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GAVI Gender Policy

GAVI Gender Policy. Meegan Murray-Lopez. NVS IRC - Orientation Workshop Geneva, 5 October 2012. Outline of the session. Learning objectives GAVI Alliance Gender Policy Key study GAVI and programmatic approach to gender IRC processes. Learning objectives.

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GAVI Gender Policy

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  1. GAVI Gender Policy Meegan Murray-Lopez NVS IRC - Orientation Workshop Geneva, 5 October 2012

  2. Outline of the session • Learning objectives • GAVI Alliance Gender Policy • Key study • GAVI and programmatic approach to gender • IRC processes

  3. Learning objectives • IRC members understand the GAVI Gender Policy, key findings of research on gender and immunisation, and their relevance to the NVS IRC.

  4. GAVI Alliance Gender Policy

  5. GAVI Alliance Gender Policy Goal: • To promote increased coverage, effectiveness and efficiency of immunisation and related health services by ensuring that all girls and boys, women and men, receive equal access to these services.

  6. GAVI Alliance Gender Policy Guiding principles: • Apply a gender perspective in all GAVI’s work • Complement partners’ efforts to promote gender equality in health. • Promote country ownership and alignment with regard to gender issues. • Exercise strong leadership and demonstrate political will.

  7. GAVI Alliance Gender Policy Strategic directions: • 4.1 Generate, report and analyse new evidence • 4.2 Ensure gender-sensitive funding and policies • 4.3 Advocate for gender equality as a means to improve immunisation coverage and access to health services

  8. GAVIAlliance Gender Policy Strategic direction 4.2 • ‘Policymaking and funding support present central opportunities to highlight the gender dimensions of immunisation and related services. It can also leverage change across and beyond the GAVI Alliance to improve both the gender outcomes of immunisation and development more broadly.’

  9. GAVI Alliance Gender Policy Strategic Direction 4.2 (continued) • The GAVI Alliance commits to… Review and revise funding guidelines to ensure that countries include age- and sex-disaggregated data and gender analysis in needs assessments and that proposed targets and outcome measures incorporate a gender perspective.

  10. GAVI Alliance Gender Policy Evaluation: • External evaluation of the GAVI Alliance Gender Policy currently underway • Evaluation will assess • To what extent the planned activities have been implemented, outputs delivered and outcome attained • To what extent the policy is fit for purpose

  11. Key study

  12. Key study: WHO Gender and Immunisation • Purpose: To explore the evidence around sex disparities and gender-related barriers to children’s immunisation status • Methods: • Analysis of DHS data from 67 countries • Qualitative systematic review of 23 peer-reviewed studies in: • 4 countries with low coverage (Bolivia, Ethiopia, India, Nigeria) • 10 additional countries (Bangladesh, Cameroon, China, Gabon, Haiti, Kenya, Mozambique, South Africa, Senegal, Togo, Turkey)

  13. Key study: WHO Gender and Immunization Key findings: • Sex discrepancies: Girls and boys have the same likelihood of being vaccinated in most countries. But sex discrepancies favouring boys or girls are found in a few countries and subgroups. • Gender-related barriers: In societies where women have low status and therefore lack access to immunisation and other health services, both girls and boys are less likely to be immunised.

  14. Gender-related barriers to vaccination services • Women responsible for health outcomes of their children, but they do not have the power to make decisions related to child care • Immunisation programmes fail to recognize constraints women face in accessing and utilizing services • Immunisation services are gendered in how they are understood, presented and managed • Mothers’ experience at health centre compromised by power differentials • Men or fathers rarely implicated in vaccination programmes

  15. GAVI and programmatic approach to gender

  16. Opportunities to engage with countries on gender • Existing opportunities: • Applications/reporting and IRC: • Annual Reporting - APRs • Proposals for HSFP – application/guidelines • Proposals for new vaccines – application/guidelines • New and upcoming opportunities: • Decisions on HPV/rubella • Country by Country policy – proposed equity indicator includes 3 ‘triggers’: wealth, geography, and gender • Redesigned Country Responsible Officer role

  17. Monitoring IRC - 2011 APR - revised gender questions 5.3 Monitoring the Implementation of GAVI Gender Policy • In the past three years, were sex-disaggregated data on immunisation services access available in your country? • If yes, please report all the data from 2009-2011 • Have you been using the above data to address gender-related barriers to immunisation access? • If no sex-disaggregated data is available at the moment, do you plan in the future to collect sex-disaggregated data on routine immunisation reporting? • What action have you taken to achieve this goal?

