Presented by Brittany Schriver Iskarpatyoti at the 2016 AEA conference.

1. Evaluations of Gender-Integrated
Reproductive Health Interventions:
A Review of Measures and Designs
Brittany Schriver Iskarpatyoti, MPH
MEASURE Evaluation
University of North Carolina, Chapel HiIl
October 26, 2016
American Evaluation Association Conference
Photo: David Snyder, ICRW

2. Outline
• Background
• Study methods
• Summary of findings
• Conclusion

3. Background
Gender inequality is associated
with poor health outcomes
• Higher child mortality, stunting, and
wasting
• Lower maternal health care
utilization, higher maternal
mortality
• Higher risky sex behavior
• Gender-based violence (GBV)
Gender norms and expectations
affect family planning

4. Aim
To conduct a systematic
review of peer-reviewed
articles on evaluations of
gender-integrated RH
programs with regard to:
• Study design
• Gender considerations in data
collection and analysis
• Gender measures

5. Methods
Nested within larger systematic
review of peer-reviewed
articles
• English-language
• LMIC
• January 1, 2008—June 30, 2013
• Evaluation
• Outcome: RMNCH, HIV and other
STIs, GBV, TB, universal health care
• Gender-aware intervention
Electronic database, sourced
bibliography, organizational and
conference website searches
n=2,450
Titles reviewed and
excluded
n=709
Abstracts reviewed and
excluded
n=1545
Final peer-reviewed articles
included in broader review
n=99
Peer-reviewed and grey
literature included in broader
systematic review
n=196
Grey literature excluded
n=97
Abstracts reviewed
n=1,741
Articles with RH as a primary
outcome
n=23

6. Methods
34 point futura and copy
• 24 point futura and copy
34 point gill sans mt and
copy
• 24 point gill sans mt and copy
Source: Interagency Gender Working Group (IGWG). 2013.

7. Methods
Abstracted data:
• Theory of change
• Study design
• Evaluation design
• Sampling
• Endline measures
• Gender integration
• Data collection
• Data analysis
• Outcome measure
Photo by Arundati Muralidharan

8. Findings: Demographics
23 Studies
• 11 accommodating
• 12 transformative
Primarily in:
• sub-Saharan Africa
• South Asia
Sub-Saharan
Africa
39%
South Asia
26%
Latin America
and the
Caribbean
18%
Middle East
and North
Africa
13%
East Asia and
the Pacific
4%

9. Findings: Theory of Change
9 papers (39 percent)
explicitly discussed a
theory of change (ToC)
• Social Learning Theory
• Theory of Reasoned Action
• Health Belief Model
• Information-motivation-
behavioral skills (IMB)
model
• Self-defined ToC
Malawi male motivator project used the
IMB model to impact FP use and
couples’ communication.

10. Findings: Study Design
Methods
• 61% (n= 14) quantitative
• 13% (n= 3) qualitative
• 26% (n=6) mixed methods
Sampling
• 87% (n= 20) basic sampling
information
• 35% (n= 8) discussed
power/calculations
Endline
• 17% (n= 4) included
multiple endlines
• 3 accommodating
• 1 transformative
0
1
2
3
4
5
6
7
8
9
Accomodating Transformative
Study Designs
Qual Quant Mixed

11. Findings: Gender Integration
Data collection
• Same-sex interviewers
• Time/place
Data analysis—sex
disaggreation
• 12 studies collected data from
only one sex
• 9 disaggregated data by sex
• 2 no sex disaggregation

12. Findings: Measures
70 percent of
evaluations reported
including at least one
specific gender-
related outcome
• Only two studies used
validated gender
scales/indices
Common Gender RH Measures
Express favorable/positive attitudes
towards healthy sexuality
Women's increased decision-making
power
Attitudes towards male
participation/support
Increased support (emotional,
instrumental, family planning, or general
support) from partners or community
Increased gender-equitable attitudes and
beliefs

13. Conclusion
Mixed methods
Gender integration throughout
study design
Gender-sensitive measures
Photo by Kim Tyo-Dickerson

14. This presentation was produced with the support of the United States Agency for
International Development (USAID) under the terms of MEASURE Evaluation
cooperative agreement AID-OAA-L-14-00004. MEASURE Evaluation is
implemented by the Carolina Population Center, University of North Carolina at
Chapel Hill in partnership with ICF International; John Snow, Inc.; Management
Sciences for Health; Palladium; and Tulane University. Views expressed are not
necessarily those of USAID or the United States government.
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