Globalization, Health Sector Reform, Gender and ... - Ford Foundation

powerful special interest groups, and the acute health needs of alarge, impoverished population. As a result, inequalities betweenwomen and men that are primarily caused by structural and institutionaldiscrimination remain either openly manifest or latentwithin the health sector and its program interventions.HSR is not a uniform concept. It covers a wide range of structuraland institutional changes which have definite consequences forgender equity, sexual and reproductive health, and the generalhealth of the entire population. When some of the dilemmas thathave direct or indirect impact on sexual and reproductive healthare highlighted, the enormous implications of the HSR approachfor sexual and reproductive health advocates, and thus for institutionssuch as the Ford Foundation, become clear. Identifying thebarriers and opportunities for bringing a gender perspective tosexual and reproductive health in a context of HSR will enablethe RHAG to create options to drive the HSR and sexual and reproductivehealth agenda forward.Sexual and reproductive health advocates can have a significantinfluence on the reform process once they understand their possiblerole in managing change within the health sector. Achievingthis understanding sometimes requires re-training of staff andpossibly changes in the skills mix, attitudes and organizationalstructure of the advocates’ institutions.Being part of the HSR process requires an understanding of thereform’s main components and of the development of the reformprocess within a country. Only then will it be possible to influencethe HSR process to ensure that it supports reproductive healthobjectives and is gender-sensitive.If health reformsare to succeed, theyrequire the leadershipand participation ofboth the nationalgovernments and thewider civil society.40