Addressing gender inequality, harmful gender norms and gender-based violence
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Health programmes should integrate actions to remove gender-related barriers to health
Interventions to address gender inequality, harmful gender norms and gender-based violence are critical enablers for access to health care. Recommended interventions include review and reform of laws and policies as well as activities to strengthen access to justice and law enforcement.
Examples of interventions may include:
- Awareness-raising and sensitization programmes with young people to reduce gender inequality, raise awareness about different gender identities and reduce gender-based violence
- Dialogue, awareness-raising and sensitization programmes with religious leaders, traditional leaders and community members on harmful practices that violate the health and development rights of women, girls and other gender identities
- Law review and reform to strengthen gender equality in law and to eliminate gender-based violence and discrimination
- Legal literacy (“Know Your Rights”) campaigns to educate women, young girls and other vulnerable and key populations of their legal rights and avenues for redress for human rights violations
- Legal support services to support access to redress for discrimination and human rights violations on the basis of a person’s sex, gender, sexual orientation or gender identity, and
- Working with law enforcers to address gender-based violence, including sexual violence, in the harassment and abuse of key populations such as sex workers and transgender persons.
Programmes to address gender-based violence are critical to reducing the risk of HIV amongst adolescent girls and young women. HIV programmes should be integrated within existing gender-based violence programmes to:
- Support economic empowerment and gender training of AGYW
- Working with men and boys to transform harmful gender and social norms
- Integrating strategies to address violence in HIV services such as HIV testing and counselling and mental health care
- Providing emergency contraception and post-exposure prophylaxis (PEP) for HIV within a comprehensive package of services for sexual assault
In South Sudan, in its role as Global Fund Principal Recipient, UNDP supports a program to train health care workers to respond to GBV and refer survivors to a range of appropriate services. The provision of co-located psycho-social and legal referral services for women are a great example of the integrated service provision necessary to address gender-based violence and HIV.
In addition, the program supports a number of behavioural change communication initiatives aimed at preventing GBV and supporting the use of GBV services, using the popular medium of radio. These messages are translated into multiple languages, including those spoken by internally displaced populations, and are aimed at removing the stigma and gender inequality that drives the HIV epidemic and often prevents survivors of GBV victims from accessing key HIV-related prevention services.
In Afghanistan, UNDP, as co-Principal Recipient of Global Fund grants for TB and building resilient and sustainable health systems, is supporting six non-governmental organisations to train women to become community health nurses. Women in Afghanistan struggle to access health care, since they must be seen by a female practitioner and be accompanied by a male family member - doubling travel costs and contributing to health inequity. With an increase in the number of female nurses available, Afghan women will have expanded access to health services, especially in rural areas. However, the development benefits go beyond health, also contributing to women’s empowerment and livelihoods in a country with very high female illiteracy and few education and employment opportunities for women.
In Nepal, a toolkit to empower women to protect their rights in healthcare settings has been rolled out, covering know your rights, how to access justice if rights are violated and how to improve transparency and accountability of health care providers.
Interventions that aim to empower adolescent girls and young women and strengthen their socio-economic circumstances are equally important. They may include:
- Community mobilisation and building leadership amongst AGYW and young men, to strengthen their engagement in challenging harmful gender and social norms
- Cash transfers and social grants to meet basic survival needs, help keep girls in school and prevent AGYW from entering into transactional sex or making partner choices based on economic necessities
- Advocacy and support for programmes to keep girls in school, to reduce early marriage, risky sexual partnerships and increase opportunities for AGYW.
Keeping Girls in School
Higher education is linked to reduced HIV prevalence in later life – it helps to create educated, more independent young women who are better placed to make healthy life choices.
HIV prevalence among young women who received an additional year of schooling in Botswana was 17% after 10 years, compared to 25% among those who did not receive the additional year of schooling. A study in South Africa showed that the risk of HIV for girls who stayed in school was reduced by two thirds.