On the 19 October 2023 the MAGE project convened a stellar panel of experts to explore and advocate for gender-responsive monitoring and evaluation of health programmes. In this blog our Director, Kate Hawkins, has synthesised ten key points from the webinar for health systems researchers to consider.
- A gendered approach encompasses needs, rights, and preferences, as well as gender power relations and systems. It is crucial to recognise that gender extends beyond just biological differences and beyond the gender binary of men and women.
- Women, who often suffer from inequitable power relations and systemic disadvantages, are often a primary focus of gender-responsive monitoring and evaluation in health. An intersectional lens should be adopted to address issues like class, age, race, ethnicity, and geographical location, recognising that gender intersects with multiple aspects of identity.
- Indicators should be sex-specific, sex-disaggregated, and related to gendered power relations and systems, enabling a better understanding of gender dynamics.
- Power imbalances disproportionately disadvantage women and girls and affect their health outcomes, posing a threat to achieving universal health coverage. Sexual and reproductive health plays a significant role in empowering women and girls to make choices about their lives, and it is heavily influenced by gender norms. Controlling women’s bodies, sexuality, and reproductive choices is a significant contributor to gender inequality, making it crucial to understand these power dynamics to improve health outcomes in these areas. Health directly affects access to education, economic opportunities, and participation in social and political life, impacting women and girls’ ability to attain gender equity.
- Programmatic priorities should have a gender lens from the outset, enabling the creation of indicators to monitor progress on gender-related issues. Equitable participation and representation of diverse groups in interventions are essential for promoting gender equality.
- Gendered aspects of health in outcomes and determinants must be measured to prioritise these issues in the analysis and emphasise their importance. Striving for improvement in research and programs is vital while also being vigilant to prevent unintentional gendered harms.
- Gender-focused interventions often target women, men, and communities to change gender norms and roles in family planning, but the health systems supporting these communities are often overlooked. Identifying gaps and measuring inequalities within the health system is essential, requiring gender-responsive monitoring and evaluation.
- Addressing practical issues, such as inadequate facilities in health centers, lack of access to health insurance, and gender disparities in the health workforce, is crucial alongside normative processes.
- Progress should be tracked in real time, and responsive actions must address the specific challenges faced by women and girls.
- National health information systems may not capture all necessary gender-related data, and integrating information from other sources, like primary research, may be necessary to fill these gaps. Considerable capacity development may be needed at multiple levels of the health system to introduce and strengthen this approach, including improving political will in this area.
The workshop speakers emphasised that “We measure what we treasure, and we treasure what we measure.” The time for measuring gender in health is now.
MAGE is a partnership between Johns Hopkins University (JHU) and the Global Financing Facility for Women, Children and Adolescents (GFF), a multi-stakeholder partnership housed at the World Bank that is committed to ensuring women, adolescents, and children can survive and thrive. They do this through the advancement and strengthening of gender- and equity-intentional monitoring and evaluation.
Speakers at the webinar included: Anju Malhotra, PhD, Professor of the Practice, International Health, Johns Hopkins Bloomberg School of Public Health, Senior Gender and M&E Advisor, GFF, The World Bank • Choolwe Jacobs, PhD, Head of Department of Epidemiology and Biostatistics at the School of Public Health, University of Zambia, Country Lead, Women in Global Health, Zambia • Rosemary Morgan, PhD, Associate Scientist, Johns Hopkins Bloomberg School of Public Health, USA • Asha George, PhD, South African Research Chair in Health Systems, Complexity and Social Change, School of Public Health, University of the Western Cape, South Africa