Report of the Training Programme on Gender (7Th to 11Th September, 2009)

Report of the Training Programme on Gender (7th to 11th September, 2009)

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Report of the Training Programme on Gender (7th to 11th September, 2009)

• Day One : 7th September, 2009

• Day Two : 8th September 2009

• Day Three: 9th September 2009

• Day Four : 10th September 2009

• Day Five: 11th September 2009

• Annexure I Programme

• Annexure II List of Participants

• Annexure III List of Resource Faculty

• Annexure IVList of Resource Faculty from NIHFW

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Report of the Training Programme on Gender (7th to 11th September, 2009)

Training Course for the Health Personnel

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Background Note

Capacity Building in the context of achieving the ICPD Goals and MDGs is one of the major challenges being faced by the developing countries. South-South Cooperation stems out from the premise that there is a wealth of knowledge and expertise among the developing countries. The South has got the capacity that combines attributes, expertise and knows how developmental values. These capacities need to be coherent and strategically oriented to perform and sustain. Capacity is most sustainable when it responds effectively to the needs of the people and is based on long-term vision.

Conscious of the need to move strategically and attain meaningful results, Partners in Population and Development (PPD) conducted a Needs Assessment among the institutions involved in Capacity Building in PPD Member States. It documented their capacity building programmes, the gaps and potentials. Findings delineated the focus areas as well as needs and priorities of countries and also the factors that constrain South-South Cooperation in the field of Capacity Building, in relation to human resources, systems and organizational structure.

At a Consultative Meeting of Experts and representatives of 17 Partner Institutions from the developing countries held in Talcang, China during 10-15 May, 2007, the assessment findings were discussed. Experts proposed development of specific generic modules on selected priority themes to be incorporated and integrated into existing curriculum of PIs and to be utilized through PPD’s Capacity Building programmes. Experts worked intensively to develop generic modules which were shared and discussed among all the Partner Institutions. At another Consultative Meeting held in Dhaka, Bangladesh, on 18 and19 June 2007, experts discussed and finalized the following four modules.

1. A Historical and Institutional Perspective on Population, ICPD Goals and MDGs,
2. Population and Poverty,
3. Reproductive Health and
4. Increasing Human Capacity to Address Gender Equity in Development.

This training programme has been adapted from the Generic Module on “Increasing Human Capacity to Address Gender Equity in Development” and the training module on ‘Gender’ developed by Partners in Population and Development (PPD), the South-South initiative.National Institute of Health and Family Welfare acknowledges the contribution of all the experts from the partner institutions of the Partners in Population and Development (PPD).

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Introduction

T

he adoption of Millennium Declaration in 2000 by the Governments of developing countries has once again placed gender equity and women empowerment as critical developmental goals that mutually reinforce goals of sustainable development. Gender equity has been accorded high priority both as a part of the ICPD Goals and as Millennium Development Goals. The National Rural Health Mission has also accorded high priority to achieve these goals and a number of initiatives have been undertaken by the Government of India to this effect.

During the last three decades, the participation of women in all areas of work and development has increased. This has been possible with various policies and programmes charted out specifically for the development of girl child and women. More specifically, the “Women in Development” or WID approach grew out of the idea that women had been “outside” of the health and developmental process. In order to correct this situation and to integrate them into the mainstream, it was necessary to target the young girls and women. In most cases, women are in a position of socio-economic disadvantage that affects their health and it is thus, necessary to promote interventions that seek to improve women’s disadvantaged situation. Therefore, until equity is achieved, it requires a gender approach to put special focus on women’s situation. In the light of the above, this training programme is organized to sensitize the health professionals on the inter -relationship between gender, health and development.

It is expected that the training course would enable the participants to initiate changes in the policies and/or programmes that would be gender inclusive and gender sensitive in their respective organizations.

General Objective of the training programme was“to sensitize and enhance the knowledge of health personnel for operationalizing gender approach in the health system.”

Following Specific Objectives were framed: At the end of the training programme, the participants willbe able to:

• Describe the concept of gender, health and development,
• Discuss the gender approach and its relevance to areas of health and human development,
• Describe methodologies for applying ‘gender approach’ in their work profiles,
• State the concept of Gender Budgeting,
• Lay down strategies to incorporate gender into health projects and programmes,
• Define methods of gender analysis for their own areas of work, projects and programmes and
• Describe the application of tools for gender analysis and planning the National Health Programmes.

Course Contents

The following contents were covered in the training programme:

• Concept of gender, development and mainstreaming in health sector,
• Gender inequalities of concern,
• Gender Equity and Reproductive Health,
• Tools for gender analysis and planning,
• Concept of Gender Budgeting including entry points,
• Gender appraisal of health programmes using checklists,
• PC-PNDT Act,
• Gender and HIV/AIDS vulnerability,
• Domestic violence and health consequences,
• Analysis of gender aspects in National/State programmes and policies and
• Action Plan.

Methodology

Orientation to concepts was done through lecture-discussion method. Participatory approach was used for practical work and group exercises.

Nature of participants

Programme Officers and other officers involved in the planning and implementation of the National Health Programmes, faculty/ trainers of medical colleges and training institutes and officials of NGOs engaged in data analysis in the health sector participated in the training.

