Going All the Way: Gender Integration Beyond Sex Disaggregation

1. Going All the Way: Gender Integration Beyond Sex Disaggregation Brittany Iskarpatyoti, MPH Jessica Fehringer, PhD MEASURE Evaluation December 2017

2. Integrating Gender

3. Integrating Gender… Is Like a Puzzle So, let’s think of it that way! ▪ Each of you have been given a puzzle piece ▪ Find the other TWO pieces that match yours and sit with those people! ▪ Hint: each puzzle has the same general structure:

4. Each of these puzzles represents a real-life issue to which MEASURE Evaluation staff has responded. Integrating Gender… Is Like a Puzzle Gender Norm Implications for Research MEASURE Response

5. Puzzle 1: Gender and HIS Gender norms affect health outcomes of men, women, boys, and girls differently Gender Norm Sex and age disaggregation is increasingly required in HIS, but not all systems adhere and not all systems have the same disaggregations. Implications for Research MEval actively monitors the data exchange between health information systems, including sex- and age-disaggregation, and coordinates the use of matching disaggregates. MEASURE Response

6. Puzzle 1: Gender and HIS DATIM–HIV testing 62 58 103 25 <15, male >15, male <15, female <15, female FACTS Info–HIV testing <15 years old >15 years old

7. DATIM–HIV testing 62 58 103 25 <15, male >15, male <15, female <15, female FACTS Info–HIV testing 62 58 103 25 <15, male >15, male <15, female <15, female Puzzle 1: Gender and HIS

8. Puzzle 1: Gender and HIS Considerations for harmonizing disaggregates: ▪ Organizational • System owners • Motivation • Stakeholders ▪ Technical • Manual mapping • Automatic exchange ▪ Behavioral • Data collection • Data analysis and use

9. Puzzle 2a: Gender and Evaluation Gender and Field Team (BMMS 2016) Field teams generally have male supervisors. Gender Norm This may create power imbalance in the team if the male supervisor is not receptive of feedback from the team. Which might create hindrance for field level activities. Implications for Research MEval encourages participation during the de-briefs of the whole team, so not only the supervisors speak. MEASURE Response

10. Puzzle 2b: Gender and Evaluation Gender and Data Collection Time (BMMS 2016) Survey respondents are often women with household responsibilities and workloads. Gender Norm The workload of the respondents can impact timing of data collection and quality of data. Implications for Research Data collection agencies take into account respondents preferred time to participate in the survey, so that the collected information are not given in haste. MEASURE Response

11. Puzzle 2c: Gender and Evaluation Gender and Cultural Sensitivity (BMMS 2016) Women are expected to cover themselves in public, in some clusters. Gender Norm When doing research, interviewers need to consider how they present themselves to be accepted into clusters. Implications for Research Female interviewers needed to cover the head to enter the cluster. MEASURE Response

12. Puzzle 3: Gender and Key Populations Gender has traditionally been understood as a “woman’s empowerment” issue. Gender Norm Gender analyses lack important information on key populations (KPs). Implications for Research MEval is reviewing the “state of the evidence” on gender integration and KPs programming. MEASURE Response

13. Puzzle 3: Gender and KPs ▪ Focus on Haitian female sex workers (FSWs) in the Dominican Republic to describe gender norms, gendered relations, and the influence of race/ethnicity, legal status, and economics on these norms and relationships ▪ Identify gender-related factors (aim 1) that increase vulnerability to HIV infection and serve as barriers to HIV testing, treatment, care, and retention for Haitian FSWs Sex work and intersectionality

14. Puzzle 3: Gender and KPs Female partners of people who inject drugs (PWID) in Vietnam ▪ Understand the gender-related factors influencing stigma and HIV prevention and treatment UNAIDS Vietnam 2015 Country Progress Report http://www.unaids.org/sites/default/files/country/documents/VNM_narrative_report_2015.pdf

15. Gender norms typically dictate men are in control; programs challenging this may lead to household conflict and can impact the overall health and well-being of caregivers and OVCs. Evaluation studies of OVC programs and/or programs on economic empowerment need to consider using gender norms and gender-based violence (GBV) measures. MEval included measures on youth attitudes towards gender equality and GBV in youth survey and experience of GBV in caregiver survey. Experience of GBV questions must follow specific ethical procedures in data collection. Puzzle 4: Gender and Orphans and Vulnerable Children (OVC)

16. Puzzle 4: Gender and OVC

17. Men and women frequent different types of venues and transmit HIV in different ways in different locations. Gender Norm Visualizing condom distribution needs to take into account the separate behaviors of different subpopulations, such as men and women. Implications for Research Maps made for studying HIV transmission behaviors reflect the underlying behaviors both by venue and by type of population visiting each venue. MEASURE Response Puzzle 5: Gender and geographic information systems (GIS)

18. Puzzle 5: Gender and GIS

22. Contact a gender advisor: MEASURE_gender@unc.edu Still Have Questions?

23. 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. www.measureevaluation.org