Health and Gender
Gender and other inequalities significantly influence health and wellbeing outcomes across the globe. For over thirty years, the Health and Gender Strand has worked to systematically apply a research-to-practice approach to improve the health and wellbeing—including improving the relationships, livelihoods, and citizen contributions—of women and girls, men and boys, and communities around the globe. With a focus on conducting applied research and providing technical assistance, gender is at the core of the Health and Gender Strand’s work, which covers: gender equality and inequality, adolescence and youth programming, family planning and reproductive health, social and behavioral health, social norms, gender-based violence, and engaging men and boys. Work from the U.S.-Afghan Women’s Council, a public-private partnership with the U.S. Department of State and the Afghan government, based at GUCCHD, also informs these concerns, addressing critical health issues such as maternal mortality and disability services among some of the world’s most vulnerable populations, women and girls in Afghanistan. The hallmark of our work is translating research and theoretical concepts into simple and practical guidance for programming for marginalized communities in low- and middle-income countries, working at the central, district, and community level.
The Health and Gender Strand’s work thrives through diverse, collaborative partnerships with implementing partners who provide Community Services that work with stakeholders to increase acceptability of family planning methods, increase gender equality and equity, and reduce gender-based violence.
With decades-long background in applied research, the Health and Gender Strand’s Research and Evaluation activities are intrinsic to our work, with focus on implementation science, monitoring, evaluation, and learning, and strategic scale-up. This work has added to the evidence for the integration of fertility awareness-based methods, natural and effective modern family planning methods, into national family planning programs, and the piloting, implementation, and strategic scale-up of norms-shifting interventions.
Technical Assistance (TA) to build capacity and promote co-learning is offered by the Health and Gender Strand, grounded in hosting and facilitating skills-building workshops and events to disseminate learnings from our research and best practices in the field. We also offer on-the-ground TA, using co-creation approaches to addressing problems and defining research. The current focus of TA efforts is on supporting norms-shifting interventions to bring a ‘norms-aware’ lens to behavior change interventions, including participatory methods for formative assessments, theory of change development, and scale up planning and learning. In previous programs, TA has been provided to support and strengthen national family planning services, with a focus on building capacity to provide fertility awareness-based methods and mobile solutions for reproductive health.
Through our capacity-building efforts over the years, we have contributed to Workforce Development within the family planning, gender equality, and norms-shifting programming spheres where we work. These efforts encompass service provision, community-driven program, monitoring and evaluation, and strategic scale-up.
- The Institute for Reproductive Health, a Health and Gender Strand center, has been contracted by UNICEF-Senegal to develop and test a methodological guide aimed at assisting field-based stakeholders facilitate a participatory dialogue around female genital mutilation/cutting (FGM/C) to increase community awareness and prevent the practice . To create this guide, IRH draws on extensive experience using a social norms approach, and is working closely with community stakeholders to understand the existing social norms that underpin the practice of FGM/C.
- Funded by Global Affairs Canada and lead by the Institute for Reproductive Health, a Health and Gender Strand center, the three-year Bien Grandir Plus! (BG+) project seeks to improve the health and wellbeing of both very young and older adolescent girls and boys in the Democratic Republic of Congo. A scale-up of the USAID/Bill & Melinda Gates Foundation project Growing Up Great!, BG+ addresses the gender-based barriers that adolescent girls and boys face in accessing sexual and reproductive health and rights, with a focus on increasing knowledge, self-efficacy, and positive attitudes towards: safe sexual activity, use of contraception, sexual and gender-based violence response services, parent-child communication about sexuality, and attitudes and behaviors relating to gender equality. With this work, BG+ aims to ensure that adolescent girls and boys will have the ability to transition safely through puberty and achieve their full rights to SRH, live more gender-equitable lives, and ultimately have improved health and well-being through the achievement of the following objectives.
- The Women’s Initiative to Strengthen and Empower (WISE) Afghanistan, a member of the U.S.-Afghan Women’s Council housed at GUCCHD, has provided access to basic healthcare for thousands of women in communities with limited access to health facilities and a high level of poverty. The primary focus areas are on malnutrition, maternal and child health, and menstrual health and hygiene. The organization has provided access to healthcare for over 8,000 women and children and conducted trainings for both health professionals and patients within its various areas of focus. In January 2018, WISE launched Salamat, the first maternal health application in Afghanistan aimed at improving the quality of data among health facilities and to enable health professionals to better address the needs of women and their children. Recently, the WISE team completed a successful pilot of Salamat with five health facilities in Kabul through the support of Johns Hopkins University and received approval from leadership at the Ministry of Health to expand the app throughout Afghanistan. WISE aims to continue to transform health care throughout Afghanistan through its core pillars of technology, education, and advocacy.
