Gender and THEORIES OF CHANGE (original) (raw)
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Advancing gender equality to improve HIV prevention: A study of practice
Addressing gender inequality as a social driver of HIV risk and vulnerability has become a key activity of non-governmental organisations (NGOs) in South Africa. This paper sheds light on the environmental factors that influence gender and HIV activities in this context. A multisite ethnographic study including 150 hours of participant observation and 32 in-depth interviews was conducted with 26 NGOs carrying out gender and HIV prevention interventions. Using thematic network analysis, 108 different intervention activities were identified, categorised and further analysed to explore environmental factors that influence the design and delivery of these activities. The findings highlight how practitioners draw on different theories of change about how to address the gender inequalities that contribute to HIV risk and vulnerability, which in turn influence the way interventions are delivered. Despite these theoretical differences, commonalities arise in practitioners’ use of popular narratives about the right to health and lived experiences of AIDS to ensure interventions are contextually relevant and to gain buy-in from participants. Other environmental factors influencing intervention activities include the role that insecure funding for gender plays in undermining the capacity of practitioners to design interventions based on their local knowledge and experience by forcing NGOs to adapt to the priorities of international donors.
Mainstreaming gender in HIV programs: issues, challenges and way forward
It is increasingly being recognized that gender inequality is a critical factor fuelling the HIV epidemic in India and elsewhere in the world. To undertake a research and programmatic review to understand how gender has been integrated in existing HIV interventions in India and to highlight the challenges associated with gender mainstreaming to propose recommendations to fill the gaps. Review of literature both published and grey along with exploration of selected HIV program both HIV focused (targeted interventions) and non HIV focused programs interventions across the country. While gender mainstreaming as a process finds mention in program plans and priorities, efforts to operationalize gender within HIV prevention programs have not been easy. This is largely due to the structure of programs which are target driven and defined. While efforts to reduce structural vulnerability of women to HIV like violence against women have been introduced in some targeted interventions, they are largely perceived as 'additional components' which put emphasis on service delivery. The lack of gender sensitive indicators presents another challenge for most programs. To reduce the vulnerability and risk of women to HIV, current HIV programming in India should expand its focus from only 'risk reduction' to include 'vulnerability reduction' measures as well so that structural inequities that emanate from gendered relations are addressed within programs. In this effort, men along with women should be seen as allies leading this process. In addition, gender indicators should be developed that are mapped regularly along with service delivery indicators to measure impact of program. A robust monitoring and evaluation mechanism should be considered a critical part of project design and delivery.
Looking back, moving forward: Promoting gender equity to fight HIV, Horizons studies 1999 to 2007
Horizons developed and tested ways to optimize HIV prevention, care, and treatment programs; worked to reduce stigma and improve gender-biased behaviors; and greatly expanded knowledge about the best ways to support, protect, and treat children affected by HIV and AIDS. In all its projects, Horizons strengthened the capacity of local institutions by providing support and training to colleagues. This series of synthesis papers presents lessons learned and best practices on six key topics that Horizons investigated: HIV-related stigma, access to antiretroviral therapy, men who have sex with men, orphans and vulnerable children, HIV and gender, and prevention of mother-to-child transmission of HIV.
2017
This study was motivated by the commitment of the researcher to contribute towards the agenda for the development of women, in particular women affected and infected with HIV/Aids, through a better understanding and improved knowledge of the national and international legal and policy framework aimed at empowering women in South Africa. This study builds on countless efforts which have been implemented internationally to transform the world and create a peaceful and liveable world for women who have been historically oppressed, unrecognised and, in the case of women affected and infected with HIV, ABBREVIATIONS AIDS Acquired Immune Deficiency Syndrome AU African Union C9 Chapter Nine Institution BPFA Beijing Platform for Action CBO Community-based organisation CD4 CD4 count is a laboratory test that measures the number of CD4 T lymphocytes (CD4 cells) CEDAW Convention on the Elimination of All Forms of Discrimination against Women CED Conference on Environment and Development CGE Commission on Gender Equality CHBC Community home-cased care DWCPD Department of Women, Children and People with Disabilities DNA Deoxyribonucleic acid, a self-replicating material which is present in nearly all living organisms GBV Gender-based violence GFP Gender focal point 2.5.1. Public Education and Information Function of the Commission on Gender Equality .
