A group of experts on gender issues convened by the Pan American Health Organization (PAHO) cited significant progress in the implementation of a gender equality policy that was developed by PAHO and endorsed by the ministers of health of the Americas. But the group also pointed to obstacles that still need to be overcome, including resistance to change and the lack of a coordinated approach to gender issues across U.N. agencies.

The Gender Equality in Health Technical Advisory Group (TAG) met for two days (Feb. 16–17) at PAHO headquarters to examine the results of a report on the implementation of the PAHO Gender Equality Policy, which was approved by PAHO’s 46th Directing Council in 2005. The group’s observations and recommendations will be incorporated into a revised version of the report, which will be presented to the PAHO Executive Committee in June and eventually to the Pan American Sanitary Conference in September 2012.

The PAHO Gender Equality Policy provides a framework for PAHO technical cooperation in its member countries that promotes equality and improved efficiency and effectiveness through the incorporation of a “gender perspective” into planning, implementation, monitoring and evaluation of health policies, programs, projects and research. The policy also seeks to advance gender equality within PAHO as an organization.

A gender perspective recognizes that men and women have different health profiles and face different health risks, and that collecting and analyzing health data by sex is critical to accurately assess these differences and to formulate effective policies, programs and interventions.

PAHO Director Dr. Mirta Roses told members of the TAG that the Gender Equality Policy has had a clear impact on PAHO’s secretariat as well as on the Organization’s technical cooperation in member countries.

“In PAHO, we have established gender as a cross-cutting priority and have included gender in all PAHO planning instruments and in our results-based management framework,” said Dr. Roses. “This has resulted in a culture change within PAHO and has helped us to address inequities in our Region. Introduction of the gender approach has also helped make our programming more efficient and responsive.”

The report on the policy’s implementation, which covers the period 2009 to 2011, cites a number of areas of progress in implementing the policy. Highlights of the report include:

• Seven countries in Latin America and the Caribbean— Bolivia, Costa Rica, Honduras, Mexico, Peru, Panama and Uruguay—have published national health profiles on women and men. Three others—Colombia, Nicaragua and Trinidad and Tobago—have included gender analyses in their countries’ health situation reports.
• Five countries—Colombia, Costa Rica, Ecuador, Peru and Uruguay—have included home-based health care in their time-use surveys, to assess this largely unpaid, female-dominated type of health care. Colombia, Ecuador and México are quantifying this contribution within the framework of National Health Accounts.
• The Andean countries have developed a set of gender and health indicators that will be incorporated into a subregional health information system promoted by the Andean Community (Comunidad Andina de Naciones, CAN).
• More than two-thirds of PAHO member countries report that they have developed guidelines for integrating gender into health information, policies, and programs. More than half also report they have used these guidelines for planning, monitoring and advocacy during the period 2005-2010.
• Virtually every country in Latin America and the Caribbean has ratified the Convention to Eliminate All Forms of Discrimination against Women (CEDAW), which calls on governments to end gender disparities and to fund gender-transforming activities.
• Most countries have passed national gender equality or equal opportunity laws that apply to the health sector.
• PAHO’s Gender, Diversity and Human Rights (GDR) program has set up a network of 35 observatories in Latin America, made up of civil society organizations and academicians, to produce and use gender and health information for analysis, advocacy, and monitoring. GDR has also established an electronic discussion list through which over 70 participants can exchange publications and other information.

As for remaining obstacles, the report notes: “the greatest challenge to gender integration in health is insufficient political support. Lack of will is reflected in resistance to change and an insufficient investment in gender mainstreaming, training and staffing.”

TAG participants made a number of recommendations for how to promote both a gender perspective in health and greater gender equality in general. These included:

• Unite gender monitoring with the human rights system, particularly the work of the human rights rapporteurs.
• Raise awareness among policymakers about the issue of “masculinities” and the need for policies that acknowledge and promote men’s roles in and responsibilities for care work.
• Coordinate and articulate a common U.N. agenda on gender.
• Jointly with CEPAL, approach the U.N. Statistical Commission and national statistical offices to generate improved data on violence against women.
• Provide capacity building in leadership to women health leaders.

Participants in this week’s meeting included TAG Co-Presidents, Gita Sen, of the WHO Social Determinants Commission, and Carmen Barroso, of the Independent Expert Review Group, Global Strategy for Women and Children’s Health; Michal Avni of the U.S. Agency for International Development (USAID); Sonia Montaño of the U.N. Economic Commission for Latin America and the Caribbean (ECLAC); Gabriela Vega of the Inter-American Development Bank (IDB); Carolina Taborga of UNWomen, Mercedes Kremenetzky of the Organization of American States (OAS); and Sonia Heckadon of the United Nations Population Fund (UNFPA); and Nivana Gonzalez of the Health Network of Women of Latin America and the Caribbean (RSMLAC).