In line with the United Nations Programme on HIV/AIDS (UNAIDS) and with the aim of highlighting different inequalities on Zero Discrimination Day this year, the Women’s Integrated Sexual Health Programme (WISH) programme, through its Leave No One Behind approach works to end inequalities surrounding gender, economic status, and disability that continue to hinder universal access to sexual and reproductive health and rights (SRHR).
For Zero Discrimination Day this year, we highlight three ways we are working on ending inequalities around gender, disability, and poverty in SRHR.
- Addressing the role of men in SRHR
Considering how gender stereotypes, power dynamics, and norms around masculinity contribute to women’s SRHR outcomes and their ability to access services, ‘male responsibility / male engagement’ is a key mass media campaign theme within the WISH programme. WISH mass media campaigning tackles common barriers to male engagement by sparking sexual reproductive health (SRH) conversations and perspectives on the issue. WISH radio spots challenge male partners to consider both the health and financial benefits of smaller, better spaced families. To systematize male engagement efforts across countries, the Wish2Action Hub developed a series of listening guides and community discussion guides to engage with groups of men and boys.
As part of its media campaigns, WISH in conjunction with Development Media International (DMI), developed a series entitled “Role of Men videos” that seek to promote male involvement in discussing and making decisions about family planning, addressing stigma, myths, and barriers to accessing SRH. The use of animated video series dubbed Temzu Town pushes boundaries to challenge social norms and address stigma faced by young people including those living with disabilities in accessing SRHR services.
WISH has over time recognized the role of influencers in supporting and creating an enabling environment for women and girls in accessing SRH services. Working closely with men and boys who are key opinion leaders, and service users, is an important strategy to ensure gender equality and support for women’s’ access to SRH in male-dominated societies. IPPF affiliated member associations (Mas) involved in the program identified men and boys as both primary audiences (in their role as users of male-controlled methods of contraception) and as secondary audiences (in their role as partners of women). They hold regular male dialogue sessions, community dialogues with men, boys, and other sensitive groups organized by community health volunteers in which they share information on SRH/FP and engage them in supporting family and communities for better health. Continued engagement with community gatekeepers (chiefs, village elders, religious elders) to hold community dialogues with men, boys, and other sensitive groups is also crucial.
To better understand young men’s and community gatekeepers’ involvement in SRH, WISH conducted social norms research in Malawi, Burundi and South Sudan and found that a lack of gatekeeper support entrenches and propagates the negative beliefs and norms in the community, pushing parents use these negative beliefs to discourage their young girls from taking up SRH/FP. The study recommends harnessing community gatekeepers’ positive attitudes and their role to address persisting negative attitudes and build their capacity on SRH/FP.
Read more on the findings: https://bit.ly/3gTtCNg
- WISH interventions for Disability Inclusive SRHR services:
WISH employs disability social behaviour change communications (iSBCC) and inclusive community mobilization to reach out to persons with disabilities on an individual & communal level aiming to help them gain more knowledge on SRH/FP & identify ways on how they can participate in SRH information & services. WISH works with organizations of people with disabilities (DPOs)to pre-test messages for different key audiences.. All IPPF MAs have conducted DPOs assessments to assess their capacity in advocacy/awareness raising and community mobilization, while health facilities assessments assessed facilities’ capacity to provide quality ISRH services.
These assessments informed the development of an improvement plan for facilities, which were shared with the cluster management committees (CMCs) and/or facility head to take appropriate follow up actions. Other interventions to support disability inclusive SRHR services within WISH include supporting disability inclusive policy and advocacy and support to Governments, strengthening capacities of local health committees and involvement of representatives of persons with disabilities, training of health workers on disability inclusion and basic sign language.
- Interventions to reach the poor with SRHR services
As a strategy to improve equitable access to services, WISH strives to reach the poor by providing services to an estimated percentage of active WISH sexual and reproductive health service delivery points (SDPs) /sites in areas that meet or exceed the national average of women of reproductive age living in poverty. To achieve this, the programme uses innovative interventions to increase provision of SRHR services to the poor. These include:
Use of poverty heatmaps: The WISH project has worked with service delivery partners to collect accurate geolocation data for all SDPs using a free open-source data platform mobile form on Kobo Collect.
WISH has used population data from Worldpop and poverty data from demographic health survey to create population density and poverty data maps. By overlaying poverty heat maps with SDPs, the WISH service delivery implementers can determine which clinics are closest to the areas of greatest poverty and any corresponding SRHR needs and where they could potentially run outreach services to reach these populations.
By specifically targeting services to areas with high populations of people living in poverty, the project is able to reach more people through:
- Intensifying project activities
- Increase frequency of outreaches and refresher training for Community Health Workers (CHWs) on Social Behaviour Change Communication (SBCC) [MG1] and demand generation
- Intensifying community-based engagement through CHWs, youth peer educators, and community dialogues
- Challenging negative social norms through community dialogues and community awareness campaigns utilizing already developed communication messages during community level activities.
By recognizing that the poor and persons with disabilities (PWD) are critically underserved populations, and by developing the innovative strategies as detailed above, WISH ensures that the poor and often marginalised not only have access to SRH services but also receive high quality services without stigma and discrimination.
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Women’s Integrated Sexual Health Programme (WISH) and Gender Equality
Gender equality is a cross-cutting theme across the Women’s Integrated Sexual Health (WISH) programming. With the recognition that gender inequality is associated with multiple poor sexual reproductive health and rights (SRHR) outcomes, WISH contributes to Sustainable Development Goals (SDGs) 5 on Gender Equality through the provision of SRH services, prioritising reaching women and girls under 20, the poor and persons with disabilities (PWD).
By providing family planning (FP) and access to safe abortion, WISH enables women and girls to control their own fertility, which directly impacts their ability to attend school and maintain employment, financially plan, and participate in decision-making. WISH addresses the structural and policy barriers to gender equality by progressing policy amendments that enable greater access to essential health care services for women such as safe abortion, and focuses on shifting harmful social norms, and gendered power dynamics that contribute to gender inequity.
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