Gender

Community-based access to health services and products such as family planning methods is important, in part, because of gender inequalities that limit women’s ability to access facility-based care. Likewise, women’s ability to decide the timing and spacing of their pregnancies is a critical component of gender equality, as it gives women more freedom to pursue educational, economic, and social endeavors that benefit themselves, their families, and their communities. Recently, the health and donor communities have increased both attention and commitment to promoting gender equality in health programs, and the evidence base for gender integrated health projects has grown accordingly. Advancing Partners & Communities (APC) seeks to integrate gender into all its activities and provides support for sub-grantees to do the same.

Photo credit: Arne Hoel/World Bank

Below are select resources related to key issues within gender.

Women’s Economic Empowerment

Family planning and women’s economic empowerment are mutually beneficial: when women have control over their bodies and family size, they are better positioned to pursue educational and economic goals outside the home, and when women have greater access to and control over economic resources they are better able to access and use family planning. Many women do not have access to cash resources or transportation for accessing health services and products like contraception. Moreover, in some areas, restriction on women’s ability to move around in public limits their access to health resources. Community-based distribution, free provision of commodities, and conditional cash transfers can accommodate these gender inequalities to make it possible for women to space or prevent pregnancies.

Impact of Conditional Cash Transfers on Maternal and Newborn Health
April 2013 | Paper

This policy paper is a review of studies from eight countries on conditional cash transfers (CCTs) that report maternal and newborn health outcomes. The review concludes that there are positive health outcomes from CCTs and discusses priorities for future investment in CCT programs.

The Impact of Family Planning on Women’s Educational Advancement in Tehran, Iran
December 2012 | Study

This study assesses the impact of contraceptive use and delayed childbearing on urban married women’s ability to seek educational and employment opportunities after marriage in Tehran. The paper examines trends across three marriage cohorts, based on a 2009 survey collected by the author examining birth and contraceptive histories as well as education and employment status of husbands and wives over the life-course.

Family Planning and Economic Growth
April 2011 | Paper

In this Working Paper, part of a series from CFR's Women and Foreign Policy program, Joy Phumaphi explores the relationship between access to voluntary family planning and economic growth.

Men’s Engagement in Family Planning

Increasingly, family planning programs understand the need to foster male partners’ active and supportive roles in planning their families. Family planning is often seen as solely a woman’s concern, and yet many women do not have the power to access and use contraception without the permission, cooperation, or support of their spouses or family members. Moreover, norms of masculinity in many areas place a high value on men’s virility and ability to father children and discourage health-seeking behaviors of men, which can be perceived as a sign of weakness.

Men’s roles in family planning may range from open communication and shared decision-making with their female partners about ideal family size and family planning methods, to financial support for accessing family planning, to men’s own uptake of vasectomy and condom use. Efforts to encourage men to become involved in planning their families can also lead to overall improvements in couples’ communication.

Increasing Men's Engagement to Improve Family Planning Programs in South Asia
July 2012 | Literature Review

This literature review synthesizes recent research on cultural barriers to men’s engagement in family planning and presents successful strategies for increasing men’s engagement based on global and regional evidence. Additionally, the literature review provides guidance for designing activities to engage men in family planning programs.

Changes in Couples' Communication as a Result of a Male-Involvement Family Planning Intervention
April 2012 | Journal Article

Building upon a recent evaluation of a theory-based male-involvement intervention in Malawi, this study examined the role of communication in the intervention's success, through semi-structured in-depth interviews with male participants and female partners of study participants. Note: A subscription is required to read the full article.

Encouraging Contraceptive Uptake by Motivating Men to Communicate About Family Planning: The Malawi Male Motivator Project
June 2011 | Journal Article

This journal article examines the effect of a peer-delivered educational intervention, the Malawi Male Motivator intervention, on couples’ contraceptive uptake.

Engaging men and boys in changing gender-based inequity in health: Evidence from programme interventions
January 2007 | Publication

This publication assesses the effectiveness of programme interventions seeking to engage men and boys in achieving gender equality and equity in health.

Gender-Based Violence

Gender-based violence is pervasive worldwide. Violence against women in particular has implications for community health programs, especially those that address family planning. Women and girls who experience sexual violence and coercion have an urgent need for family planning, including emergency contraception, to prevent unintended pregnancies. Women experiencing intimate partner violence may have lower demand for family planning, are more likely to use contraception in secret, and have higher rates of both unintended pregnancies and unsafe abortions.

Gender-based violence also increases during pregnancy, which has serious implications for maternal health. Children of women who experience violence during pregnancy also suffer poor health outcomes.

Community health services present an opportunity to screen women and girls for gender-based violence and to refer them to appropriate services for support.

Flowchart: Integrating GBV Screening Within HIV Support Services in Guyana
November 2017 | Infographic

This flowchart breaks down the process for GBV screening within HIV support services in Guyana.

Gender-Based Violence & You: Know Your Rights
November 2017 | Brochure

This brochure provides information on how to get help for gender-based violence.

Gender-Based Violence Screening Tool
November 2017 | Training Guide

This screening tool was developed by APC Guyana to screen gender-based violence.

Guyana Gender-Based Violence Services Resource Directory
November 2017 | List

This directory from Guyana provides a rating system that is geared towards collecting information on how acceptable GBV services of each organization are for members of the key population.

Addressing Stigma and Gender-Based Violence to Improve HIV Service Delivery to Key Populations
November 2017 | Assessment

This rapid assessment was conducted to gather information on the programmatic and capacity needs of the NGOs supported through APC to implement services for key populations as well as the structural challenges faced by these NGOs.

