Gender influences on child survival, health and nutrition: a ... - Unicef

<strong>Gender</strong> Influences On Child Survival, Health And Nutrition: A Narrative Review
2 GENDER-SENSITIVE INTERVENTIONS ADDRESSING
CHILD HEALTH AND NUTRITION
Introduction
This section addresses the question “Which approaches to addressing the impact of gender inequalities,
roles and relations on young child survival have been assessed and with what results?” as outlined in the
introduction to this document. In order to achieve this, we have reviewed evaluations of interventions
which have used an aspect of gender-awareness in their intervention design with the aim of addressing
issues around child health and nutrition.
As highlighted in the methods section we conducted an extensive search using a number of databases
and hand searching journal issues as well as contacting 42 gender and health experts and accessing over
20 websites to ensure we had covered academic and ‘grey’, non-academic literature. Despite using this
combination of methods we have identified only 4 evaluated interventions, plus a review of 20
conditional and non-conditional cash-transfer programmes (see Annex I for a table summarizing these
evaluations and their findings). While there are important examples of evaluations of interventions
which have encompassed aspects of gender in relation to maternal and reproductive health, more
needs to be done to plan and evaluate gender dimensions of child health and nutrition initiatives.
The following sections explore these interventions in three categories: first, those addressing service
delivery; second, those addressing community participation; and third, those beyond the realm of health
and nutrition programmes, addressing social protection and financial inclusion (e.g. cash transfers and
micro-credit schemes). It is important to note that although most of the interventions identified do not
explicitly refer to the concept of gender in their description of their activities, they have been included
because their approach implicitly addresses dimensions of gender explored in the review.
2.1 ADDRESSING SERVICE DELIVERY
Service delivery through facility-based services produces considerable barriers that are gendered and
structural and relate to women’s freedom to travel, the distance they might be required to travel and
the costs incurred through user fees. Furthermore, facilities are not always male-friendly and may place
emphasis on women to attend, thus discouraging parents to share responsibility for accessing
healthcare for their children.
GENDER SENSITIVE INTERVENTIONS
There are other issues in expecting women to use facility-based services. As seen in section 1.3.1 of the
review, one of the problems with encouraging women to engage in paid labour through microcredit
schemes lies in the potential for such ‘extra’ work to impede on women’s already tight schedules. This
potential clash of ‘benefits’; one being increased income for women and their families; the other being
their access of healthcare provision for their children; may be addressed through the provision of such
healthcare services at more appropriate times or in more appropriate places for women and their
families.
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