How Can We Strengthen Gender Competency in Reproductive Health Services? October 27, 2023 By Olivia Peters, Katherine Andrinopoulos, and Janna Wisniewski What is gender competency? Piloting the revised Gender Competency Self-Assessment Tool with a FP provider in Uganda. © 2022 Eve Namisango, Data for Impact Gender competency can seem like a vague term that is hard to incorporate tangibly into health programs. This is especially true for family planning (FP) providers whose time is already constrained by the various demands of their profession. The new Gender Competency Self-Assessment Tool for Family Planning Providers bridges this gap, allowing for the improvement of gender competency of healthcare providers. The term gender competency includes provider attitudes and skills to help clients achieve their FP goals, despite the influence of gender norms and gender inequities. It also refers to provider knowledge about how gender norms and dynamics influence clients’ beliefs and power to make decisions about FP. Possessing higher levels of gender competency allows providers to respond to clients’ diverse needs while delivering high-quality FP services. This intersectional approach creates an inclusive healthcare atmosphere that respects clients’ multi-dimensional reproductive health goals. The United Nations and World Health Organization acknowledge that gender significantly influences health outcomes. The UN has called for gender prioritization, with the creation of the Sustainable Development Goal (SDG) 5, “achieve gender equality and empower all girls and women.” Gender differs from biological sex, and instead refers to culturally defined expectations, roles, and responsibilities of women and men, based on socialization and learned behaviors; furthermore, despite a strong call for gender competency, more actions and resources are needed to support its integration into the global health sphere. D4I has recognized the importance of gender, mandating its integration into every aspect of our work. Moreover, the recently developed Gender Competency Self-Assessment Tool for Family Planning Providers directly assesses gender competency by providing a way for FP providers to assess their current understanding of the topic. How can FP providers use the tool? Using the Gender Competency Self-Assessment Tool for Family Planning Providers addresses the first step in cultivating a gender-competent environment. Providers can use this tool in several ways—self-assessment, group assessments, and integration with other quality assessments. When first approaching the assessment, providers are met with six key domains: (1) gender-sensitive communication, (2) promoting individual agency, (3) supporting legal rights and status related to FP, (4) engaging men and boys as partners and users, (5) facilitating positive couples’ communication and cooperative decision making, and (6) addressing gender-based violence. The tool is intended for FP providers in various regions and from diverse cultures who need support or gentle reminders on how to best navigate gender norms and dynamics in their practice. The tool has a separate module for each gender competency domain. The modules include self-assessment statements that range from “I can explain the full range of contraceptive methods to men as effectively as I can to women” to “Through my family planning counseling, I can help clients make family planning choices that keep them safe from gender-based violence.” The assessment user rates themselves from “strongly agree” to “strongly disagree” on statements across the six domains. Overall, the tool consists of 71 statements and takes approximately 60 minutes to complete. After providers navigate through the statements in each domain module, they then use an answer key to score their assessment, which tells them how they performed. Each module also includes a discussion guide, summarizing key points. Understanding a provider’s current degree of gender competency both helps them provide better care for clients and supports program and administrative staff in identifying areas for additional training. Once assessed, providers can improve their understanding of gender competency by completing a self-paced eLearning course which was developed by HRH2030 with support from USAID. The six domains of gender competency and eLearning course were based upon formative research from the Philippines and Ethiopia. Prioritizing gender: Contextualizing the FP tool The tool was piloted in Ghana and Uganda, in collaboration with the Family Planning Division of Ghana Health Services and the Family Planning Activity (FPA) implemented by Pathfinder International in Uganda. Further, the USAID Missions in Ghana and Uganda were enthusiastic about activities related to gender and FP. Piloting the tool led to several changes in content including an emphasis on how religion influences gender norms and how gender pressures may differ across the life course. This means providers may need to meet different needs in their service delivery for girls and boys, compared to women and men. We also learned different ways to present the concept of “power” including explaining it as having control over decisions, and authority in different situations. Finally, feedback from providers led to the development of a discussion guide as part of the tool. This guide explains why certain responses to the statements demonstrate higher gender competency. It also provides users of the tool with a summary of main points for the domain, as well as personal and group reflection questions. Gender competency in all its dynamic facets can be overwhelming for providers to tackle with everything else on their plate. However, the Gender Competency Self-Assessment Tool for Family Planning Providers offers a stepping stone to understanding and reflecting on the ways gender affects FP providers, their clients, and their practice. Altogether the tool allows for insight into the complexity of gender while presenting opportunities for providers to thoughtfully interact with their FP clients. Authors: Olivia Peters, MPHOlivia is a recent graduate from the UNC Gillings School of Global Public Health. She worked with D4I as a dissemination specialist. Katherine Andrinopoulos, PhDKatherine is a Research Associate with D4I and an Associate Professor with the Tulane School of Public Health and Tropical Medicine. Janna M. Wisniewski, PhDJanna is a Research Associate with D4I and an Assistant Professor at the Tulane School of Public Health and Tropical Medicine.