Research and Evaluation
- The Passages project is a USAID-funded implementation research that addresses the root of chronic challenges in family planning and reproductive health such as gender-based violence, child marriage, and unintended pregnancy by shifting social norms. Lead by the Institute for Reproductive Health, a Health and Gender Strand center, Passages is a consortium project that aims to address a broad range of social norms, at scale, to achieve sustained improvements in family planning and reproductive health. This implementation research project is building the evidence base and contributing to the capacity of the global community to strengthen normative environments that support reproductive health and well-being for young people, especially among very young adolescents, newly married youth, and first-time parents.
- The Fertility Awareness for Community Transformation (FACT) Project was a USAID-funded research, intervention, and technical assistance project that ran from 2013-2019, implemented by the Institute for Reproductive Health, a Health and Gender Strand center. Building off of earlier work under the USAID-funded Fertility Awareness Methods project, FACT fostered an environment where women and men can take actions to protect their reproductive health throughout the life-course by testing strategies to increase fertility awareness and expand access to fertility awareness methods at the community level. The project tested two primary hypotheses: first, that increased fertility awareness improves family planning use, and second, that expanding access to fertility awareness methods increases uptake of family planning and reduces unintended pregnancies.
- The Institute for Reproductive Health, a Health and Gender Strand center, is working with partners on the Templeton Foundation-funded Masculinities, Faith and Peace Project in Nigeria. This project aims to reduce sexual and gender-based violence, increase healthy timing and spacing of pregnancies, and improve inter-religious relationships. It does so by addressing social norms that shape inequitable gender relations and prevent the use of modern methods of family planning, in mixed Christian and Muslim communities in Plateau State, Nigeria. An adaptation of the Transforming Masculinities intervention, MFP works with religious leaders select and train key members of their congregation as facilitators of community dialogues. Each cycle of facilitated community dialogues also includes a health talk from a trained family planning provider, and ends with an inter-religious community celebration.
- The Social Norms Exploration Tool (SNET) was developed by the Institute for Reproductive Health, a Health and Gender Strand center, with support from the USAID-funded Passages project and members from the Bill & Melinda Gates Foundation-funded Learning Collaborative to Advance Normative Change. It is a five-phase participatory learning resource that provides actionable guidance and information on how to conduct a social norms exploration, a process for identifying social norms within communities and addressing them within global health and development programs. With IRH’s TA, this field-tested version of the SNET has been applied in over 15 settings, and IRH continues to provide distance and in-country TA to organizations and projects that wish to use it.
- The Institute for Reproductive Health, a Health and Gender Strand center, has been contracted as a sub-grantee to Catholic Relief Services for the USAID-supported Girma project in Niger. Girma, which means “dignity, prestige, and growth” in Hausa, the local language, uses a multi-sectoral, layered, participatory, and sensitive approach to gender, youth, persons with disabilities and climate change. The Institute for Reproductive Health provides technical assistance for the integration of fertility awareness-based methods service delivery and the contextual adaptation of GrowUp Smart curriculum into the Girma project. With this work, IRH is implementing and documenting a strategic approach for introducing and scaling-up fertility awareness method activities closely linked to Catholic Relief Service couple strengthening approach in Niger.
- The Institute for Reproductive Health, a Health and Gender Strand center, sits on the Steering Committee of the Learning Collaborative to Advance Normative Change. Made up of a network of experts committed to facilitating collaborative knowledge- and skills-building between organizations and individuals working on adolescent sexual and reproductive health norm-shifting interventions, the Learning Collaborative is working to enhance collective efforts, build knowledge, and develop shared tools to strengthen effective social norm theory, measurement, and practice in the social norms field. The Learning Collaborative has also fostered regional communities of practice (COPs), one in South Asia, and one in Francophone Africa. These COPs convene regional networks of practitioners with the objective of building capacity and advancing knowledge-sharing, collaboration, practice, and advocacy related to norms-shifting interventions for adolescent and youth reproductive health and wellbeing.