Defining Gender Mainstreaming
According to the Council of Europe (1998),
“gender mainstreaming is the (re)organisation, improvement, development and evaluation of policy processes, so that a gender equality perspective is incorporated in all policies at all levels and at all stages, by the players normally involved in policy making.”
What is “gender mainstreaming” in health?
Research, interventions, health system reforms, health education, health outreach, and health policies and programs should regard gender perspective. Health professionals and policy makers should be aware how gender affects health. Health status is influenced, not only by biology aspects or by health care, but also by socio economic determinants of health (social status, social support networks, education, working conditions, social environments, housing, gender, culture, ethnicity). Any analysis of health and health care should consider socio-economic determinants and include a gender perspective.
What organisational barriers hinder implementing gender equality policies both within and outside the health sector?
In order to understand gender inequality in general and gender inequities in health, key organisational issues have to be addressed. Working towards gender equality challenges long standing male dominated power structures, and patriarchal social capital within a variety of organisations.
Gender mainstreaming crosses the boundaries of people’s comfort zones by altering of existing lines of control over material resources, authority, and prestige. It requires people to learn new ways of accomplishing objectives they may have little conviction or receive little benefit from such alterations. Gender mainstreaming involves unlearning old habits and practices. Resistance to gender mainstreaming may take the form of trivialisation, dilution, subversion or resistance. Resistance hinders gender equality laws, policies or programmes (WGEKN 2007).
Understanding the context for gender mainstreaming also reveals some of the challenges. Often, policymaking is characterised by a lack of connectivity between government departments and health agencies. Furthermore, policymakers in various sectors of government and health agencies are not encouraged to gather evidence on gender, gender impacts or gender differentiated outcomes. As a result, policy is rarely fully informed or analysed.
“In all the activities referred to in the Community shall aim to eliminate inequalities, and to promote equality, between men and women.”
Existing EU-Level Policies:
The Treaty of Amsterdam
Gender mainstreaming was included in the Treaty of Amsterdam. The European Commission adopted a strategy to promote equal opportunities for women and men in institutions, organisations and politics.
“The Community shall have as its task […] to promote throughout the Community a harmonious, balanced and sustainable development of economic activities, a high level of employment and of social protection, equality between men and women, […] a high level of protection and improvement of the quality of the environment, the raising of the standard of living and quality of life, and economic and social cohesion and solidarity among Member States” (Section 2).
Strategy for Equality Between Men and Women 2010-2015
The Strategy builds on the Roadmap for Equality Between Women and Men 2006-‐ 2010. It addresses issues concerning women’s economic interdependence, equal pay, decision making equality, and gender based violence using principles from the European Commission’s Women’s Charter (Europa, 2007).
5th Community Action Programme on Equal Opportunities 2001-2006
The programme aims to promote gender equality in the European Community with a budget of 61.5 million Euros. The projects must be transnational, involving at least three Member States and promote equal opportunities for men and women through disseminating values and practices, increasing understanding gender equality issues, and developing networks to exchange good practice (Europa, 2007).
Success of Gender Mainstreaming Efforts
By specifying gender equality as a common objective, the legal basis for the implementation of gender mainstreaming in all EU political, organisational, and administrative actions is reinforced.
Gender mainstreaming has not been highly successful until recently within EU due to the lack of agreement on the importance of changing gender systems by those who can alter them (Danau et al., 2010).
The Need for Gender Mainstreaming
Gender mainstreaming has the potential for conflict, but also is one of the most effective tools to eliminate gender inequality (Walby, 2005).
In order to be effective, gender mainstreaming should be integrated into all policies, even if they appear to be gender neutral (e.g. transport, finance, and environment). Gender mainstreaming should be applied at all levels national, regional, and local (Danau et al., 2010).
Gender mainstreaming offers a multidimensional approach that values the diversity among both women and men. The concepts of gender, gender roles and gender socialisation may differ between institutions and societies and may change over time.
Gender mainstreaming aims to eliminate harmful effects on either sex before making a decision (Booth and Bennett, 2002).
