Click a country below to learn about WI-HER’s experience!
Democratic Republic of the Congo : WI-HER led the development of a gender analysis and a Gender Implementation Strategy for Chemonics' Improving Reading, Equity, and Accountability (I-READ) Project in the DRC, which aims to improve equitable access to education and learning outcomes for girls and boys. WI-HER developed a gender analysis to identify gender-related constraints and opportunities, and provided subsequent training and recommendations to I-READ staff and partners to address gender-related issues. The gender implementation strategy will assist I-READ staff to address gender issues and provide illustrative strategies to redress gaps and barriers to equal educational attainment. With the USAID ASSIST Project, WI-HER trained Kinshasa QI team members on gender integration in QI during a Learning Session. The customized training aimed to build local capacity to identify and respond to gender-related gaps to improve linkage, retention, and adherence in HIV testing, care, and treatment. The training included exercises and discussions on the differences between sex and gender; a review of our six-step approach to gender integration; an overview on how to conduct a gender analysis; sex-disaggregated and gender-sensitive data collection and analysis; and exercises and discussions on gender issues affecting ASSIST DRC facility QI work.
Tanzania : WI-HER provided technical assistance to USAID/Tanzania to conduct an assessment to identify key gender issues and gaps that affect the diagnosis and treatment of severe febrile illness among children under the age of five in the Lake Zone of Tanzania in the Tibu Homa Project. WI-HER staff developed a conceptual framework that depicts how gender influences the vulnerability of girls and boys under five to febrile illness as well as treatment-seeking behavior by women and men, qualitative and quantitative assessment methodologies, and data collection tools, which included focus group discussions and key informant interviews and surveys. Technical support provided by WI-HER for data collection and analysis, resulted in recommendations for USAID/Tanzania
Botswana : With the USAID ASSIST Project, WI-HER supported Botswana ASSIST staff to build their capacity for integrating gender in their quality improvement (QI) work to strengthen the community health system response to HIV/AIDS. WI-HER provided customized training over three days, aimed at building local capacity to identify and respond to gender-related gaps to improve linkage, retention, and adherence in care at the community level. The training included exercises and discussions on the differences between sex and gender; an in-depth review of our six-step approach to gender integration; an overview on how to conduct a gender analysis; sex-disaggregated and gender-sensitive data collection and analysis; sensitization to and discussion about gender-based violence; and exercises and discussions on gender issues affecting ASSIST Botswana community QI work.
Burundi : As the lead gender integration partner on the USAID ASSIST Project, WI-HER supports all ASSIST teams in their efforts to identify and address gender issues in their projects. In Burundi’s PMTCT project, this led to an effort to increase male partner testing in order to improve maternal and child health as well as expand men’s access points for health services. A number of activities were tested, including sending invitation letters to male partners inviting them to visit the health care facility, offering desirable incentives for couples, and using male leaders to educate male community members on the advantages of couples HTC. As a result, the rates of male partner engagement and male partner testing increased, as did the rate of pregnant women enrolled and tested for HIV, and the number of exposed children were tested at 18 months.
Côte d’Ivoire : WI-HER worked with the USAID ASSIST Project to integrate gender in nutrition assessment, counseling, and support services. Initially, facility-level data were sex-disaggregated but quality improvement data collection tools did not allow for the collection of sex-disaggregated data. WI-HER worked with the ASSIST Côte d’Ivoire team to adapt documentation, enrolment, and retention data collection tools to include sex r to allow for the analysis of sex-disaggregated data. This then allowed for the analysis of sex-disaggregated data and introduction of gender-sensitive improvement efforts and indicators, as appropriate.
Ghana : With Millennium Challenge Corporation (MCC) funding, WI-HER is currently leading the development of a Social and Gender Inclusion Plan (SGIP) for the Ghana Compact. The SGIP will serve as an operational guide and a monitoring tool to ensure a systematic gender and social inclusion process during the implementation of Compact projects and activities. We are working with several electricity companies – the Compact’s Implementing Entities – to identify entry points for greater diversity, social inclusion and female participation in the energy sector, focusing on projects that deal with electricity generation and distribution. For the SGIP, we worked to develop key activities and recommendations for gender and social inclusion in areas that included private sector participation, infrastructure improvements, power outage and technical loss reduction, performance monitoring, education, and public information, amongst others.
