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Nancy Yinger & Charlotte Feldman-Jacobs Population Reference Bureau May 17, 2005

Nancy Yinger & Charlotte Feldman-Jacobs Population Reference Bureau May 17, 2005. A Gender Perspective. Recent Headlines. Sri Lanka Maids’ High Price for Foreign Jobs, NYT, 5/8/05. Charlotte, Grace, Janet and Caroline Come Home , NYT Magazine, 5/8/05. Gender not Sex.

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Nancy Yinger & Charlotte Feldman-Jacobs Population Reference Bureau May 17, 2005

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  1. Nancy Yinger&Charlotte Feldman-JacobsPopulation Reference BureauMay 17, 2005 A Gender Perspective

  2. Recent Headlines • Sri Lanka Maids’ High Price for Foreign Jobs, NYT, 5/8/05. • Charlotte, Grace, Janet and Caroline Come Home, NYT Magazine, 5/8/05.

  3. Gender not Sex • Gender refers to the roles that women and men play in society and the relative power they wield. • Sex refers to the innate biological differences between women and men. • Most health inequities are rooted in gender inequities.

  4. HIV/AIDS Ischaemic heart disease Cerebrovascular disease Unipolar depressive disorders Road traffic injuries Tuberculosis Alcohol use disorders Violence Unipolar depressive disease HIV/AIDS Ischaemic heart disease Cerebrovascular disease Cataracts Hearing loss (adult onset) Pulmonary disease Tuberculosis 8 Leading Causes of Adult Disease Burden (2002) Males Females Source: WHO, World Health Report, 2003

  5. Areas of Progress; Areas of Stagnation Positives: • Girls’ school enrollments up. • Use of modern contraception up. • Women’s share of the nonfarm labor up slightly. Negatives: • Girls’ schooling lags behind boys’ in the world’s poorest regions. • Childbearing begins early in these regions. • Maternal mortality not abating. • Women hold less than one-fifth of seats in national parliaments.

  6. Measuring Gender • Social scientists have a long history of studying gender. • Used to be “status of women” and was measured by “proxies,” especially female education. • Measurement now more precise, but also more complex. • Variables now define power to act in healthy ways, e.g. control fertility.

  7. Example of Empowerment Variables Who in your family usually makes decisions about: • Health care for yourself? • Major household purchases? • Purchases for daily household needs? • Visits to your family or relatives? In your opinion, is a husband justified in hitting or beating his wife in the following situations: • If she goes out without telling him? • If she neglects the children? • If she argues with him? • If she refuses to have sex with him?

  8. Moving Beyond Proxies • IGWG’s “So What” paper presents 25 examples of reproductive health projects that have included and evaluated a gender perspective. • Interventions that include efforts to transform gender relations report positive reproductive health outcomes.

  9. Gender and Fertility The Navrongo experiment in N. Ghana: • Gender explicitly included in the design. • Three models of service delivery compared with a control area. • In most intensive experimental area, fertility down by 16%. • Gender-based violence increased.

  10. Gender and Very Low Fertility Proposition: In high fertility countries, gender inequities tend to support high fertility, and in low fertility country they tend to support very low fertility.

  11. Industrialized Countries.................…….…. 1 in 2,800 East Asia/Pacific...........….…………………… 1 in 283 Latin America........………………....………… 1 in 160 Southeast Asia…………………………………. 1 in 140 South Asia………………….…………………… 1 in 46 Sub-Saharan Africa…..………………………… 1 in 16 Risk of Dying of Maternal Causes World Health Organization, UNICEF, and UNFPA, Maternal Mortality in 2000.

  12. Addressing Maternal and Neonatal Mortality from a Gender Perspective The Warmi Project in Peru included • Participatory problem solving through women’s groups. • Support for interventions such as emergency transportation funds and efforts to include husbands. Evaluation from 1990-1998 showed a decline in • maternal mortality (from 141 to 99 deaths per 10,000 births). • neonatal mortality (from 70 deaths to 16 per 1,000 live births).

  13. Sex distribution of adults living with HIV/AIDS in Sub-Saharan Africa Number infected: 9,776,646 Number infected: 13,256,189 Source: UNAIDS, Report on the Global HIV/AIDS Epidemic, July 2002.

  14. Addressing Gender and HIV/AIDS The Sonagachi Project in Calcutta included • Free health clinics and HIV/AIDS education. • Training to deal with legal issues. • Literacy classes. Evaluation of activities showed • An increase in HIV/AIDs knowledge (31% in 1992 to 86% in 1993). • A decrease in gonorrhea (13% to 4%). • An increase in condom use (from 4% in 1995 to 30% in 1999).

  15. Conclusions • Social science now has better tools to measure gender; they need to be applied more broadly. • The evidence is mounting: health programs that incorporate gender better achieve their objectives; but many projects still not well evaluated. • PRB looks forward to working with many partners to continue disseminating life-saving gender and health information.

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