Gender inequality inhibits women and girls from effectively understanding and utilizing reproductive, maternal, neonatal, child and adolescent health (RMNCAH) services. This includes the use of family planning methods to control if, when and how often to become pregnant; the ability to deliver safely in a facility or with a skilled birth attendant or take her child to health services; and access to services that are sensitive to her holistic needs, including care for gender-based violence (GBV).

When women are empowered to make decisions about their bodies and their families, studies show they are healthier, happier and more prosperous. MCSP works to mitigate the inequalities that act as barriers to optimal health outcomes for women and girls: lack of women’s knowledge, choice and decision-making power; GBV and other discriminatory treatment; limited male engagement in RMNCAH; and mistreatment during services; and gender discrimination faced by health workers themselves that mitigates quality services.

The Program works with providers and facilities to ensure that women and men can avail of health care facilities that guarantee equal access to respectful care for clients of any gender, ensuring accessibility, privacy and confidentiality, cordial and informative provider-client interaction, and appropriate infrastructure and commodities.

We are improving and assuring quality of care by:

  • Conducting quality assurance and improvement on gender-sensitive service delivery in facilities using a standards-based supervision tool in a participatory process with providers;
  • Addressing gender-based discrimination leading to mistreatment of health workers and clients, through sensitization, skills-building and mentorship of health providers;
  • Mitigating RMNCH risks posed by GBV through the provision of high-quality post-GBV care; and
  • Building family planning services that are non-stigmatizing or gender-discriminatory to adolescents.

Men play a key part in RMNCH, yet they are often neglected in outreach and service delivery. In many countries, men make most household decisions about sexual behavior, the use of family planning, family size, whether to give birth in a facility or at home, whether a sick child will be brought to a health facility, the allocation of household assets, and the division of household labor and caregiving. Additionally, men themselves are sexual beings and have their own needs and right to services.

MCSP is currently engaging men through:

  • Encouraging facility improvements (such as screens for privacy) and orientation of providers to allow women to bring their partners into the delivery room;
  • Facilitating couple and community dialogues to transform traditional gender norms that act as a barrier to RMNCAH; and
  • Building skills and providing on-going support to providers and health promoters to engage men in birth preparedness planning and complication readiness both in health facilities and in community dialogues.

Studies across multiple global regions have consistently demonstrated that GBV is associated with poor reproductive and maternal and child health outcomes. Violence during pregnancy has been associated with: miscarriage; late entry into prenatal care; stillbirth; hemorrhage; low-birth-weight or small-for-gestational age infants; fetal injury; unsafe abortion; premature labor and birth; sexually transmitted infections, including HIV; obstetric complications; depression, substance abuse during pregnancy; suicide; and homicide.

The Program is working to prevent GBV, to identify survivors and link them to care, and to strengthen post-GBV services in facilities through:

  • Skills-building, monitoring quality of services, and mentorship;
  • Integrating GBV screening into antenatal care and family planning services, and examining the impact of screening on care for women; and
  • Raising community awareness and dialogue about GBV to increase demand for services and prevent its occurrence.

The Program recognizes that female health workers also face unique challenges, including fewer opportunities for hiring, training and promotion; sexual harassment; pressure by families to manage both work and household duties; and unequal pay. We work to empower female health workers by revising effective teaching skills training for clinical mentors to improve gender-sensitivity of teaching methods. MCSP also integrates gender and leadership sessions in pre-service training for health providers to both empower themselves as well as help them to be more gender-sensitive to clients.

To download MCSP’s gender fact sheet, click here.

Key Results

  • MCSP developed a gender module for the Knowledge, Practices and Coverage Survey, which is being implemented in DR Congo, Nigeria, Mozambique and Tanzania to examine how gender norms, roles and household decision-making impact reproductive, maternal, newborn and child health. Through applying the survey again at endline in select countries, MCSP will be able to determine how gender interventions may have facilitated improved outcomes.
  • MCSP co-chairs the Male Engagement Taskforce of the Interagency Gender Working Group. In this role, the Program facilitates dialogue and exchange of lessons on engagement in reproductive, maternal, newborn and child health. In fall 2016, MCSP hosted a panel and consultation on engaging men in maternal and newborn health and in respectful maternity care. The Program is also in the process of developing job aids for providers on engaging men in RMNCAH.
  • In Tanzania, MCSP incorporated gender into community social and behavior change communication efforts led by community health workers (CHWs). More than 10,000 community members — including more than 4,000 men — participated in community-gender dialogue sessions led by CHWs. In Mara, 91% of men who participated indicated that they are willing to educate others at community and church meetings.
  • In Conakry, Guinea, the Program established a network of seven health facilities comprising 42 healthcare providers with 125 community educators, 10 paralegals and school/university committees to support gender-based violence (GBV) survivors. In addition, 180 educational sessions on GBV have reached 13,000 people, including security forces and local government officials.
  • In Rwanda, MCSP has supported GBV services for 4,964 survivors. Capacity-building of 173 trainers and 468 health providers on gender, GBV and male engagement has helped strengthen RMCNH services overall and has improved GBV identification, care and referral. Complementing services are community dialogues to transform gender norms and engage men in RMNCAH; through these dialogues MCSP has reached 4,267 individuals.
Maternal Child Survival Program
Maternal and Child Survival Program