Gender and Equity
In order to achieve Universal Health Coverage, we need to address the barriers that stop some of the most marginalised, underserved and under-reached people accessing health care. This includes the very poor, disabled, senior citizens, women and children, highly marginalised caste/ethnic groups and those living in remote areas. We need to enable and increase access to and use of quality essential services by addressing demand and supply side barriers.
In Nepal, considerable progress has been made in understanding how the health system and services operate in a context of socio-economic and geographical disparities, where cultural norms perpetuate social exclusion and the neglect of women and girls, and how inequities can be reduced. More disaggregated information is now available, and we have identified from evaluations and studies those factors that contribute to health inequities, and the impact of various policies and interventions on gender and equity. Despite this, more work is needed to further institutionalise gender and equity within service delivery as part of the current health strategy (NHSS 2015 – 20).
We bring expertise in:
- Creating structures and strengthening capacity to integrate gender and equity across the health system’s building blocks and down through the health service delivery structure.
- Improving the quality and use of evidence in planning and delivery of health care so that services are better designed to meet the health needs of the entire population and leave no one behind.
- Strengthening and expanding equitable delivery of quality essential health care services.
- Developing services that are accessible to all, irrespective of gender, poverty, caste, ethnicity, disability or remoteness, so that those most in need have greater access to care.
- Forging multisectoral partnerships to address the cultural and social barriers to accessing health care, to empower women and communities to lead social change, and to deliver integrated responses to gender based violence.
Our experts have strengthened levels of understanding and appreciation of gender and equity and why it needs to be addressed within the health system by central, regional and district level policy makers and managers. This includes taking forward the integration of gender and equity into health sector business plans and annual work plans and budgets. We have supported:
- establishment of a comprehensive institutional structure for gender and equity mainstreaming from the Ministry of Health down to individual health facilities and the development of related operational guidelines
- an enhanced focus on reaching underserved geographical areas and communities in maternal, neonatal and child health programming and basic health care services
- the scaling up of social auditing and piloting of social service units and one-stop crisis management centres to respond to survivors of gender based violence
- the integration of gender and equity into disaster recovery and transition programming including mental health and gender based violence.
- the generation, analysis and use of disaggregated and combined quantitative and qualitative data to assess health outcomes of women, and poor and excluded people and the barriers these groups face in accessing services.
- the development of the national Health Management Information System to collect and incorporate data disaggregated by sex and caste/ethnicity.
Gender and equity concerns, targets and activities integrated throughout the Nepal Health Sector Strategy
21 OCMCs established and strengthened in hospitals
8 social service units piloted for subsidised and free health care for target groups, serving 103,289 clients
Social auditing of 1,252 health facilities in 55 districts