Adaptive learning for gender-responsive health systems

We, in our engagement with the Bill & Melinda Gates Foundation and as a learning and evaluation partner for the Bihar Technical Support Project (BTSP), have built up considerable insight into the gender deficit in health system functioning and its negative impact on provider performance. Additionally, the Foundation has supported us to undertake a scoping study on ‘Integrating Gender in Health System’s Strengthening (HSS).

Building on these analyses and an identified need to strengthen gender-responsive health systems, with the support of Bill & Melinda Gates Foundation (India Office), ‘Adaptive Learning for Gender Responsive Health Systems’ supports the Foundation and its Technical Support Unit (TSU) partners in Uttar Pradesh and Bihar with active learning opportunities and technical support to build a robust understanding of processes and pathways for gender integration, identify programmatic entry points and design discrete approaches that can be adaptively tested. Towards this, we have initiated two key interventions:

• Creation of an active gender and health systems learning network GenderCollab. GenderCollab is a Community of Practice that brings together experts from around the globe to initiate dialogue, share their experiences, and spark action.
• Establishment of a ‘gender support desk’ that can provide need-based technical and advisory support to the Foundation, TSU partners and government stakeholders.

Challenges

Our in-depth work and learning made it abundantly clear that there is little by way of gender programming and evidence for women healthcare providers and managers within health systems, particularly in Low and Middle-Income Countries (LMICs). Conversations around gender integration in health systems have begun amongst the global community, but its penetration on the ground through various efforts is yet to be realised in any significant way. Through these interventions, the project aims to establish both a process i.e., adaptative, collaborative and flexible, and identify specific programmatic entry points for making health systems programming gender intentional, particularly in low resource settings. 

Additionally, through the GenderCollab, the project aims to bridge the learning and knowledge gap by enabling experts and partners to learn from each other’s efforts at integrating gender in their health systems. Although most partners are now adopting gender intentionality in their programmes, there is a gap in terms of practical entry points for shifting behaviour and work culture towards being more gender-responsive. Through this project, we are collaborating with partners to understand their programmes and collaboratively work through initiatives but given this is a new area of work, the process is both complex and slow and may not always garner the required support to initiate more transformative processes.

Expertise

We recognised that the entry points and opportunities to engage and provide support to strengthen gender integration in the health system require a collaborative, adaptive and flexible approach. For example, a TSU may identify an entry point in government where gender can be strengthened, or the Foundation may identify a specific gap in knowledge. The establishment of a ‘Gender Support Desk’ provides a means for us to respond with rapid technical assistance to TSU partners, the Foundation, and potentially the government. The ‘Gender Support Desk’ draws on OPM’s internal health, gender, and governance experts, as well as an associate pool of gender and health experts in India and international experts as required.

As a complementary initiative, we developed an active learning network - GenderCollab, curated to the needs of TSU partners to facilitate their efforts towards gender integrative programming. This is a Community of Practice (CoP) that brings together partners who are interested in learning and actioning practices to make their work in the health systems strengthening more gender-responsive and intentional.

Impact

Through this project, an immediate impact we envision is the strengthening of TSU’s efforts towards integrating gender into their health system programming.  In the long term, the project will be able to establish key learnings on processes and entry points that can be adopted by health systems in LMICs to integrate gender in health systems strengthening initiatives. Overall, we hope that by establishing a strong learning network, providing practical entry points and knowledge products that enable easy adoption in health systems, the project will contribute towards addressing the existing gender disparities that healthcare providers and clients face be it at the systemic, policy or at the facility level. With improvement in the gender responsiveness of health systems and facilities, universal health coverage may be a reality.