Vital

News & commentary about the global health workforce
Vital Home

Where is the United States Government Going on 'Gender'?

I’ve been watching the ebb and flow of the gender equality movement for many years now. I’m glad to see that the ebbing, including the social backlash of the 1980s and the political chill of the 1990s, has been replaced by positive policy “flow”—if not flowering—in the U.S. government’s commitment to achieve gender equality in development assistance and diplomacy. Just recently, we’ve seen some clear signs that the Administration recognizes that gender equality and women’s empowerment are central to development, peace, and security.

Just last week, the Global Health Initiative leaders discussed the new Supplemental Guidance on Women, Girls and Gender Equality, which was developed by an Interagency Working Group.* The ten key implementation elements of the draft GHI guidance on women, girls, and gender equality are:

1. Ensure equitable access to essential health services at facilities and in the community

2. Increase meaningful participation of women and girls in health programs (give voice)

3.  Prevent and respond to gender-based violence

4. Empower pre-adolescent and adolescent girls

5. Engage men and boys

6. Promote policies and laws to improve gender equality, health, and access to health care

7. Address social, economic, legal, and cultural determinants of health

8. Employ multi-community-based programmatic approaches

9. Build capacity of individuals, especially women, through health systems

10. Strengthen capacity of institutions to improve women’s and girls’ health.

The new supplemental guidance has several exciting implementation elements. First, it supports country teams to conduct gender assessments and analysis with host country partners to inform the design of projects and activities and also sets up an expectation for monitoring and evaluation on gender-related indicators. Second, the focus on adolescent and pre-adolescent girls reflects the priorities of the Coalition for Adolescent Girls—a policy and advocacy body that has recently increased its focus on implementation (my colleague Maryce Ramsey co-leads one of the technical working groups). Third, the guidance encourages us to formally recognize the social, economic, legal, and cultural determinants of health and seek solutions to women’s and girl’s health problems through multi-sectoral partnerships. Also, increasing women’s legal protections and increasing access to income and productive resources are now powerful and mutually reinforcing themes in both the GHI and PEPFAR guidance. Finally, the ninth implementation element, building the capacity of individuals, with a deliberate emphasis on women as health care providers, caregivers, and decision-makers, is often overlooked and one I specifically focused on in a recent blog, “Focusing on women, girls and gender equality: let’s not forget female health workers.”  

The release of the supplemental GHI guidance followed closely on the USAID Administrator Dr. Rajiv Shah’s April 26thstatement:

“[S]trengthening human rights and fueling sustainable economic growth in developing countries both depend on empowering women and working toward gender equality. Eliminating hunger, mitigating the effects of global climate change, and drastically reducing maternal mortality relies on bolstering the role women play in their societies.”

USAID has taken steps to act on these intentions by renaming the Economic Growth, Agriculture, and Trade Women in Development Office as the Office of Gender Equality and Women's Empowerment. As such, this office will emphasize “female entrepreneurship, scale up initiatives designed to enhance women's ownership of key assets like land and housing and work to reduce gender gaps in access to new technology and infrastructure.” USAID is also transferring its responsibility for fighting sexual and gender-based violence and human trafficking to the Bureau of Democracy, Conflict, and Humanitarian Assistance, though the rationale for this remains unclear. The administration has also appointed a new senior coordinator for gender equality and women's empowerment and a senior gender advisor who is working with a new policy task team to formulate USAID’s new gender equality policy. Dr. Shah’s announcement was preceded by the April 14th meeting on the U.S. government Quadrennial Diplomacy and Development Review (QDDR), where Ambassador at Large for Global Women’s Issues, Melanne Verveer, and USAID Senior Gender Advisor, Caren Grown, both spoke. Notably, Ambassador Verveer indicated that the QDDR is the first US diplomacy and development plan to integrate gender.  

Given all this recent and welcome focus on gender equality, perhaps the only major issue U.S. government policies have not addressed is the gross gender inequity we see in the production of health care, especially in the burden on women and girls in caring for those infected by HIV/AIDS. The U.S, government needs a policy or strategy to end the exploitation of girls and women’s voluntary labor. Workforce policy, planning, and development are practical entry points to do so. In the meantime, there is enough unity of vision and policy guidance to move program design and implementation in the direction of gender equality, health, and development. 

*The Interagency Working Group is made up of representatives from the United States Agency on International Development, the Office of Global AIDS Coordination, Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services, the Millennium Challenge Corporation, Peace Corps, the Department of Defense, civil society groups and U.S. missions.