Gender Analysis
Annex 4: NZAID gender analysis good practice example
Gender Advisory Support for East Sepik Women and Child Health Project (ESWCHP) - Papua New Guinea
Background
The East Sepik Women and Child Health Project provides critical development services in a part of PNG noted for its almost complete lack of government service, vast populations spread across diverse environments and entrenched, and often violently expressed, gender inequality. It trains often poorly educated women as ‘marasin meris’ to deliver primary health care to rural communities.
The ESWCHP has been supported by NZAID, under the management of Save the Children, New Zealand for 10 years.
Why gender analysis
NZAID’s ongoing appraisal and monitoring of grass-roots health projects in PNG had uncovered a number of gender-related issues that could potentially jeopardise the project’s effectiveness and sustainability. This suggested the need to strengthen the integration of gender equality in project design and implementation.
The NZAID Development Programme Manager (DPM) in consultation with SAEG advisors called for advisory support to conduct analysis of gender related issues; develop strategies to effectively integrate gender equality and women’s empowerment; and identify specific gender equality results for the project. The review team were also to facilitate a two way learning process to contribute to NZAID’s and the project partner’ knowledge and experience in effectively integrating gender equality and women’s empowerment in grass-roots development.
How the Team worked
The review team was comprised of a New Zealand gender specialist with extensive Pacific experience and a locally engaged Papua New Guinean consultant with expertise in community mobilisation and capacity development The team visited PNG to meet and interview relevant personnel including: government officials, Church Health Services, project staff, NZAID, and the Village Health Volunteers, their families and communities. The Team also spent 2 weeks in the East Sepik area, conducting participatory research including gender-based analysis in communities to assess progress towards achieving the project’s original aim of empowering women and reducing gender inequalities.
A participatory approach was initiated from the outset to ensure as many stakeholders as possible, including grassroots health care providers, communities and project staff, were given the opportunity to identify issues and be involved in the design of strategies to promote gender equality and women’s empowerment. The team’s focus was on building relationships with the project partners and communities in order to better understand the ways in which social relations were negotiated and were inherently gendered.
What they found out
ESWCHP offers useful lessons about dealing with gender inequality and advancing women’s empowerment in Papua New Guinea. Most importantly it shows how small incremental support to women provides them with opportunities to more successfully negotiate the complex social relations that characterize their lives and their communities in Papua New Guinea.
Learning lessons from these projects requires an initial understanding that gender differences are not the origin of women’s subordination and oppression. Rather, in PNG, men and women become what they are as they enter into the negotiation of complex social relations. The relative differences accorded to men and women in these negotiations, however, stem from the particular socio-cultural politics of different places, the majority of which deliver more power to men than women.
In order to effect gender equality and empower women, closer attention to these socio-cultural politics of place is required. This is why supporting women in their negotiation of social relations must be the focus of ‘gender work’. Ensuring that women get to the ‘bargaining table’ is the first step and this requires explicit support to grassroots women in the form of, for instance, training opportunities, the creation of meaningful work with some cash returns, and good health.
The identified impacts of the project were deeply rooted in philosophical positions taken at key times in the development of the project. Phase One had been very successful in terms of the identification of an effective way to deliver public health support in isolated communities by the use of locally trained and support ‘marasin meris’. As the project moved into Phase Two, with the increasing integration with the rural health services in PNG and greater focus on infrastructure support, the project lost its focus on women and gender equality.
The health outcomes of Phase One were widely appreciated by the communities. The establishment of a cadre of 332 (mainly women) marasin meri and marasin man (medicine woman and man) who were trained and provided basic family health care in isolated villages were appreciated and there were many anecdotes of their work making a substantial improvement in health and wellbeing of the rural poor. The review identified some areas in which the delivery of these services could be improved to ensure increased positive impact on the health side eg the improved provision of medical supplies.
The review also found that the removal of the explicit gender equality and women’s empowerment goal resulted in the project having a preoccupation with health delivery issues and the initial intended focus on women’s issues was lost and with it the need to support the core people, the marasin meris, in this project.
The analysis showed that gender focus was lost for three reasons:
- the lack of an explicit goal
- because managers were not committed to or skilled in working with a gender equality and human rights perspective
- local social pressures
What the Team recommended
- Make explicit the goal of women’s empowerment and gender equality. The focus on women and children has strategic importance (women play crucial role in improving and maintaining the primary health care of rural communities) as well as practical importance (the provision of village based assistance for minor health problems minimises the numbers of people presenting to more distant clinics with major problems stemming from unattended minor problems).
- Expand the focus on improvement of basic family health to refer to women’s empowerment as being central to the project. This is because women are the major health care providers within communities and also because they are critical for sustaining improved livelihoods.
- Change the name of the grassroots workers from voluntia back to marasin meri and marasin man - the shift to the term voluntia has meant a shift from the familiar gendered grassroots health care provider to an unfamiliar, ungendered community person working for nothing.
- Ensure regular replenishment of medical supplies - important for health objective of project but also because community support for and credibility of the grassroots workers (mainly women) broke down when they were ill equipped.
- Expand basic kit to include materials for personal hygiene and for night work. The lack of these provisions in the kits means that marasin women and men are drawing on their own limited domestic resources which in some cases is creating unnecessary gender tensions in households.
- All project staff must have gender skills training because getting it right inside the workplace is core to getting it right outside the workplace.
- Address gender equality and women’s empowerment issues within workplace by examining practices around hiring, capacity building, up-skilling and re-skilling.
For more info on this see DPM PNG or the SAEG Gender Advisor