Number of participants:(19) Nineteen participants from – Goa, Maharashtra, Punjab, Sikkim, Tamil Nadu, Haryana, Uttar Pradesh and Delhi (from 8 states) participated in the training.

SessionObjectives: A brief overview of the session objectives planned for the training programme is as below:

Session 1: Concept of Gender and Mainstreaming in health sector,

• Explain the concept of different terminologies: gender, inequal gender relations, gender equity, gender disparities, gender inequalities, gender mainstreaming, gender sensitive and gender balance.

• Describe social, economic and political perspectives of development in relation to gender equity.
• Identify and describe importance of gender equity issues in relation to economic and human development of respective states.

Session 2: Planning for Gender Inclusive Projects & Programmes in Health

• Describe how to plan project/programmes with gender inclusive approach
• Explain thrust areas for addressing gender in policies /projects /programmes

Session 3:Gender Inequalities of Concern in National Health Programmes

• Describe gender issues affecting the health of girl child and women.
• Describe gender inequalities in health.

Session 4: Sharing of Experiences on Gender specific Innovations/schemes by the State Representatives

• Share and list experiences by the state representatives.

Session 5: Gender Budgeting and Entry Points

• Describe practical application of gender budgeting
• Recommend gender budgeting for current equity issues

Session 6: Gender Charter

• Describe the Gender Charter proposed by the Government of India.

Session 7: Gender Appraisal of Health Programmes using Checklist

• Analyze the Health Programmes using the checklist

Session 8: Gender Equity and Reproductive Health

• Describe gender gap in reproductive health policy, programming, service delivery and monitoring & evaluation

Session 9: Gender and HIV Vulnerability

• Describe gender inequalities in relation to the HIV and AIDS epidemic
• Identify and outline the changes needed in gender-based norms and inequalities that make men and women vulnerable to HIV
• Identify gender and HIV and AIDS responses that reduce vulnerability and exposure
• Describe gender inequalities in HIV and AIDS policy, programming, service delivery and monitoring & evaluation

Session 10: Measurement and Evaluation of Gender Inputs, Outputs and Outcomes

• Enhance institutional/organizational change to facilitate integration of gender equity perspective in the management of development results
• Describe basic concepts and practical approaches to results-based monitoring and evaluation
• Demonstrate ability to design monitoring and evaluation frameworks and plans for gender interventions
• Demonstrate techniques specifically used to monitor sub-national levels gender and development interventions

Session 11 & 12: Gender Appraisal of National Health Programmes:

• Undertake gender appraisal of selected National Health Programme using various tools.

Session 13: PC-PNDT ACT

• Describe the legal and ethical consideration of PND ACT.

Session 14: Declining Sex Ratio and Social Responsibility

• Explain the social aspects related of declining sex ratio,
• Suggest strategies to address female foeticide.

Record of the Proceedings

A brief Record of the Proceedingsof the Training Programme:

Day One: 7thSeptember 2009

Inaugural Session: Dr. Dinesh Aggrawal, National Professional Officer, UNFPA.

Dr. Dinesh Aggrawal complemented the National Institute of Health and Family Welfare for undertaking this training programme which is in great demand today. He said that there is realizations that public health goals cannot be achieved succeed without the participation of the women. Hence, a lot of states are initiating partnerships and involving NGOs at grassroot levels to work with poor, women and disabled especially where the reach of the public health system is limited.

He highlighted that gender is a very important element of the health system and the concept has evolved gradually from women as mere beneficiaries to women as partners. The need is to undertake and analyse the specific areas for effective programme and planning. He mentioned that gender is not about females. But it is about the power equations among the males and females in the society.

Given this, there is need to identify the missing links and gaps the in policy programmes in mainstreaming gender. He hoped that this training course would address many such issues and the state level officers present would be able to implement this in their respective states.

Session: Concept of Gender and Gender Mainstreaming in Health

Resource Person: Dr. Poonam Khattar, Reader, Dept. of Education and Training, NIHFW

Dr. PoonamKhattar introduced the concept of gender and gender mainstreaming in health to the participants in the opening session with an aim to sensitize the participants with the concept of gender and need for this training. She gave a brief account of the difference between the two concepts, ‘gender’ and ‘sex’, gender roles, difference between gender equity and gender equality. She introduced the male gender issues and the problems faced by the elderly in the country.

She highlighted the importance and the need of gender mainstreaming in health by giving an example of RCH 2/NRHM. There is a need of male participation in the reproductive health for the success of the programme. She encouraged the participants to assess the gender impact in the ongoing health programmes and reforms in the life cycle approach from the infancy to later years and the problems and the priority action which need to be followed.The session gave a food for thought to the participants about the changes required to address the gender issues in the country.

