The Gender Analysis for Planning ITN Distribution (the gender analysis tool) is a tool that insecticide-treated nets (ITN) distribution planners can use to identify the specific needs of women, men, girls and boys when it comes to ITN distribution, use, care and maintenance in a mass campaign or continuous distribution setting. Maintaining gender equality in ITN distributions is important because it is in line with the main objective of reducing overall morbidity and mortality due to malaria and reaching those most at risk. In campaign settings, ensuring gender equity means that everyone has equitable access to ITNs to achieve universal coverage. In the long term, ensuring gender equality and equity in a distribution contributes to overall gender development which supports the socio-economic development of communities and countries as a whole.

How we interpret or understand “gender development” (or “gender and development”) globally is continuously evolving. For the purposes of the gender analysis tool, gender development is about power relations between women and men from the household to the national level and trying to eliminate any imbalances, inequalities and inequities that may exist in these relationships. The primary objective is the empowerment of women so that they can fully participate in all aspects of the ITN campaign. Empowerment in itself should cover the different concepts of power (as laid out by Jo Rowland[1] including:

  • Power over (relationship of domination and subordination)
  • Power to (make decisions or problem solve)
  • Power with (people organizing together to achieve their goals)
  • Power within (self-confidence to act)

It is important to note that gender “equity” differs from gender “equality” and differs again from “justice”. Equality focuses on achieving an even distribution of goods and services, while equity focuses on custom made programmes and activities to reduce the barriers to inequality. Justice looks at making sustainable changes to the system so that equality is achieved. While all three are important, this gender analysis tool will focus primarily on achieving “equitable” access to ITNs. This means that it can help national malaria programmes and implementing partners customize the ITN campaign strategy, plan of action and activities so that everyone has access to ITNs and campaign services as a means of malaria prevention. Examples of customized activities designed to achieve “equitable” access to ITNs and campaign services includes recognizing each wife in polygamous households as a head of household or holding meetings with market women after hours as they may be at work during door-to-door messaging.

[1] Rowlands, Jo. (1995). Empowerment examined. Development in practice. 5. 101-7. 10.1080/0961452951000157074.

Image credit: Tony Ruth for Design in Tech Report

For ITN campaigns, a gender analysis looks at:

  • Who (amongst men, women, boys and girls) are the most affected and vulnerable to malaria and the dangers associated with malaria?
  • Who does not have access to prevention, diagnosis and treatment measures (including key information)?
  • What are the barriers to this access above?
  • How can these barriers be eliminated, overcome or reduced?

When assessing gender equity, planners and implementers should also analyse the gender context within their own organization. As a key contribution to sustainable gender development, planners and implementers should also be putting into practice their own recommendations when it relates to gender equity. This applies to the gender representation within the organization as well as representation in the campaign personnel structure.

Gender equity is also further affected by intersectional factors such as race, colour, age, disability, sexual orientation, as well a myriad other factors that by themselves can cause inequities.  Example, while young men may be more at risk of malaria because they are not perceived to be in a high risk group and are thus not prioritised for ITN access, young gay men may be purposely missed during the ITN distribution because of their sexual orientation.  Intersectional factors will not be taken into account in the gender analysis tool, but national malaria programmes can refer to the “TDR INTERSECTIONAL GENDER RESEARCH STRATEGY”[2] should they wish to explore this concept further.

[2] https://apps.who.int/iris/bitstream/handle/10665/332288/9789240005068-eng.pdf?ua=1

The gender analysis tool is designed to help national malaria programmes and their implementing partners quickly:

  • Understand the gender context in the country or targeted area for the campaign
  • Assess to what extent gender equity and social inclusion are reflected within the planning and implementation of their ITN campaigns
  • Analyse key information and reflect on considerations and recommendations that can help achieve gender equity when planning and implementing ITN campaigns so that it is more gender sensitive and inclusive

Section One – Mapping out the gender context in the country or targeted area. This information is “nice to know” and it is not obligatory for national malaria programmes to complete this section to ensure a gender component in their strategy and plan of action. It is, however, strongly recommended to complete this section before discussions on the ITN campaign strategy, as it provides an overview of the gender context in the country/target area which can influence the strategy or operating context.