  18. NVS IRC – October 2012 – revised gender questions • NVS guidelines includes as assessment criteria an analysis of immunisation programme including socio-economic and gender barriers • NVS application form specifically requests: • Whether sex disaggregated data is used in routine reporting systems • If gender aspects relating to introduction have been addressed in the introduction plan • Any recent evidence of gender-related barriers

  19. HSFP IRC – May 2012 • Countries were requested to provide an analysis of any barriers to access, including gender-related barriers • HSFP IRC noted on gender and equity: • Most of the reviewed HSS proposals did not adequately consider gender barriers and inequity of access to immunization. • However, none of the reviewed country applications proposed how GAVI-funded HSS interventions will address these challenges. • What is lacking in all the HSS proposals is adequate consideration of how precisely the GAVI HSS funding will address and reduce gender barriers and inequity of access through health systems strengthening interventions and how such interventions will be implemented. • Recommendation that the Secretariat review and revise the guidelines and forms

  20. Monitoring IRC – July 2012 • Monitoring IRC convened sub-group on gender and equity • Monitoring IRC Report included chapter on gender and equity – and a summary table of all gender responses in an Annex • Only 20% of countries reported having sex-disaggregated data available • Monitoring IRC recommended that GAVI should: • review APR section 5.3 to ensure that gender questions address programmatic action rather than solely data collection • consider requesting countries that report no gender barriers, provide no information in 5.3 and/or state no action will be taken, to provide justification • consider requesting countries to analyse sex-disaggregated data and to develop actions to address identified gender barriers

  21. NVS IRC 2011 report - gender • Most countries responded that sex-disaggregated data were not being used in their routine immunization systems, although most collected and analysed these in surveys and other studies.  • The IRC found that hardly any proposal demonstrated that a country had considered gender aspects in any depth. • A few applications simply stated that the country offers immunisation services equally to boys and girls without discrimination, and some countries mentioned that routine EPI data collection forms are being revised to ensure the collection of sex-disaggregated data. • The  implications of addressing gender issues do not appear to be well understood, and some support should be provided to countries to address this deficiency. 

  22. Questions for reviewers • What recommendations can you make on how GAVI can better address gender? • It would be helpful to know whether sex disaggregated data is being reported on? (Is it consistent with the data from Monitoring IRC?) • Have any countries provided recent evidence of gender-related barriers to immunization (eg, lack of decision making power or lack of control over resources by women; constraints for women in reaching and utilising services)? Are any actions described in the application to address these barriers? • With regards to HPV applications, have countries addressed gender aspects within their applications/delivery strategies?

  23. Thank you GAVI/2011/Ed Harris

  24. Basic definitions

  25. Basic definitions Sex or gender: • Sex refers to the biological and physiological characteristics of males and females, such as reproductive organs, chromosomes, hormones, etc • Gender refers to the expected behaviour, roles and activities and attitudes that have been learnt or imposed on us according to our sex. Source: WHO/Dept of Gender, Women and Health

  26. Basic definitions Gender equality or gender equity • Gender equality means equal opportunities and access to resources and services within families, communities and society for women and men at all ages • Gender equity means fairness and justice in the distribution of benefits, power, resources and responsibilities between women and men according to their needs Source: WHO/Dept of Gender, Women and Health

  27. Basic definitions Gender-related barriers to vaccination services: • Barriers to accessing services that are related to social and cultural norms about men and women’s roles Source: WHO/Dept of Gender, Women and Health

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