning objectives of Module 2 Outline the principles of gender analysis Understand the health and gender related considerations when conducting gender analysis Be familiar with WHO gender analysis tools for gender analysis of a health problem.

3 Slide 2.2 Outline of Module 2 Section 2.1: What is gender analysis? Section 2.2: Introducing WHO gender analysis tools Gender Analysis Questions Gender Analysis Matrix Section 2.3: Using WHO gender analysis tools Group work on selected health issues

4 Section 2.1 What is gender analysis?

5 Slide 2.3 Gender analysis is an essential step in gender mainstreaming Gender analysis identifies, analyses and informs actions to address inequality that come from: Different gender norms, roles and relations Unequal power relations between and among men and women The interaction of sex, gender and factors such as sexual orientation, ethnicity and education or employment status

6 Slide 2.4 Gender analysis in health looks at how gender inequality affects health and wellbeing. Examines how biological and sociocultural factors interact to influence health behaviour, outcomes and services. Highlights how gender-based inequality disadvantages the health of women and girls. Uncovers health risks and problems among men and boys as a result of gender norms, roles and relations.

7 Slide 2.5 Guiding principles of gender analysis Sex is not gender / Women and men are different. Policies and programmes do not affect men and women in the same way. Diverse types of evidence are needed to understand how gender operates as a determinant of health. Evidence based Critical questions Requires looking for information where there is no evidence Sustained commitment is necessary.

8 Slide 2.6 Gender analysis helps to identify and respond to practical and strategic needs Practical gender needs: necessities such as adequate living conditions, water provision, health care and employment. Examples: provision of health care, food, shelter or income. Characteristics: Short term (such as health care, food, shelter and income) Needs are addressed through direct action such as installing water pumps and building schools or health facilities

9 Slide 2.7 Gender analysis helps to identify and respond to practical and strategic needs Strategic gender needs: requirements to overcome women s unequal status. Examples: engaging men in domestic responsibilities and ensuring that women have control over their bodies. Characteristics Long term (such as legal and policy changes) Usually relate to vulnerability to physical violence, restricted legal protection and other resources such as education

10 Slide 2.8 Gender analysis is not enough! Gender analysis alone does not fix the problem you need to take many more steps to develop appropriate responses in the health sector. Avoid adding gender salt on top of existing efforts, and use gender analysis to inform every stage of health planning and programming. The actual work of addressing gender-based inequality in health begins with analysis but requires action. No more gender words without gender actions!

11 Section 2.2 Introducing WHO gender analysis tools

12 Slide 2.9 WHO Gender Analysis Matrix Factors that influence health outcomes Health-related considerations Risk factors and vulnerability Access to and use of health services Health-seeking behaviour Biological factors Factors that influence health outcomes Gender-related considerations Sociocultural factors Access to and control over resources Treatment options Experiences in health care settings Health and social outcomes and consequences

13 WHO Gender Analysis Matrix Gender-related related considerations

14 Slide 2.10 Gender-related related considerations: factors that influence health outcomes Biological factors: anatomy, physiology, genetics, immunology Sociocultural factors: socially constructed norms, roles and relations; gender stereotypes; gender-based division of labour Access to and control over resources: access is the availability of a resource; control is the ability to influence and use a resource

15 Slide 2.11 Gender Analysis Matrix Gender-related related considerations Biological factors Recap from Module 1: do you remember the definition of sex? Biological factors can be classified as follows. Reproductive and/or conditions related to hormonal changes such as pregnancy and menopause and sex-specific organs such as cervical and prostate cancer. Genetic or hereditary conditions or those transferred from parent to child through chromosomes, such as colour blindness and haemophilia

16 Slide 2.12 Gender Analysis Questions: Biological factors Who gets ill? Can biological factors explain why women, men, girls or boys are affected differently by a condition? Does the individual s sex increase the risk of or vulnerability to this? How? Do age or other physiological factors, such as hormone levels, matter? How? What are the predominant health and social outcomes of this condition? Who, other than the immediate person with the condition, is also affected? Children? Partners? Families? Communities? How? Do these effects differ by sex? How are men and women coping with the effects of this condition? How do sex and other biological factors affect coping strategies for this condition?

17 Slide 2.13 Gender Analysis Matrix Gender-related related considerations Sociocultural factors Recap from Module 1: do you remember the definition of gender? Gender refers to the norms, roles, relationships of and between women and men. varies from society to society and can be changed requires long-term strategies. Gender norms, roles and relations are often hierarchical and privilege one group over another.

18 Slide 2.14 Which sociocultural factors? Recap from Module 1: do you remember the five elements of gender? 1. Relational 2. Hierarchical 3. Historical 4. Contextually specific 5. Institutionally structured

19 Slide 2.15 Gender Analysis Questions: Sociocultural factors When does this condition occur? Is it at any specific time in the life course? Are there any gender norms, roles and relations during this period that may explain increased vulnerability? What are the people affected by the condition doing about it? Do sociocultural factors affect health-seeking behaviour related to this condition? How? Are these factors different for women and men? How? Do gender norms, roles or relations affect women s or men s willingness and ability to recognize that they are ill and/or to seek treatment? How? How do women s and men s access to and control over resources affect their willingness and ability to recognize that they are ill and/or to seek treatment? Are women able to decide to seek treatment on their own?

