Gender in Health Governance Tool

By Mahesh Shukla, MD, DrPH, MPA, Public Sector Governance Senior Technical Advisor, LMG Project, and Belkis Giorgis, PhD, Senior Technical Advisor for Gender, LMG Project

   Photo: Rui Pires

The Importance of Gender in Governance

Women play three important roles in a health system: 1) as governance decision makers and senior managers; 2) as health workers and health care providers; and 3) as users of services. Nevertheless, governing bodies in health systems and health institutions are most often dominated by men. As a result, the issues faced by women leaders, women within the health workforce, and women who are users of health services too often do not receive adequate attention.

Gender responsiveness in health governance has the potential to enhance health outcomes not only for women but also for the entire community. Gender-responsive governance is ensuring that governance decision-makers respond to different needs of their internal and external clients based on gender. For example, gender-responsive leaders insist on collecting and using sex-disaggregated data for decision-making, or establish a gender-sensitive implementation process for implementing a decision.

Gender-transformative leaders go beyond being just responsive; they actively work toward gender equity. For example, they give voice to women and women’s organizations in governance decision-making, establish a gender policy, create a comprehensive agenda to overcome discrimination, ensure a safe and harassment-free environment, or work to increase the proportion of women in leadership, governance and senior management roles in their organization.

The Gender in Governance Tool

Governance leaders should periodically assess how gender-responsive they are when making governance decisions (i.e., while making policies and regulations, setting organization’s strategic direction, or allocating resources). To help them carry-out this self-assessment, currently there is no readily available instrument. To fill this gap, LMG Project has developed a simple tool based on the spectrum of gender responsiveness[1], and plans to test it in the coming year with the LeaderNet online learning community.

This tool serves twin purposes: it reminds the governing body members or governance leaders of their responsibility to be gender-responsive, and also explains how they can fulfill that responsibility. You may access the tool here.

The Gender in Health Governance Tool: A Simple Test

The following is a simple test that members of a governance body should read over prior to making a substantive decision. They should then take the test after the governing body meeting to see how gender-responsive they have been in the decision they ultimately made.

After the decision is made, members can then assess themselves using the following instrument on a scale from 0 to 10. After individual members have assessed themselves, the average of their combined score can be considered the gender responsiveness score of the governing body meeting. The results can then be used to discuss the need to make adjustments when necessary.

  1. The maximum score that can be earned is 100.
  2. Score of 84 and above indicates the governing body demonstrated a high degree of gender-responsiveness
  3. Score of 51-83 indicates the governing body demonstrated gender-responsiveness
  4. Score of 17-50 indicates the governing body demonstrated not enough gender-responsiveness
  5. Score of 16 or below indicates the governing body was not gender-responsive

This self-assessment tool can be used periodically by the governing body to monitor and enhance the gender responsiveness of their decision-making.

You can download the Gender in Health Governance Tool as a PDF here.

Related Links:

An Open Mind and a Hard Back: Conversations with African Women Leaders

LMG Hosts Online Discussion on “Women in Leadership” on LeaderNet

LMG Survey on Mentoring of Women Health Leaders

Ethiopia’s Ministry of Health: Walking the Talk on Gender Issues

[1] The Spectrum of Gender Responsiveness is described on pp. 9-11 in the downloadable LMG eManager publication entitled, “How to Govern The Health Sector and its Institutions Effectively,” March 2013.

[2] The Interagency Working Group on Gender (IGWG) developed a conceptual framework known as the Gender Integration Continuum that defines the concepts of gender blind, gender exploitative, gender accommodating, and gender transformative in the context of gender integration. See The Interagency Gender Work Group (IGWG). A Manual for Integrating Gender Into Reproductive Health and HIV Programs: From Commitment to Action. 2nd Edition. August, 2009: http://www.igwg.org/igwg_media/manualintegrgendr09_eng.pdf.