Integrating Gender-Based Violence Screening Into HIV Services Provided by Non-governmental Organizations in Guyana
November 2017 | Toolkit

The following protocol was created to assist community-based nongovernmental organizations in Guyana with implementing gender-based violence screening. Social workers can use this tool to understand ways to detect GBV and to better prepare themselves for implementation of GBV screening.

Flexible Family Planning, Reproductive Health and Gender-based Violence Services for Transition Situations (“Flex FP”) Project Evaluation
May 2013 | Report

This report is an end-of-project evaluation of the Flexible Family Planning, Reproductive Health and Gender-based Violence Services for Transitions Situations Project to document project performance, impact, and lessons learned.

Gender-Based Violence: Impediment to Reproductive Health
September 2010 | Journal Article

This article presents background on the frequency of gender-based violence and outlines the ways in which it is an impediment to health passed on from generation to generation.

Gender-based Violence and Family Planning Services in Bolivia: A Review of the Evidence through the Lens of the Demographic Health Survey and the Health Policy Initiative Avances de Paz Project
September 2010 | Report

This report primarily presents the results of an assessment that sought to understand whether, how, and to what extent gender-based violence (GBV) affects women's use of family planning/reproductive health (FP/RH) services.

WHO Multi-country Study on Women's Health and Domestic Violence against Women
November 2005 | Publication

This publication analyzes data from 10 countries and sheds new light on the prevalence of violence against women in countries where few data were previously available. It also uncovers the forms and patterns of this violence across different countries and cultures, documenting the consequences of violence for women’s health.

Early Marriage

Around the world, many girls are married while they are still children (under age 18). Early marriage is most common in poor and rural communities and is likely to be arranged with little or no knowledge or consent from the girl herself. Girls who marry early are less able to continue their educations and are at increased risk for gender-based violence and health complications of early sexual initiation and childbearing. Interventions are needed both to prevent early marriage and to provide support to married girls.

Towards Improved Economic and Sexual/Reproductive Health Outcomes for Adolescent Girls (TESFA), CARE Ethiopia
July 2014 | Publication

This publication describes the TESFA project in Ethiopia. TESFA is a three year project funded by the Nike Foundation that works to improve economic, and sexual and reproductive health outcomes for ever‐married adolescent girls in Ethiopia.

Ending Child Marriage & Meeting the Needs of Married Children: The USAID Vision for Action
October 2012 | Publication

This publication focuses on development efforts to combat child marriage in regions, countries, and communities where interventions to prevent and respond to child marriage are most needed and most able to achieve results.

Evaluation of Population Council’s Berhane Hewan: A Program to Delay Child Marriage in Rural Ethiopia
March 2009 | Journal Article

This article reports on the success of the Berhane Hewan program, one of the first rigorously evaluated interventions to delay marriage in Sub-Saharan Africa. It also suggests that well-designed and effectively implemented programs can delay the earliest marriages until later adolescence.

Addis Birhan Project
January 2009 | Brief

This brief outlines the Addis Birhan Project. The curriculum for men includes modules on gender, relationships, caring for children and families, drugs and alcohol, HIV and AIDS, sexual and reproductive health, and violence.

Early Marriage, A Harmful Traditional Practice. A Statistical Exploration
April 2005 | Publication

This publication estimates the prevalence of child marriage and seeks to identify and understand the factors associated with child marriage and cohabitation. The statistical linkages identified can help programmers promote delayed marriage and use advocacy and behavior-change campaigns to prevent child marriage.

Gender Norms of Health Care Providers

Gender norms are part of the community and affect everyone. Community health programs must recognize that everyone, including program designers and healthcare providers themselves, are socialized into certain ways of thinking and behaving as women and men, and about women and men. As a result, women and men often experience stigma and discrimination from healthcare providers. Healthcare providers should receive training in gender sensitivity to challenge their thinking about gender norms and be mindful of gender issues when interacting with clients.

Putting Gender Perspective into Practice
August 2008 | Publication

This publication summarizes how FRONTIERS project improved understanding of the impact of gender issues on reproductive health and helped identify effective actions for incorporating gender perspective into

Gender sensitivity in the service delivery environment
December 2001 | Fact Sheet

This fact sheet outlines the requirements for a health and family planning facility to be designated gender sensitive.

Community Health Worker Motivation

In the face of global health worker shortages, the use of community health workers (CHWs) is an important health care delivery strategy for underserved populations. In Uganda, community-based programs often use volunteer CHWs to extend services, including family planning, in rural areas. This study examined factors related to CHW motivation and level of activity in three family planning programs in Uganda.

Community Health Policy Matters
May 2017 | Video

APC’s Community Health Policy Matters video tells the story of fictional characters Winnie and Mary, and how a fragmented health system affects each woman’s ability to access family planning services in her respective community. This animated video highlights how policy can improve the health system for women.

Below you will find links to resources created by APC and other organizations.

External Resources

Early Marriage, A Harmful Traditional Practice. A Statistical Exploration
April 2005 | Publication

This publication estimates the prevalence of child marriage and seeks to identify and understand the factors associated with child marriage and cohabitation. The statistical linkages identified can help programmers promote delayed marriage and use advocacy and behavior-change campaigns to prevent child marriage.

Gender sensitivity in the service delivery environment
December 2001 | Fact Sheet

This fact sheet outlines the requirements for a health and family planning facility to be designated gender sensitive.

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