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Module: Gender Dimensions of Family Planning and Reproductive Health
REVIVING EVIDENCE–BASED FAMILY PLANNING IN MEDICAL EDUCATION AND TRAINING IN THE PHILIPPINES
Training Objectives
◦Locate gender in the overall reproductive health framework of the Department of Health
◦Explain the gender concepts and how it affects the reproductive health of men and women
◦Apply gender concepts in family planning
OverviewSession 1: DefinitionsSession 2: DOH Integrated
RH FrameworkSession 3: Rights-Based
Approach to RH and FP
Reproductive Health
A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its function and processes. (Source: ICPD, para 7.2, SPFA para 94, Beijing+5 Review Document 2000 p.25 )
10 elements of RH
VAWC
SexualHealth
STI/ HIV/AIDS
PMACMCHN
FertilityManagement
Infertility/Sexual
Disorders
ARH
Men’sResponsibilities
/ RHCancersof the
Repro. Tract
SRH
What is a rights-based approach?
A recognition that reproductive health is part of human rights
13 Sexual & Reproductive Health Rights
The Right to LifeThe Right to Liberty and Security of the PersonThe Right to Equality, and to be Free from all Forms of
DiscriminationThe Right to PrivacyThe Right to Freedom of ThoughtThe Right to Information and EducationThe Right to Choose Whether or Not to Marry and to
Found and Plan a FamilyThe Right to Decide Whether or When to Have
ChildrenThe Right to Health Care and Health ProtectionThe Right to the Benefits of Scientific ProgressThe Right to Freedom of Assembly and Political
ParticipationThe Right to Be Free From Torture and Ill-TreatmentThe Right to Development
Taken from a presentation on sexual and reproductive rights by Reproductive Rights Resource Group (3RG-Philippines)
Sex and Gender SessionsSession 1: Gender & SexSession 2: Gender AnalysisSession 3: Integrating
Gender and FP/RH
Exercise: Sex and Gender(metacards)
Because I am a (woman/man), I can….◦____◦____
If I were a (man/woman), I could….◦____◦____
Sex & GenderSEX GENDER
Primarily refers to physical attributes—body characteristics notably sex organs and secondary sex characteristics which are distinct in majority of individuals
Gender is what makes one masculine or feminine; socially determined; culturally defined;
Is biologically determined—by genes and hormones
Is learned and perpetuated primarily through: the family, education, religion (where dominant) and media; thus, it is an acquired identity
Universal, fixed, and is a valid distinguishing variable.
A cultural, contrived distinguishing variable. It is concerned with differentiatingpeople based on perceptions, roles, and social expectations
Is relatively fixed/constant through time and across cultures
Changes across time; changes across places and cultures; learned behavior
Sex & GenderSEX GENDER
Primarily refers to physical attributes—body characteristics notably sex organs and secondary sex characteristics which are distinct in majority of individuals
Gender is what makes one masculine or feminine; socially determined; culturally defined;
Is biologically determined—by genes and hormones
Is learned and perpetuated primarily through: the family, education, religion (where dominant) and media; thus, it is an acquired identity
Universal, fixed, and is a valid distinguishing variable.
A cultural, contrived distinguishing variable. It is concerned with differentiatingpeople based on perceptions, roles, and social expectations
Is relatively fixed/constant through time and across cultures
Changes across time; changes across places and cultures; learned behavior
Gender refers to “the economic, social, political and cultural attributes and opportunities associated with being male and female.” (DAC Guidelines for Gender Equality and Women’s Empowerment in Development Co-operation. OECD: Paris. 1998).
Note…Gender Roles are NOT inborn; not biologically
determined; But what is biological can be socially
constructed to justify certain roles, responsibilities and activities (e.g., gender division of labor) and the values given to such roles (e.g., female labor is usually considered cheap, low-skilled)
Gender influences the ways women and men are involved in different types of work, take up roles and obligations, acquire traits and behavioral patterns, are allocated opportunities and benefits and decision-making in private and public spheres.
Gender and HealthGender differences and
disadvantages in the field of health are manifested in the way: ◦health and disease are distributed in
a population◦health is promoted, ◦disease is prevented and controlled, ◦patients are cared for, ◦models are adapted for structuring
health social security systems
Socialization of GenderExercise: “Magpakalalaki Ka!;
Kababae mong tao!”