20 Slide 2.16 Gender Analysis Matrix Gender-related related considerations Access to and control over resources Geographical or physical accessibility Resources must be located in places where women and men of different social groups can physically access them. Roads, transport and other infrastructure elements are often necessary to ensure that the population can access resources. Financial accessibility Access to many health-related resources depends on user fees. Social accessibility Access must be facilitated in culturally appropriate ways for women and men. Participation and membership in a village health council, for example, may only be possible for some women if their household grants permission and if meetings are held in places where women can gather safely.

21 Slide 2.17 Health-related resources are about more than money Economic resources Money, credit or loans, land, other assets Social resources Community resources or networks, social support networks (or supportive social relations), transport and other social services Education or training (formal or informal), information Political resources Decision-making processes and leadership at the institutional, household, community, district or national levels, civic participation High-quality health care services (formal or informal), medication, health insurance (public or provided by an employer) Economic, social, political, civil and cultural rights Other resources Basic necessities: time, water, shelter, clothing, food

22 Slide 2.18 Gender Analysis Questions: Access to and control over resources How do access to and control over resources affect the provision of care? Do women or men in the affected group have particular financial or social vulnerability that may affect their ability to access and use health services? Is this vulnerability worsened by age, ethnic or religious affiliation, sexual orientation or other factors? Are user fees affordable for this condition? Do they differ for men and women of different groups? How? Are there any individual indirect costs, such as transport or child care, related to accessing health services that may affect women and men differently?

23 WHO Gender Mainstreaming Manual for Health Managers: A Practical Approach Slide 2.19 Revisiting the power walk Put yourselves in the shoes of your power walk character: How did your access to or control over resources affect your ability to move forward? Did gender norms, roles or relations have anything to do with it? Power walk, Module 1 Salzburg interregional capacity-building workshop 2006

24 Slide 2.20 Power walk character analysis Power walk statement Key healthrelated resources required Access to these resources? Control over these resources? I can consult health services when and if I need to I eat at least two full meals a day

25 Slide 2.21 Gender-based discrimination unfair practices made based on gender norms, roles and relations that prevents women and men from enjoying their human rights. perpetuates gender inequality by validating stereotypes about men and women of different groups.

26 Slide 2.22 Gender-based discrimination Examples Health care workers often dismiss how disease is expressed (symptoms) among women as being related to stress or emotions without proceeding to physical examinations to verify these symptoms. Men who have sex with men face stigma with respect to HIV. Women are rarely heads of state based on the perception that women are not good, strong leaders. Violence prevention campaigns fail to address men as victims of violence, treating them as perpetrators of violence only.

27 Slide 2.23 Recall from Module 1 Empowerment A complex process that helps people gain or strengthen control of their lives. Action required Awareness-raising, building self-confidence, expansion of choices, increased access to and control over resources at individual and community level Transform the structures and institutions that reinforce and perpetuate gender-related health inequity

28 Slide 2.24 Factors that influence health outcomes Health-related considerations Risk factors and vulnerability Access to and use of health services Health-seeking behaviour WHO Gender Analysis Matrix Biological factors Factors that influence health outcomes Gender-related considerations Sociocultural factors Access to and control over resources Treatment options Experiences in health care settings Health and social outcomes and consequences

29 WHO Gender Analysis Matrix Health-related considerations

30 Slide 2.25 Risk factors and vulnerability Risk factors Focusing on risks to health is key to preventing disease. Risk factors refer to underlying causes of disease and illness. Understanding them can lead to interventions that diminish the harmful effects of exposure or eliminate exposure altogether. elements associated with the development of disease or illness but that are not sufficient to cause it. Some risk factors, such as tobacco consumption, are related to several diseases; some diseases, such as cardiovascular disease, are related to several risk factors. Exposure to risk factors is often linked to gender norms, roles and relations and therefore differs for women and men. Women and men are often in different occupations with different risks of work-related illnesses or accidents.

31 Slide 2.26 Risk factors and vulnerability Types of risk factors Socioeconomic: poverty, age, ethnic affiliation, gender inequality Geographical location: rural, urban, housing and/or working conditions, physical access to services Psychosocial or lifestyle factors: tobacco or alcohol consumption, nutrition, physical activity Physiological factors: sex, body type, genetics, blood pressure, cholesterol levels

32 Slide 2.27 Risk factors and vulnerability Vulnerability refers to the degree of susceptibility of exposure to risk factors. the degree of diminished capacity to cope with exposure to risk factors. Susceptibility does not mean that such populations are automatically at risk. Differential vulnerability refers to differences in access to and control of resources. In general, males have better access than females to nutritious food (lifestyle risk factor), which increases the vulnerability of females to infectious diseases and the rate of complications in childbirth.

