Women Influencing Health, Education, and Rule of Law (WI-HER) LLC
"Many of the core components of malnutrition and hunger - the multigenerational effects, behavioral manifestations, gender inequality - have proven to be insurmountable for traditional interventions."
This CORE Group technical resource guide, along with the complementary technical brief, is designed to build the capacity of development practitioners working in nutrition and food security to plan, implement, and evaluate gender-sensitive social and behaviour change (SBC) programming in order to improve nutritional outcomes for pregnant and lactating women (PLW) and children under the age of 2 years (or 1,000 days). It does this by providing an overview, rationale, critical actions, best practices, resources, and tools for integrating gender-sensitive SBC into project activities. The guide and brief are intended to represent work conducted in the United States Agency for International Development (USAID)-funded Food for Peace (FFP) countries that have active development projects. While the research focuses on this subset, findings may be applicable to similar projects in other countries.
As explained in the guide, women and girls typically eat a lower quantity and variety of food that is generally less nutritious than the food eaten by their male counterparts; at the same time, while women comprise a large percentage of the agricultural labour force, they often have limited access to the information and resources (e.g., income, land, equipment, training) needed to improve food security.
The premise of the resources summarised here is that gender-sensitive programming could be useful in this context. This is an approach or intervention in which the different needs, abilities, and opportunities of women, men, girls, and boys are identified, considered, and accounted for. In addition to understanding the influence of gender roles and norms on relevant practices and subsequent outcomes, it addresses constraints and opportunities in an accommodating and/or a transformative way during project planning, implementation, and monitoring and evaluation (M&E) by proposing content that addresses women's and men's interests and needs and by adopting methods that enhance women's and men's active participation in the development process (see Box 1 on page 5). Addressing gender is also designed to allow for successful and effective linkages across sectors, spanning health, agriculture, food security, and economic empowerment, among others.
SBC is a behaviour-centred approach to facilitating individuals, households, groups, and communities to adopt and sustain improved, evidence-based practices. The approach draws upon social science and behaviour change theories to design policies and interventions that change behaviour due to information, motivation, and skills as well as transform the environment within which behaviour change occurs. "Malnutrition can be greatly reduced through the delivery of simple interventions encouraging specific behaviors at key times in the lifecycle - for the mother, during pregnancy, and for the mother and child, during delivery, infancy, and early childhood." Nutrition-specific interventions address the immediate causes of nutrition such as treating acute malnutrition, increasing micronutrient intake and supplementation, and promoting exclusive breastfeeding (EBF) and complementary feeding.
While there are too many potential gender-sensitive SBC interventions to list, a figure on page 3 of the brief or page 9 of the guide highlights a number of them that impact nutrition during the 1,000-day window of opportunity. The interventions fall into the categories of: interpersonal/individual/family approaches; community-level approaches and advocacy; mass media and information and communication technology (ICT); and structural/systems approaches (enabling environment). Evidence suggests that using multiple SBC interventions to change behaviours is more effective than using one, that reaching out to multiple contacts has a greater effect than reaching out to only the woman herself (e.g., other women, husbands, mothers-in-law, community leaders), and that more visits or contacts results in greater change.
The next section presents an overview of actions necessary to improve the gender sensitivity of SBC programming during each programming phase, along with best practices suggested by practitioners implementing relevant programmes. Key resources and tools are provided for each phase; a complete list of resources and tools can be found in Annex 1 of the resource guide, including overarching guidance and checklists. Case studies are presented throughout this guide to demonstrate global examples of gender-sensitive SBC programming.
In brief, in the area of programme planning, it is suggested:
- Conduct a gender analysis and SBC formative research, interviewing women, men, girls, and boys to understand relevant gender dynamics in the community.
- Ensure that project strategies and plans are gender sensitive.
- Strengthen gender-related partnerships, such as by meeting with community members to understand promising points of entry to transform gender attitudes and norms and how to leverage them to create change.
- Ensure that project objectives and SBC interventions address gender needs and gaps; involve women, men, girls, and boys in designing objectives and interventions to ensure that everyone's needs are met. Beyond impacting maternal and child nutrition outcomes, projects should strive to transform gender relations to make a lasting difference.
- Make linkages across multiple sectors; gender should be addressed within other project components and be given as much time as other project components receive.
In brief, in the area of programme implementation, it is suggested:
- Engage a range of important influencers, trying to achieve gender balance in the recruitment of project participants and recognising families who demonstrate optimal practices or celebrating the championship of community workers to inspire others.
- Consider needs and preferences of men and women when implementing activities. For example, if men or women are reluctant to participate in activities, set minimum target levels for gender-balanced participation. In addition, help beneficiaries recognise the impact of programme activities. For example, when parents see a difference in their child's health, dialogue in couples can increase.
- Ensure that gender and SBC trainings are integrated, balanced, and impactful, such as by being sensitive to the local context and personal beliefs when facilitating training. When projects send staff to trainings, give them a role when they return; this allows them to apply the learning, build their facilitation capacity, and share knowledge.
- Review project messages and materials to ensure gender considerations are included, where appropriate, developing an internal checklist with input from stakeholders.
- Ensure that interventions "do no harm".
In brief, in the area of programme M&E and documentation, it is suggested:
- Collect and analyse sex-disaggregated and gender-sensitive indicators, ensuring that project teams conducting M&E activities and project beneficiaries sampled in data collection are comprised of both women and men.
- Standardise gender-sensitive SBC measures within and between projects and broaden the focus of SBC indicators and evaluation designs to include those that will measure antecedents on the pathway to behaviour change.
- Continue M&E of gender-sensitive SBC programmes after implementation because SBC related to gender is an ongoing, long-term process. Facilitate partnerships on research and M&E for gender-sensitive SBC amongst national research boards, local universities, and global health partnerships.
- Document and share results, best practices, and lessons learned.
In brief, in the area of gender mainstreaming (incorporating a gender perspective into organisational policies, strategies, and administrative functions, as well as into the organisation's institutional culture), it is suggested:
- Ensure that leadership is supportive of and committed to gender issues. In addition to leading gender integration across project activities, the gender point of contact should be a core member of the project implementation team.
- Consider gender issues in the hiring process and workplace.
- Build capacity of all staff to address gender; regular fieldwork should be conducted to understand gender realities and findings need to be shared with all staff to inform programme planning and implementation.
In conclusion: "More rigorous research is needed to fully demonstrate the impact and the cost effectiveness of gender-sensitive SBC approaches. While this evidence base is growing stronger and wider, more efforts need to be made to ensure that such approaches become an integral component of all programs to help achieve improved outcomes at a wider and bigger scale. Addressing gender is a community effort and requires broad participation and multisectoral linkages to achieve project goals. Transforming habits and preferences around food and care takes effort, research, resources, but the effort and investments are well worth the undertaking and can make an invaluable contribution to the nutritional health and wellbeing of women, men, girl[s], and boys."
Slimline C4D Network Twitter Trawl: 29 February - 6 March 2016; and CORE Group website, July 13 2016. Image credit: Maggie Jacoby, courtesy of Photoshare