Gender Socialization Exercise
MAGPAKALALAKI KA! KABABAE MONG TAO!
Question: Ano ang kailangan ninyong gawin/dapat maging, para matawag kayo o mapatunayan na kayo ay isang lalaki/o babae? (Magsalita bilang isang anak, ama o ina, asawa, kapatid, lolo/lola, tiyo/tiya, at iba pa).
Gender Socialization ExerciseWho are the major influencers of
actions both inside and outside the box? Who or what institutions ensure that a person acts like a man or a woman?
SWS Survery: Trait of a “Real” Man?
Responsible: 36 %Mabait: 9 %May paninindigan: 7 %Mapagmahal: 6 %Matapat: 5 %Hindi pabaya sa pamilya: 5 %Masipag: 5 %Word of honor: 3 %Maalaga: 3 %May takot sa diyos: 3 %
Gender SocializationThe process through which the individual
learns and accepts roles is called socialization. Socialization works by encouraging wanted and discouraging unwanted behavior.
Gender socialization refers to the learning of behavior and attitudes considered appropriate for a given sex. Boys learn to be boys and girls learn to be girls. This "learning" happens by way of many different agents of socialization. (Henslin, 1999)
Stereotyping and Gender Biases: ExerciseStatements: “Agree” “Disagree” “Neutral”
1. Ok lang pagmahaba ang buhok nang lalaki, pero ang babae na nagpapakalbo ay masagwang tingnan.
2. Ang babaeng nakadamit at kumilos ng sexy pagnarape ay kasalanan niya.
3. Hindi na uso ngayon ang nagpapaupo ng babae sa bus.
4. Kasalanan ng babae kapag taon-taon siyang nangaganak.
5. Ok lang kung magkaroon ng kabit ang lalaki pero kung ang babae ay may ibang lalaki, hindi katangap-tangap.
6. Pagsumipol ang mga lalake sa babae, ibig sabihin appreciate nila ang kagandahan ng babae.
7. Ang ama ang haligi ng tahanan at ang ina ay ang ilaw.8. Under the saya ang lalake kapag siya ay naglalaba,
nagluluto at namamalengke.9. Bading ang lalake kapag pink ang kanyang suot.10. Yung lalake na masyadong malinis sa katawan ay
bading.11. Karamihan ng mga STIs ay nanpapalaganap ng mga
babae na ‘GRO’.
Stereotyping and Gender Biases
Gender Stereotypes: are qualities, attitudes, behaviors that are arbitrarily attributed to any particular sex.
In line with these stereotypes, men are socialized to lead and dominate while women are socialized to follow and care for others.
Lead to biases and double standards
Stereotyping RH Clients and Gender Biases among Service Providers
Exercise – In meta cards…
Question 1: Which situation would be most difficult for you if you were that person?
You are 16, currently 2nd place in your class, pregnant You are gay but in a party got a girl pregnant and the girl
wants to marry you You are working in an entertainment establishment but
regularly go out with customers who pay bar fines and pay you extra for sex. Now you have abdominal pains, foul smelling greenish to yellowish vaginal discharge and intensive itchiness
You are pregnant with your 8th child. Your 7th child was born 14 months ago
Your wife is pregnant with another man’s baby. You are a woman who wants an abortion You just learned you are HIV positive. You are a 32-year old married women with five children
with multiple bruises on your thigh and upper arm
Question 2: Which situation would be most difficult for you to counsel or treat ? You are 16, currently 2nd place in your class, pregnant You are gay but in a party got a girl pregnant and the girl
wants to marry you You are working in an entertainment establishment but
regularly go out with customers who pay bar fines and pay you extra for sex. Now you have abdominal pains, foul smelling greenish to yellowish vaginal discharge and intensive itchiness
You are pregnant with your 8th child. Your 7th child was born 14 months ago
Your wife is pregnant with another man’s baby. You are a woman who wants an abortion You just learned you are HIV positive. You are a 32-year old married women with five children
with multiple bruises on your thigh and upper arm
Exercise, continued
What were the differences between your choice of scenario for the personal (first round choice) and for the professional (second round choice)?