Kenya : WI-HER worked with the USAID ASSIST Project team in Kenya to identify and respond to gender-related barriers to antenatal care (ANC) that pregnant women face. Improvement efforts included the initiation of male partner testing, and involvement and education of male partners during couples’ visits to ANC clinics. WI-HER also worked with the Kenya team to identify and address gender issues in orphans and vulnerable children (OVC) activities. The team identified early marriage, female genital cutting, unequal nutritional access, and late/no birth registration as issues negatively affecting girls’ health and education outcomes. The team promoted changes to respond to these issues, including linking girl students with older female role models in the community, and educating and sensitizing parents, caregivers, community health volunteers, and older children on prevention, basic treatment, and referrals to health clinics. The team also identified that boys who had undergone traditional circumcision had higher school dropout rates in part due to the cultural norm that they were now men, and responded by working with community leaders and creating a mentoring program between male college students and boys undergoing circumcision, which contributed to a decrease in dropout rates.
Lesotho : WI-HER developed and delivered a customized gender sensitization and gender integration training to build local ASSIST staff capacity for gender integration. Through this training and additional support, gender-related issues affecting project health outcomes were identified. These included high rates of adolescent pregnancy and its negative impacts, including girls dropping out of school. Interventions such as involving male partners and mothers-in-law were identified as potential ways to help improve the retention of mother-baby pairs in health services.
Malawi : WI-HER trained ASSIST staff and improvement teams in gender integration in quality improvement (QI). This led to ASSIST staff and improvement teams collecting and analyzing sex-disaggregated data and conducting a root cause analysis to identify the underlying gender-related gaps in educational performance between girls and boys. Improvement teams then tested a variety of changes to overcome issues identified. For example, at one primary school it was identified that most girls who failed exams did not attend school regularly and had a heavy load of domestic chores. The ASSIST team then established Malawi Mother’s Groups as a vehicle through which older women could counsel girls on the importance of education and the negative impact of dropping out of school. These groups also tracked girls’ daily school attendance and performance. WI-HER also developed customized gender sensitization and gender integration materials for local ASSIST staff to use in malaria and febrile illness focused QI trainings and learning sessions in order to identify and address gender issues and build the capacity of implementing partners and QI Teams to integrate gender.
Mali : WI-HER delivered a training to USAID ASSIST Mali staff to build local capacity in gender integration. The training included defining gender and related concepts; understanding the steps to conduct a gender analysis; understanding how to develop, analyze, and report on sex-disaggregated data and gender-sensitive indicators; identifying and addressing gaps and issues related to gender in ASSIST activities; and gender-sensitive program planning. With WI-HER staff assistance, ASSIST Mali also conducted a gender analysis to inform their activities. In addition, WI-HER developed customized gender sensitization and gender integration materials for local staff to use in learning sessions and QI trainings.
Niger : WI-HER supported USAID ASSIST staff in Niger to identify and respond to gender-related issues affecting post-partum family planning (PPFP) uptake through the sensitization of health facility teams to gender issues and through the involvement of husbands. Successful approaches included designating a special space for counseling, making FP services available 24 hours a day instead of only in the morning, taking advantage of PP women’s discharge day to conduct couples’ counseling on PPFP, and sending an invitation to husbands (by phone) to be present at their wives’ hospital discharge thus creating an opportunity to conduct PPFP couples’ counseling.
Nigeria : WI-HER worked with the ASSIST team in Nigeria as a continuation of the work from the predecessor Health Care Improvement (HCI) project which worked at the national level and in 12 states in Nigeria: Lagos, Ekiti, Cross River, Akwa Ibom, Enugu, Ebonyi, Kaduna, Kano, Taraba, Bauchi, Benue, and Federal Capital Territory. The work focused on improving standards of care for orphans and vulnerable children and children infected and affected with HIV.
