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Using a Gender Strategy for Iterative and Adaptive Gender Integration

Written by: Elizabeth Stones

You’ve completed your project’s gender analysis, but what do you do with the findings? How can you ensure the recommendations will be implemented consistently? How do you hold your staff accountable to ensure gender integration in all project activities?

In Ethiopia, the USAID Transform: Primary Health Care project’s process for developing, monitoring, and updating its project-level gender strategy exemplifies EnCompass’ collaborative and strengths-based approach to gender integration. The team convened project and external stakeholders at key reflection points to identify gender-related needs and opportunities, design gender-sensitive and gender-transformative interventions, assess progress and impact, and adjust interventions.

The project’s gender strategy guided and documented this process. It outlines the vision, approaches, and measures for gender integration activities. Importantly, it is a living document. The gender team updates it each year following an annual review with the leaders of each technical team (leadership, management, and governance; health system strengthening; quality improvement; maternal and newborn health; reproductive health and family planning; and the adolescent health and youth development; and other teams).

This iterative process has enabled continual assessment and adaptation to collaboratively strengthen gender integration across the project’s result areas. There are five main steps.

1. Begin with strong partnerships

High-quality gender integration begins with high-quality partnerships. The USAID Transform: Primary Health Care project is a 5-year initiative aiming to prevent child and maternal deaths and support the Ethiopian government to implement its Health Sector Transformation Plan. Pathfinder International implements the project in collaboration with Ethiopian and international partners JSI Research & Training Institute, Inc., Abt Associates, EnCompass LLC, the Ethiopian Midwives Association, the Federal Ministry of Health, regional health bureaus, and zonal and woreda* health offices.

Within the project’s overall aims, the team focuses on maternal, newborn, child, and adolescent health and nutrition; family planning and reproductive health; and malaria. Recognizing that gender equality is a key social determinant of health and necessary for achieving the project’s goals, the project committed to gender integration from the start. That commitment carries through the entire project implementation cycle.
As the gender partner for the project, EnCompass provides support and guidance across result areas and technical teams, leads implementation of specific gender-related interventions, and provides direct support to the Women, Children, and Youth Affairs Directorate of Ethiopia’s Federal Ministry of Health.

2. Use evidence to implement and adapt gender integration

The project implemented and adapted gender-related activities based on evidence. In 2018, the project—with engagement from the Women, Children, and Youth Affairs Directorate—conducted a gender analysis that engaged project staff and stakeholders from its inception through the development of final conclusions and recommendations.

The team undertook this participatory process to ensure alignment with priorities and to use the gender analysis findings for meaningful gender integration for the duration of the project. The gender analysis and consultation process was also an opportunity for capacity strengthening with the ministry and helped inform policy priorities at the federal level.

Findings from the initial gender analysis led the project to conduct subsequent studies about the availability and quality of gender-based violence prevention and response services and the adaptability and scalability of a proven male engagement intervention.

3. Continue applying evidence in gender strategy development

Evidence generated in the gender analysis informed the development of the gender strategy. Following a consultation with project leads, USAID, the Federal Ministry of Health, and other stakeholders to share and discuss findings, conclusions, and recommendations from the 2018 gender analysis, EnCompass led a participatory workshop with project technical leads to put the recommendations into action.

Together, we developed an overall vision for gender integration in the project, specific activities to achieve that vision for each result area, a monitoring and evaluation strategy, and an action plan. The team documented these outputs in the gender strategy to guide technical teams as they implemented activities.

For example, the gender analysis showed that female employees in the health system faced difficulties in advancement, leadership, and retention. During the initial strategy workshop, the team proposed a gender-sensitive training leadership, management, and governance program to teach leaders how to better support and promote female workers and introduced a female-only cohort for targeted leadership training and mentorship. To date, 78 women from female-only cohorts have completed the training, and 8 of these women were recently promoted to leadership positions. For more examples, see the team’s synthesis of successes from the project’s gender integration interventions.

4. Keep the gender strategy alive

The USAID Transform: Primary Health Care project’s gender strategy is a truly living document that the team revisits through gender strategy reviews during each annual work planning process. In May 2019, EnCompass team members facilitated the review as a participatory workshop. In June 2020, COVID-19 restrictions and connectivity challenges required adaptation, so the team facilitated the review through an online survey.

During both reviews, technical team leaders shared gender integration successes from the previous year in order to identify effective strategies the project could build on, as well as opportunities for continued improvement or support. The team leaders used the outputs from these discussions to prioritize, adapt, and develop activities for the upcoming year to strengthen gender integration, and included the outputs in the annual update to the gender strategy.

5. Assess gender integration outcomes and impact

In its final year (2020–2021), the USAID Transform: Primary Health Care project will conduct a follow-up gender assessment and final gender strategy review to ascertain the extent and impact of its gender integration activities. The study will also identify opportunities for the Federal Ministry of Health and local entities to continue increasing gender equity in primary health care and other future programming.

Gender integration does not need to be daunting. This blog post has outlined five straightforward steps your project can follow to translate your gender analysis from a “checked box” to a set of impactful interventions that help reduce gender equality and close equity gaps in your programs. If your project could use some help, please visit our Work with Us page, which includes an email contact, or put a note in the comments below.


* Woredas are third-level administrative divisions in Ethiopia. The country divides itself into regions, zones, woredas, and kebeles.

Photo by USAID/Morgana Wingard (CC BY-NC-ND 2.0)

Elizabeth Stones

Senior Gender Specialist

Elizabeth Stones supports EnCompass’ technical assistance and evaluation work through resource development, evaluation, and training to integrate gender in health programming. She has 7 years of experience providing program management and technical assistance for gender integration, reproductive health, family planning, HIV/AIDS, and violence prevention programs in Sub-Saharan Africa, Latin America, and the Caribbean. Before joining EnCompass, she was a public health analyst at RTI International, managing HIV seroprevalence and behavioral risk studies in West Africa and providing technical support to global health research and technical assistance projects including a multi-country Zika in pregnancy study and a health system strengthening program in Guinea. As a program analyst at Global Communities, she provided support to PEPFAR programming in Rwanda, including technical assistance for the start-up of DREAMS-like activities. She also served as a gender, sexual health, and English educator for Peace Corps Rwanda. Ms. Stones holds an MPH in Women’s and Reproductive Health from Johns Hopkins Bloomberg School of Public Health. She speaks fluent English and French.

1 Comment

  • Joy Edith Angulo
    October 5, 2020

    Thanks to Liz and the communication team. The USAID MCHN Activity in Uganda has just concluded a GYSIA. These steps have come in handy as we seek to integrate gender in all the MCHN activties and ensure that findings and recommendations are acted on and implemented.


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