Session: Planning for Gender Inclusive Projects and Programmes in Health

Resource Person: Dr. Amita Pitre, Gender Consultant, UNFPA

Dr. Amita Pitre started her session by a stimulating question to the participants. She asked the participants “Howthey would like to address some of the issues related to gender after attending this training programme?” Following responses were received from some of theparticipants:

• Increase earning power for women,
• Develop projects on health seeking behaviour,
• Address what is preventing women from availing JSY,
• Train people for community mobilization,
• Incorporate gender equity in focussed projects,
• HIV/AIDS, child sex ratio to be addressed and
• Introduce gender into PIPs with areas with focus on sex ratio at block level.

She focussed on why ‘Gender mainstreaming’ is important inhealth sector. She mentioned that it would help in maintaining the records for immunization as moregirls areaffected by measles.It would also help in monitoring and evaluation to check whether the programhas served its purpose. She highlighted topics such as the role of infrastructure to deliver the services to women in health centre, safeabortion services at 24x7 PHCs, trained health manpower at the service centres at the right time,monitoringnumber of MTPs at the centres, etc.

She mentioned that the ‘Framework for Gender Mainstreaming’ should essentially look at the availability, accessibility and quality of services;facilities, safety and security of women staff and patients; and men’s participation. Thereafter, she focused on some of the principles that need to be considered for mainstreaming gender. These are theavailability of frontline workers, especially women, moving skills closer to women and community,making services responsive and accountableand reducing economic and social barriers faced by women. She concluded her session by citing some of the neglected services such as peri-menopausal and menopausal, community level screening for cervical and breast cancers, treatment for cancers possibly at the district leveland infertility services. Her session generated a lot of discussion related to the role of health personnel in gender mainstreaming.

Session: Gender Inequality of Concern in National Health Programme

Resource Person:Dr. Jagdish Kaur, Chief Medical Officer, Dtte.GHS, New Delhi MoHFW

Dr.Kaur focused on gender dimensions in health sector by discussing on various National Health programmes and related health indicators for males and females.While discussing various solutions to the issues related togender, she stated that awareness generation, education, sensitization, empowerment, right to health/health care and related issues – social, economical, etc, can resolve the problems.

Day Two : 8th September 2009

Session: Concept of Gender Budgeting, Entry Points and Gender Charter

Resource Person: Dr. Sulochana Vasudevan, Joint Director, Women’s Division, National Institute of Public Cooperation and Child Development (NIPCCD), New Delhi

Dr. Sulochana Vasudevangave thefollowing topics centred around gender among the participants and sought theirs views:

• Sex and Gender,
• Gender Bias and Gender Equity,
• Gender Analysis,
• Gender Division of Work and Unpaid Care Work,
• Equality and Equity,
• Gender Neutral and Gender Blind,
• Sex / Gender Disaggregated Data,
• Practical Gender Needs Vs Strategic Gender Needs and
• Gender Mainstreaming.

The views expressed helped the participants to internalize the concepts related to gender budgeting.She discussed the conceptual framework of ‘Gender Responsive Budgeting’ and emphasized that it is not about having separate budgets for women, men, girls or boys and about setting aside X% for gender/women. Thereafter, Dr. Vasudevan introduced the “Gender Charter” developed by the Government of India.

Session: Gender Appraisal of Health Programmes Using Checklist

Resource Person: Dr. Paramita Majumdar, Consultant, Ministry of Women and Child Development, New Delhi

Dr. Majumdar discussed on the need toanalyze budgets froma gender perspective. She pointed out that analysis of budgets provides an opportunity to examine the commitment of the government, linkages between allocations and disbursements, delivery of immediate benefits, services for women and girls, gender equality outcomes and also forms one of the bases on which the budget for the next financial year is drawn.

She defined gender budgeting as the process of conceiving, planning, approving, executing, monitoring, analyzing and auditing budgets in a gender-sensitive way. She explained that it involves analysis of actual government expenditure and revenue on women and girls as compared to men and boys and it helps governments to decide how policies need to be made, adjusted and reprioritized.

The basic pre-requisites for GB are gender orientation and sensitisation of government and non-government stakeholders, orientation to the concept and tools of Gender Budgeting and sex-disaggregated database. She explained the entry points and corresponding stepsrequired in gender budgeting. She concluded the session by stating a few roles which can be undertaken by the health professionals as given below:

1. Assess budget allocations and propose additional allocations for gender-related schemes/components,
2. Analyze and review policies, strategies, programmes and schemes from the perspective of improvement of the situation and status of women,
3. Identify constraints in flow of funds to women,
4. Institutionalize generation, collection and compilation of sex disaggregated and other gender relevant data,
5. Monitor spending and service delivery and
6. Assess the extent to which women are benefiting under the schemes and programmes of different Departments.

Session: Domestic Violence against Women

Resource Person: Dr. Mirambika Mahapatra, Reader, National Institute of Health and Family Welfare, New Delhi

Objectives of this session was to increase the level understanding of affects of domestic violence in public health and understand the role of health professionals in reducing its impact. She stated that violence is a violation of the human rights of women anddomesticviolence is a learned behaviour which is a common problem in every race, religion, ethnic group and social class and in both heterosexual and homosexual relationships. She said that domestic violence is a systematic pattern of intentional intimidation through the use of threats and violence for the purpose of gaining power and control over one’s partner in an intimate relationship. The session focused on various data in NFHS III on the theme and Domestic Violence Act.