What if you were the client, and fit into one of those descriptions◦What would you fear when you go to the
clinic?◦What would you want from the health worker?◦What could the clinic do to help you the most?
Manifestations of Gender BiasesGender Biases Manifestations
Marginalization Under or non-valuation/ non-recognition of women’s workUnequal pay for work of equal valueLast to be hired, first to be firedLimited opportunitiesExacting sexual favors
Subordination (political) PositionStatus
Decision-makingProcess of socialization
Multiple Burden Parenting Housework
Gender Stereotyping Child-rearingReligionOccupationsEducation Language
BehaviorGovernment ProgramsMediaPopular Culture
Violence Against Women Verbal, Psychological, physical, economicForms of violence: jokes, wolf-whistles, “chancing” or making sexual passes, sexual harassment, domestic violence, incest, rape, prostitution, sex trafficking
Effects of Personhood Lack or no self-esteemNo control over one’s body
Gender RolesProductive: Comprises the work done by both
women and men for payment in cash or kind.Reproductive: Comprises the
childbearing/rearing responsibilities and domestic tasks required to guarantee the maintenance and well-being of household members. It includes not only biological reproduction but also the care and maintenance of the persons who comprise the household.
Community Management Role: Comprises activities undertaken at the community level to contribute to the development or political organization of the community. It is usually voluntary, unpaid work. Women do community work that is maintenance in nature while men are usually policy-makers.
Gender Roles StudiesIn the 2000 Pilot Time Use Survey (TUS)
conducted by the National Statistics Office (NSO) for Batangas and Quezon City, results showed that for both areas, the number of hours spent by women on housework and child family care was higher than men, be it during weekdays or weekends.
In fact, hours spent by women for housework was, on the average, twice as much as by men.
This situation would of course mean less hours available to women to do other things such as engaging in economic activities.
Gender Roles
• Gender differential still remains as an issue in economic participation
Economic participation - 80% for men versus 50% for women in 2006
Employment rate - 74% for men versus 46% for women in 2005
Question
What implication would women’s multiple roles and burdens have on family planning methods, service delivery?
Gender Analysis: Access and Control of ResourcesAccess – ability to use a resourceControl – ability to define and
make decisions about the use of a resource
Resources: Internal, economic, political, social, information/education, time
Power and Decision-making
Access and Control Diagram (from WHO Training Curriculum, Gender and Rights in Reproductive Health)
ACCESS AND CONTROL OVER
Internal Resources
Economic and Social Resources
Political Resources
Information/ Education
Time
POWER AND DECISION-MAKING
Gender-responsive and Rights-Based Differences in RH and FP
Results in:◦ differential risks and vulnerabilities to
infections and health conditions; ◦ different perceptions of health needs and
appropriate forms of treatment; ◦ differential access to health services; different
consequences or outcomes from disease; and,
◦ differing social consequences as a result of ill health.
Gender and rights may influence health status in the following ways:
◦ exposure, risk or vulnerability◦ nature, severity and frequency of health
problems◦ ways in which symptoms are perceived◦ health seeking behavior◦ access to health services◦ ability to follow advised treatment◦ long term social and health consequences.
To end…
Without fully appreciating the implications and impact of gender roles and relations, health practitioners will fail in their treatment of certain groups and individuals, and health planners will inadequately serve the total population.
FOR EVERY WOMANFor every woman who is tired of acting
weak when she knows she is strong,There is a man who is tired appearing
strong when he feels vulnerable
For every woman who is tired of acting dumb, There is a man burdened with the constant expectation of knowing everything.
For every woman who is tired of being called an emotional female, There is a man who is denied the full right to weep and be gentle.
For every woman who feels tied down by her children, There is a man who is denied the full pleasure of shared parenthood.
For every woman who is denied meaningful
employment and equal pay, There is a man who must bear the full financial responsibility for another human being.
For every woman who has been taught the intricacies of an automobile, There is a man who was not taught.the satisfaction of cooking
For every woman who takes a step towards her own liberation There is a man who finds the way to freedom has been made a little easier.
Nancy Smith
Thank You!