The Aim of Gender Mainstreaming
The aim of gender mainstreaming is to incorporate equal opportunities and gender equality in all the policies and activities. By specifying gender equality of men and women as a common objective, the legal basis for the implementation of the gender equality concept is reinforced. This legal basis ensures equal opportunities and gender equality in of political and organisational action.
The idea of gender equality must be taken into consideration during the planning as well as during the realisation and evaluation. Gender equality must be considered at all levels of responsibility in politics and administration.
The History of Gender Mainstreaming
The gender mainstreaming strategy of EU can be attributed to the World Conferences on Women in Beijing in 1995, with roots in the global network of women’s movements. The overall intention was to make the institutions of the UN system committed to the systematic incorporation of a gender perspective into policymaking (Hafner, Burton and Pollack, 2002).
The UN Economic and Social Council formally defined the concept as:
“Mainstreaming a gender perspective is the process of assessing the implications for women and men of any planned action, including legislation, policies or programmes, in all areas and at all levels. It is a strategy for making women’s as well as men’s concerns and experiences an integral dimension of the design, implementation, monitoring and evaluation of policies and programmes in all political, economic and societal spheres so that women and men benefit equally and inequality is not perpetuated. The ultimate goal is to achieve gender equality”
(United Nations, 1997).
W. H. O. Definition of Gender Mainstreaming
“If health care systems are to respond adequately to problems caused by gender inequality, it is not enough to simply ‘add in’ a gender component late in a given project’s development.
Research, interventions, health system reforms, health education, health outreach, and health policies and programmes must consider gender from the beginning.
Gender is thus not something that can be consigned to ‘watchdogs’ in a single office, since no one office can possibly involve itself in all phases of an organisation’s activities. All health professionals must have knowledge and awareness of the ways in which gender affects health, so that they may address gender issues wherever appropriate thus rendering their work more effective.
The process of creating this knowledge and awareness of and responsibility for a gender among all health professionals is called ‘gender mainstreaming.”
Conclusions from Analysis of Existing Practice
The policy area of gender mainstreaming contained the main good practice (GP) categories: helping structuring a way to mainstream gender equality, providing incentives to institutions/ organisations that mainstream gender equality, and providing tools or methods to facilitate the evaluation of progress (accountability) on initiatives to mainstream gender equality.
Only public health policies combining universalism (“for all”) together with specific (at least age, sex/gender, and socioeconomic status) measures based on statistical and research data would be successful to gain equity in health. Even if the system of free economic market in theory provides equal opportunities for all citizens to seek economic independence, in practice it is not true. There are cases of all types of discrimination, besides those based on gender. This problem is faced by many other countries in the EU, finding a solution is a challenge for the future at EU level.
Implementation of gender mainstreaming in all policies has to take similar approach as “Health in all policies” (Puska, 2007). There is a need for people educated on gender issues in all policy sectors to use evidence to support and advocate gender mainstreaming for improved population health. The goal of gender equity in health should be respected and regarded seriously by politicians, policymakers and public officials.
Good Practice Example 1:
Guidelines for Gender Equality Programs in Science, Multinational/International with DG Research, European Commission
The guidelines are based on a complex work of collection and assessment of practices developed in Europe, North America and Australia. A database of gender equality programs in science and technology is available on the web. The guidelines enable capitalisation of the knowledge on promoting gender equality in science and technology. The guidelines are useful for universities, research centrums and other stakeholders striving to implement greater inclusiveness of women scientists and to improve the working conditions on their premises.
Good Practice Example 2:
Corporate “Equality in the Workplace” Seal, Lithuania
This initiative is dedicated combatting gender segregation in the workplace. Women are more often employed in service oriented spheres of the economy and less in industrial production. Lithuanian women are positioned lower in the workplace hierarchy. The system of free economic market should provide equal opportunities for all citizens to seek economic independence but this does not occur in practice. Discrimination is a problem faced by many other countries in the EU and finding a solution has been and remains a challenge at the EU level.