Mainstreaming Gender in HIV/AIDS Programs: Ongoing Challenges and New Opportunities in Malawi
2005
Numerous efforts are in place in Malawi to address the high rates of HIV/AIDS in the country. Furthermore, several successes in HIV/AIDS prevention and mitigation (including free antiretroviral drugs to people living with AIDS) have been documented. Fewer successes, however, have been achieved in integrating gender issues into HIV/AIDS programs. In this article I begin by defining gender mainstreaming and why it is central to HIV/AIDS programming. The second objective of this paper is to summarize the existing initiatives to mainstream gender in HIV/AIDS programs. The final objective is to uncover the ongoing needs, gaps and challenges for gender mainstreaming in HIV/AIDS programs. One of the biggest hurdles in HIV/AIDS prevention and mitigation remains the attitudes and cultural norms which reinforce women's disadvantaged position. Efforts to mainstream gender into HIV/AIDS programs are inadequate because they address women's practical needs rather than their strategic interests 2 . Thus, current gender mainstreaming strategies are limited by the superficiality of the approaches for addressing gender inequality and HIV/AIDS, underscoring the need for transformative planning. She has carried out field research in Indonesia, Zimbabwe,Malawi, and Kenya. Her research areas include gender mainstreaming, gender inequality, HIV/AIDS and human security, Canadian foreign aid, NGO-donor relations, and global citizenship.
The global HIV and AIDS epidemics disproportionately affect women, particu- larly young women in southern and eastern Africa. UNAIDS, amongst other actors, has singled out National Strategic Plans for HIV and AIDS (NSPs) as a critical platform for ensuring that women and girls are meaningfully included in national HIV and AIDS responses. Despite this, there is little evidence as to how or whether NSPs integrate responses to women and girls. Using a collaboratively developed framework, we assessed how 20 countries in southern and eastern Africa integrated women and girls in their NSPs. We identified that in general there is poor inclusion, apart from access to post-exposure prophylaxis in the case of sexual violence and access to vertical transmission services. Drawing on Moser’s distinction between women’s practical and strategic interests, we suggest that overall women and girls are poorly included in NSPs, and where there are policies and programmes, there is an overwhelming focus on women’s practical interests, without any consideration of women’s strategic interests. We argue that this limits the potential of NSPs to be platforms for national responses that meaningfully seek to transform gender relations.
Gender mainstreaming practice: considerations for HIV/AIDS community organisations
Gender is well recognised as a critical consideration for HIV/AIDS organisations. Since the 1990s, HIV/AIDS policy-makers, donors, non-governmental organisations and transnational corporations have adopted gender mainstreaming as the process for integrating gender into development programmes and institutions. There is an increasing body of literature on the successes and challenges of practicing gender mainstreaming within organisational environments, however, little has been said about this practice within HIV/AIDS-specific organisational environments. As a contribution to this gap, this reflective paper aims to generate debate about some of the considerations for gender mainstreaming practice in HIV/AIDS organisations. It draws on the author’s experience conducting a gender mainstreaming review with a southern African HIV/AIDS capacity- strengthening organisation, as well as a review of the development literature on gender mainstreaming. The paper looks at three key issues facing gender mainstreaming: (1) donor requirements on disaggregating data by sex; (2) connecting gender mainstreaming with the priorities of community HIV/AIDS organisations; and (3) the role of resistance to gender mainstreaming as neo-colonial. Preliminary understandings of these issues suggest that current approaches to gender mainstreaming may not be flexible enough to consider the multiple ways gender and HIV/AIDS interact in different sociocultural contexts. There is an urgent need for further debate and in- depth research into these issues, given the challenge they pose for HIV/AIDS organisations and donors that have chosen to make gender mainstreaming a criterion for HIV/AIDS funding.
Health Policy and Planning
National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0-92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women's access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable and effective HIV response and align government planning with international priorities for gender equality.