South Africa : In South Africa, WI-HER worked with the USAID Health Care Improvement (HCI) Project to analyze gender issues in HIV testing. Using sex-disaggregated data, we identified a major gap in HIV testing between men and women, even when controlling for women who received an HIV test as a part of routine antenatal care. HCI implemented changes to increase testing among men, narrowing the testing gap between men and women and increasing the number of men tested by 34%. Gender-sensitive changes included emphasizing couple HCT, male partner involvement, and targeting men for family planning education and updates.
Swaziland : WI-HER worked with the ASSIST team in Swaziland to address gender-related challenges in strengthening the implementation of integrated TB/HIV prevention, care, and treatment. One such issue was the lag in male uptake of ART compared to female uptake. With support from WI-HER, the team designed communication activities and materials, including the establishment of male group discussions and mixed group discussions regarding male uptake of ART, and scaled up the promotion of partner testing and family-centered approaches. In the Hhohho region of Swaziland, WI-HER worked with the Health Care Improvement (HCI) Project and identified that more women than men received treatment for drug resistant TB, which is inconsistent with epidemiological data. HCI then led clinics to test specific changes to promote treatment among men and identified ways to successfully retain them in care. The project also focused on reducing barriers that young girls and women face in accessing HTC by integrating HTC into ANC and FP services.
Uganda : There is great interest among Health Care Improvement project staff, USAID, Ministry of Health, and regional, district, and facility-level health workers in achieving better gender integration through quality improvement. HCI/Uganda has opportunities in all technical areas to pursue gender integration within current work plans and scheduled activities. WI-HER supported HCI in promoting gender integration in coaching visits and with the Ministry of Health and Village Health Teams. By doing so, knowledge expanded quickly and increased interest in gender integration and the empowerment of men and women was generated. Such high momentum was important to maintain and translate into actions for the benefit of even more successful program implementation in Uganda. In a very short time we were able to not only connect and present on gender integration in Quality Improvement processes, but also to bring this important topic to high-level policy and program discussions. Integrating gender into Quality Improvement has made this concept more acceptable. Dr. Sarah Byakika of the MOH said that “gender has been always a priority to us, but we did not know how to do it, now there is a way”. WI-HER has also worked with the USAID ASSIST Project in Uganda to integrate gender considerations in quality improvement activities across a range of health services. Numerous trainings on gender integration to build the local capacity of ASSIST staff and implementing partners have led to ASSIST staff to be able to identify and respond to gender issues in nearly every activity. In maternal and child health, the staff analyzed barriers preventing pregnant women from attending antenatal care (ANC) clinics and delivering at a health facility, finding that more than 20% of pregnant women said the ANC clinic’s rule that a spouse be present was a reason they did not attend ANC in the first 16 weeks of gestation. Nearly 30% said they did not go to a health facility to deliver because they were afraid to tell their husband when labor started, and many women lacked money for transport. Staff also worked to improve the retention in care of HIV-positive mother-baby pairs by encouraging male partner involvement, involving male community leaders/volunteer health workers, utilizing family support groups, and offering male-focused services. Through the VMMC Project the team worked to increase female partner involvement by creating an awareness campaign on the importance of female partner involvement and providing tailored education sessions and services to female partners, which contributed to improved adherence to follow up visits, as well as a decrease in adverse events.
Zambia : WI-HER developed and delivered a customized gender sensitization and gender integration training to build local staff capacity for gender integration. After this training and with WI-HER support, USAID ASSIST Zambia staff was able to identify that more females than males were accessing health services, assessed for nutrition status, and were malnourished, but also that males improved their nutrition substantially quicker than females once in treatment because of cultural norms regarding food allocation within families. Staff recognized the need to mitigate this identified gap and institute gender-sensitive programming in order to reach all clients equitably.
Myanmar : WI-HER developed and facilitated trainings on gender, harassment in the workforce and human trafficking for University Research Co. (URC), field staff in Uganda, Tanzania, Cambodia, and Myanmar to ensure that all URC field office staff are aware of and comprehend URC policies. A holistic, integrated approach was used to identify and respond to the differing needs of men and women. Trainings aimed to promote positive, healthy practices for greater gender equity and increased productivity and quality of work and used updated, engaging techniques, including interactive workshops that engaged participants through various media and participatory exercises.