Good Practice Example 3:
Public Health Policy Report 2010, Sweden
This monitored the implementation of health policies and interventions, evaluating their impact over five years. Results indicate that women generally reported poor health in comparison to men. Often women’s ill health is related to the work burden and stressful circumstances in their lives and at their workplaces. Women with disabilities, impaired abilities, and low education are often exposed to sexual assault and violation. Women with low incomes experience hardships with maintaining healthy behaviours and lifestyle. Gendered aspects are presented with measures and recommendations to enhance the health of both, men and women.
United Nations System Wide Policy on Gender Equality and Empowerment of Women
United Nations System Chief Executives Board for Coordination adopted the policy in 2006 to promote gender mainstreaming to empower women and achieve gender equality. The main components of the strategy are accountability; results-‐ based gender equality management; monitoring, evaluation, auditing, and reporting oversight; human and financial resources; capacity development; and coherence, coordination, coordination, and knowledge and information management. The policy was designed to work in conjunction with existing women-‐specific actions. (Chief Executives Board for Coordination, 2006).
World Health Organization Gender Mainstreaming Strategy
“The integration of gender analysis and action into the work of WHO would make an important contribution to its ongoing work on women’s health,”
Dr. Margaret Chan, WHO Director General (WHO, 2011b).
In 2007, the World Health Assembly passed the resolution mainstreaming gender in the work of WHO. The four components of the WHO gender mainstreaming strategy are to “build WHO capacity for gender analysis and planning”; to “bring gender into the mainstream of WHO’s management”; to “promote the use of sex-‐ disaggregated data and gender analysis” and to “establish accountability” (WHO, 2011b).
Steps for Policy Action
1. Strengthen gender mainstreaming at EU and national levels
Most EU member States have formally signed up to gender mainstreaming, but implementation has been extremely slow for many reasons. There has been a lack of understanding of the concept “gender mainstreaming” due to the lack of clear explanations of the value of consideration of gender in policy development. Resources such as disaggregated data and gender indicators are often lacking and these problems must be addressed. Models of good gender mainstreaming practice from member states must be examined and more widely disseminated, to the Member States.
2. Awareness raising inside and outside the government sector
Tools already exist that demonstrates how to implement gender at all institutional levels. These tools must be made available to oranisations at all levels with the support to these organisations to build capacity and expertise in the area of gender mainstreaming.
3. Strengthen political will to implement gender mainstreaming
There must be a concerted effort at EU level to convince governments and non governmetal organisations of the need for Gender mainstreaming at institutional level. The action must have sufficient funding and resources in trained personnel to ensure gender mainstreaming is accepted and implemented at an organisational level. Involve civil society in the process of awareness raising and to ensure that the efficacy of the implementation of gender in all policies and programmes is understood.
Margot Einöder Moreno, MD, Spain
Maria Hegarty, Equality Strategies, Ireland
Doriane Fuchs, European Public Health Alliance, Belgium
Peggy Maguire, European Institute of Women’s Health (EIWH), Ireland
Kristin Semancik, European Institute of Women’s Health (EIWH), Ireland
Eva Ulicna, National Institute of Public Health, Czech Republic
Hana Janatova, PhD, National Institute of Public Health, Czech Republic
Anna Månsdotter, PhD, Karolinska Institute, Sweden
Ineke Klinge, PhD, Maastricht University, the Netherlands
Carina A. Furnée, PhD, Maastricht University, the Netherlands
María Cristina Quevedo-Gómez, MD, MPH, Maastricht University, the Netherlands
Petra Verdonk, PhD, Maastricht University, the Netherlands
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2. United Nations system-‐wide policy on gender equality and the empowerment of women.
http://www.un.org/womenwatch/ianwge/gm/ UN_system_wide_P_S _CEB_ Statement_2006.pdf
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8. United Nations (1997). Report of Economic and Social Council 1997. September, A/52/3.18.
9. Walby S (2005). Gender Mainstreaming: Productive Tensions in Theory and Practice. Social politics 12 (3): 321-‐343.
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11)WHO (2011a). What is “gender mainstreaming”?
12)WHO (2011b). WHO Gender Mainstreaming Strategy.