33 Slide 2.28 Access to and use of health services Appropriate access to and use of health services are crucial factors for positive health outcomes. Gender norms, roles and relations affect the access to and use of health services. Women: restrictions on physical mobility, decreased decision-making power are often primary obstacles. Men: geographical location and the perceived importance of consulting health services often influence access to and use of health services. Both: daily tasks (paid or unpaid) of men and women may restrict their ability to effectively access and use health services.

34 Slide 2.29 Health-seeking behaviour Action carried out by a person who perceives a need for health services with the purpose of addressing a given health problem. This includes seeking help from allopathic and complementary or alternative health services. Factors that can influence health-seeking behaviour Socioeconomic status (household poverty and levels of education) Proximity to health facilities Type, duration and perceived severity of illness and long waiting times Inadequate or negative staff attitudes Adequate health education Sex and gender Examples of differences between men and women in health-seeking behaviour Men delay seeking health care for longer but use trained allopathic services first Women tend to practice self-care or use traditional medicine before seeking trained allopathic care

35 Slide 2.30 Treatment options Range from self-care to complementary or alternative therapy (such as local healers) to allopathic therapy delivered in health facilities, in the community or at home. Should address both sex and gender to be effective and respond to the health needs and realities of women and men from different groups. Factors that can influence treatment uptake or adherence Inappropriate options (such as those that are culturally insensitive) Costs Time involved Effort or behaviour change needed Stigma associated with the health condition Interference with daily tasks

36 Slide 2.31 Experiences in health care settings Previous experiences in health care settings, positive or negative, influence future health-seeking behaviour. Such experiences may come from individual experience or via the experiences of others in the household or community. Health care can be provided in discriminatory, harmful or ineffective ways that discourage women and men from seeking treatment. Health care settings that do not address gender norms, roles and relations in culturally sensitive and appropriate ways may fail to reach those in greatest need of health services.

37 Slide 2.32 Health and social outcomes and consequences Physical and emotional health outcomes Recovery, disability, long-term illness, death, etc. Health problems often cause economic and social changes for both sick individuals and their social networks. For example, what happens when the primary breadwinner falls ill and can no longer carry out paid work? Some factors that affect health and social outcomes and consequences: Monetary costs Duration of the health condition Type of care needed and whether it is available and accessible Severity of the condition Available social networks Stigma

38 Slide 2.33 Factors that influence health outcomes Health-related considerations Risk factors and vulnerability Access to and use of health services Health-seeking behaviour WHO Gender Analysis Matrix Biological factors Factors that influence health outcomes Gender-related considerations Sociocultural factors Access to and control over resources Treatment options Experiences in health care settings Health and social outcomes and consequences

39 Slide 2.34 Gender Analysis Questions and health-related considerations of the Gender Analysis Matrix Risk factors and vulnerability Access to and use of health services Health-seeking behaviour Treatment options When does this condition occur? Where does this condition occur? Who gets ill? How do access to and control over resources affect provision of care? What are those affected by the condition doing about it? How do health services meet the needs of men and women affected by this condition? Experiences in health care settings Health and social outcomes and consequences What are the predominant health and social outcomes of this 29 condition? Nov 2006 How do access to and control over resources affect provision of care? How do health services meet the needs of men and women affected by this condition?

40 Section 2.3: Using WHO gender analysis tools

41 Slide 2.35 WHO gender analysis tips Start with a process of questioning use the GAQ to fill the GAM Overlap or duplication between questions is okay. Gender related considerations (sociocultural factors and access to and control over resources) sometimes overlap or are duplicated. All the boxes do not have to be filled in. The column on biological differences often has only a few boxes filled in. When this happens, it could mean the following: Sociocultural factors have more explanatory power; No evidence is available to answer the question at the time; You need to consult with other experts or stakeholders; More research and evidence may be needed More questions will arise keep on going!

42 Slide 2.36 Group work on gender analysis Elect a rapporteur and a presenter. Use the GAQ to guide your discussions. Refer to Participant Notes for definitions, examples and gender analysis tips as necessary. When evidence is missing, make assumptions based on your work experience, knowledge, trends and conventional wisdom. Remember, the point of the activity is to use the matrix and learn about ways to analyse a health problem using gender dimensions, not to provide concise epidemiological information. Time limited? Address at least one of the first three rows and one of the last two rows to give you a chance to analyse the perspectives of both users of health services and the health sector. Leave at least 15 minutes to prepare your presentation to the group. Enjoy 29 your Nov 2006 debates!

43 Module 2 Conclusions

44 Slide 2.37 Module 2: key messages Gender analysis of a health problem is about uncovering the interaction of gender-related considerations and healthrelated considerations. Quick quiz: What are the gender-related considerations? What are the health-related considerations? WHO gender analysis tools have been developed to guide you in uncovering the interaction of these two sets of considerations. Quick quiz: What are these tools called? Gender analysis findings can do the following. Provide an opportunity to raise awareness on potential harm due to gender norms, roles or relations Be used for advocacy work Stimulate further research and assist in refining research questions Assist in planning and implementing health sector activities

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