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p. 7 of 8 BACK | NEXT Purpose of the checklist Why is gender important in health projects? Key questions and action points in the project cycle Gender issues in the health sector Gender issues in reproductive health Gender issues in family planning Gender issues in health delivery systems Strategies for gender mainstreaming in health projects

Gender Checklist: health

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Gender issues in health delivery systems

Key questions

• How effective are health services for women and men in the client population? At the primary level? Secondary level? Tertiary level? Are primary levels being bypassed for higher levels of care?
• What socioeconomic or cultural constraints do people face in accessing health services at each level? Are there differences in access between women and men?
• What associated health services (water supply and sanitation improvement, other disease control measures) do women and men in the client population have access to? To what extent do women and men actively participate in planning and managing such programs?
• Are changes being proposed in the provision of health services that will change gender relations? How will the changes affect women? Will the changes be acceptable to women/men?
• What formal health delivery systems are available to the client population, both clinical and nonclinical? To what extent do women use them? What is the ratio of female users to male users?
• Are there women health workers in the community? What are their roles?
• Is recourse to traditional medicine and traditional healers common in the project area? Is traditional medical knowledge mainly the province of men or women? Are traditional practitioners mainly male or female? Are there female traditional birth attendants?
• What traditional health measures are practiced locally? Do health delivery systems make use of traditional knowledge? Would an inventory of tra-ditional notions and practices assist the program?
• What are the constraints preventing more women from being trained or being appointed as health providers?
• What factors reduce women’s access to health services? Consider factors such as timing of ser-vices, lack of time for women, distance, lack of money for transportation, restrictions on women’s movement in public, lack of female staff in clinics, lack of privacy for examination, complicated or intimidating procedures, poor facilities.

• Collect sex-disaggregated data on the use of formal and informal/traditional health services and access to medicine.
• If the intention is to strenghten basic health services, then focus on supporting primary health care units.
• Locate family planning clinics or health centers where they are conveniently accessible to women. Ensure that hours of service delivery fit in with women’s work schedule.
• Improve the knowledge of the client population about health matters, to enable them to participate in improving health and associated services. NGOs or community-based organizations may be involved in such initiatives.
• Establish an emergency transport system in communities by supporting the currently most feasible methods of emergency transport and community commitment to transport women to hospital.
• Lower the cost of primary health services for poor individuals.
• Discuss gender issues, particularly the need for active participation by women as health providers and recipients of health services, with the executing agency/government ministry.
• Consider how women’s groups and networks can be encouraged to assist women in learning about health issues and supporting one another.
• Consider whether the executing agency can link up with NGOs for service delivery, such as for the training of field workers, to involve men and women in the community. Provide enough funds for this.
• Ensure that the executing agency places sufficient emphasis and devotes adequate resources to training women as health providers at all levels of the health delivery system.
• Consider assisting the executing agency in recognizing the need and taking action to increase the number of female health service providers by recruiting women for all areas of health delivery, as community health workers, health educators, doctors, health administrators and manager, nurses, midwives, and paramedics.
• Encourage the executing agency to make use of the services of community groups or NGOs in the delivery of health-based services and family planning.
• If necessary, ensure that women are trained as health providers at all levels of the health delivery system.
• Set quotas for the number of women to be trained by the project and/or to be appointed to positions in the project, including supervisory positions.
• Train health workers to treat and support preventive measures for the health problems that primarily afflict women (such as backaches caused by carrying heavy loads on the head, anemia from poor diet or frequent childbirth, eye and lung diseases caused by cooking smoke, lack of rest during pregnancy).

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