By Stella Abah, Gender, Social Inclusion, & Community Engagement Advisor, IHP Kebbi State, Nigeria

Gender roles are expectations set by society to define and explain how women and men should act based solely on whether they are born male or female. Despite different generations possessing their own distinct values in this regard, there are nonetheless rigid widespread similarities in how gender is perceived.[1] Rigid gender norms and gender inequalities drive ill health for women, men, girls and boys, and contribute to poverty.[2] That means everyone can be a victim of these gender norms. An adolescent girl who may want to go to school in Kebbi may be denied access to education due to the culture’s predominant restrictive gender norms and biases that creeps in at the community and home level. Such girls are sometimes forced into early marriage – often with men much older –  putting them  at greater risk for complications in pregnancy, HIV and sexually transmitted infections (STIs), exploitation and more risk of gender-based violence (GBV).[3] For boys, an emphasis on being strong or macho encourages them to engage in risky behaviors like smoking, drinking and using drugs at an earlier age.[4] They’re also more likely to get injured in traffic and occupational accidents, and die of homicide.[5]

Gender norms and related power dynamics can have particularly negative impacts on health and pose significant barriers to achieving improved health outcomes. For example, if men refuse to allow women to travel to the health center for regular pre-natal check-ups, the health of pregnant mothers and their unborn children are put at grave risk.  If men feel that they are too ‘macho’ to seek health services, they may leave conditions untreated and put their own health and well-being at risk.  If men and women do not collaborate to protect and advance the health of their families, they may perpetuate negative health outcomes that continue to plague Kebbi state.  In promoting greater human development and human rights, we must prioritize interventions that advance gender equality as it is essential to achieving significant and sustainable progress related to health.

The USAID Integrated Health Program (IHP) works in Kebbi State to strengthen health systems and improve access to and quality of reproductive, maternal, newborn, and child health including nutrition and malaria (RMNCH+NM) and primary health care services. As part of these efforts, IHP has worked in close partnership with Kebbi State’s Ministry of Women Affairs and Social Development (MOWASD) to promote gender and social inclusion integration and mainstreaming across activities, programs, and institutions.

Based on a Kebbi State strategy to address some of these gender barriers and promote gender and social inclusion (GESI) in Kebbi State, IHP in collaboration with MOWASD, officially launched the Gender and Youth Desk Officer (GYDO) role and led a three-day technical training of existing local government area (LGA) personnel and Women’s Coordinators from the State and LGAs to enhance their awareness of GESI issues, and better equip the GYDOs to provide GESI-related technical support to their constituents and the communities they serve. IHP also supported the MOWASD in developing an updated job description (JD) for the GYDOs to guide their work and enhance their delivery. As a result of this training, the capacity of the GYDOs to recognize and identify different GBV scenarios as it applies to their day to day experiences in their communities was enhanced. In addition, they identified health issues, their relation to GESI and their root causes using the “Problem Tree” exercise and developed action plans to address these issues.

As attested by one of the GYDOs, “This training has made us to be so powerful. To face our people in our village. We feel free. We feel encouraged to apply our messages and go to the health facility and give the lectures.”

Monitoring and Support

The IHP Gender Social Inclusion and Community Engagement (GSI-CE) Advisor developed a tracking tool which is being used to guide the GYDOs work and enhance their capacity. Through regular check-in calls the Advisor has provided ongoing mentoring and capacity building to the GYDOs while tracking their activities.

Results

The capacity of the GYDOs was strengthened with regards to their mobilization skills towards positive health seeking behavior in diverse populations, such as pregnant women, breastfeeding mothers, first time mothers, and adolescent girls and boys. The GYDOs also worked closely with the LGHA service providers focusing on health and hygiene. Prevention and control measures for Covid-19, addressing GBV issues and awareness, and improving nutrition at the Ready to use Therapeutic Food (RUTF) centers were key areas of engagement. In addition, four GYDOs from the Ministries Departments and Agencies e.g. Kebbi State Primary Health Care Development Agency, State Ministry of Health, Ministry of Women Affairs and Social Development and State Ministry of Education are now integrated into the State and food and Nutrition Committee, which means they will participate in State Food and Nutrition Committee activities to address gender barriers affecting women, adolescents and children around lack of access to highly nutritious foods, poor feeding practices, inadequate breastfeeding, offering the wrong foods, to promote adequate growth, good health and development outcome for the adolescents and children. IHP will continue to provide technical guidance, capacity building, and monitoring support to the GYDOs to promote GESI and collaborate with community partners and institutions to help improve the health status of individuals and families in Kebbi State.


[1] Weber, A. M., Cislaghi, B., Meausoone, V., Abdalla, S., Mejía-Guevara, I., Loftus, P., … & Buffarini, R. (2019). Gender norms and health: insights from global survey data. The Lancet, 393(10189), 2455-2468.

[2] Bianco, M. (2018). New research explores how gender norms affect health outcomes. The Clayman Institute for Gender Research. Retrieved from:  https://gender.stanford.edu/news-publications/gender-news/new-research-explores-how-gender-norms-affect-health-outcomes

[3] Lilian, G. K., Nancy, I. A., Odundo, P. A., Akondo, J. O., & Ngaruiya, B. (2015). Early and Forced Child Marriage on Girls’ Education, in Migori County, Kenya: Constraints, Prospects and Policy. World Journal of Education, 5(4), 72.

[4] Ozer, E. M., Adams, S. H., Orrell-Valente, J. K., Wibbelsman, C. J., Lustig, J. L., Millstein, S. G., … & Irwin Jr, C. E. (2011). Does delivering preventive services in primary care reduce adolescent risky behavior?. Journal of Adolescent Health, 49(5), 476-482.

[5] Singh, S. (2017). Macho Man, Little Princess: How Gender Norms Can Harm Kids Everywhere.NPR.  Retrieved from: https://www.npr.org/sections/goatsandsoda/2017/09/21/552573637/macho-man-little-princess-how-gender-norms-can-harm-kids-everywhere