Section Two – Identifying a set of key gender indices that can be used for decision-making at the macroplanning stage of an ITN campaign. The information should be used to help determine specific components of the strategy, or how it will directly influence the manner in which the strategy is implemented. For example, a digitalized ITN campaign may have to budget for additional training time if women are not as mobile phone savvy as male counterparts in the country. It is important to complete as much of this section as possible, as it is “need to know” information to ensure a gender lens to the campaign strategy.

Section Three – Assessing gender within campaign planning and implementation and the campaign structure itself. National malaria programmes should use this worksheet to reflect on the distribution of roles and responsibilities between men and women within their organization and what changes can be made if there is a gender disparity. This section must be completed as it is “need to know” information.

Each of the three sections consists of:

  1. Analyses that will help national malaria programmes visualize key gender and social inclusion strengths, gaps and challenges within their organization’s operating context and operating system as well as opportunities to reduce any identified gaps.
  2. Key recommendations and considerations to help national malaria programmes develop their strategy and/or their operational plans to ensure greater gender equity and social inclusion within their ITN campaigns and other activities.

A lot of the indicators can be obtained from health surveys including the most recent Malaria Indicator Survey, Demographic Health Survey, and the Malaria Behaviour Survey, while others can be obtained through national census data.  Other indicators might be more difficult to obtain and may not be available for all countries. Depending on available resources and time, national malaria programmes are encouraged to undertake  the necessary research and studies (whether primary or secondary) for these indicators to obtain a better assessment.

Gender can mean different things to different people and can be influenced by culture, religion, context, societal norms, etc. but the following definitions are globally recognized.

Gender refers to the social attributes and opportunities associated with being male and female, as youth and adults, and the relationships between women and men and girls and boys. These attributes, opportunities and relationships are socially constructed and are learned through socialization.

Social exclusion occurs when individuals are unable to participate in the economic, social, political and cultural life of their society. In the case of ITN campaigns and continuous distribution, social exclusion can mean individuals or groups of individuals who are unable to participate fully in all campaign activities, including as campaign staff or volunteers, as well as being excluded from benefiting from all campaign services within their community/society.

Social inclusion is measured by how much people can both participate and benefit from the ITN campaigns.

While it is recommended that these globally recognised definitions be followed, national malaria programmes are encouraged to define gender and social exclusion within their context.  It is recognised that national malaria programmes often operate in more traditional societies and so currently this tool focuses on gender and social inclusion in the biological sense, focusing on the relationships between women and men and girls and boys.  It does not focus on gender as a social construct or social exclusion beyond that of biological sex.

In this respect, to ensure gender equity, and social inclusion in the ITN campaigns and continuous distribution, it is important that national malaria programmes first evaluate the gender context in their country, their organization and the campaign structure to see how they themselves can “embody” gender equity and social inclusion. This tool provides national malaria programmes with the opportunity to quickly assess the gender context in their organization and their country. It is not designed to replace other tools that will help national malaria programmes undertake a more in-depth assessment of the gender context in their country, including the Roll Back Malaria (RBM) Malaria Matchbox[1], the Bill and Melinda Gates Foundation (BMGF) Gender Equality Toolbox[2] and the Civicus The gender and social inclusion toolkit[3]  National malaria programmes who have the time and resources, are encouraged to plan for more detailed assessments that will help them develop robust programmes that strengthen gender in development.  The Global Fund’s “How to strengthen gender approaches into the malaria response: Evidence and practical actions to accelerate progress against malaria” is a good guidance document for programmes wishing to go in that direction.

[1] https://endmalaria.org/sites/default/files/Malaria%20Matchbox%20Tool_en_web.pdf

[2] https://www.gatesgenderequalitytoolbox.org/

[3] https://www.civicus.org/documents/toolkits/CIVICUS-gender-and-social-inclusion-toolkit.pdf

Ensuring gender equity in ITN distributions can help ensure that national malaria programmes are contributing to the Sustainable Development Goals, specifically Goal 3 to “ensure healthy lives and promote well-being for all at all ages” and Goal 5 to “Achieve gender equality and empower all women and girls.” ITN distribution initiatives can do this by:

  • Enabling an end to all forms of discrimination against all women and girls
  • Recognizing and valuing unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate
  • Ensuring women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life
  • Enhancing the use of enabling technology, in particular information and communications technology, to promote the empowerment of women

 

Section One: Gender within the operational context