Training in Gender and Reproductive Health

The Programme of Action agreed at the 1994 International Conference on Population and Development states that, "In the coming years.. programmes should expand and upgrade formal and informal training in sexual and reproductive health care and family planning."

"Operationalizing Cairo and Beijing" is the title of a training initiative in gender and reproductive health that has developed as a result of cooperation between the WHO Department of Reproductive Health and Research, Witwatersrand University in South Africa, and the Harvard School of Public Health in the USA. The goals of the training initiative are two-fold, namely:

• to build institutional capacity in training centres throughout the world so that they can offer regionally-appropriate training in gender and reproductive health covering aspects of research, service delivery and policy development; and

• to increase the number of programme managers, planners, policy-makers and trainers with both a gender perspective on health and the technical skills needed to contribute to increasing access, quality and comprehensiveness of gender-sensitive reproductive health policies and programmes.

The training initiative has developed a core curriculum and is supporting its adaptation in different regions. The core curriculum features practical examples of how an understanding of gender can change the way people view the determinants of ill-health and the way research is designed and evaluated. The draft curriculum was pilot-tested in Johannesburg, South Africa, in 1997, at a course for 32 programme managers, policy-makers and trainers from Botswana, Kenya, Mozambique, Namibia, Nigeria, South Africa, Tanzania and Zimbabwe.

The core curriculum on gender and reproductive health is designed for a three-week course and has six modules: determinants of health and illness, gender, reproductive rights, research, policy, and health services. Each module comprises a range of teaching and learning sessions that include lectures, case studies, participatory exercises, field projects, and planning and research exercises.

The module on the determinants of health and illness introduces the concept of social determinants of health to show how health is more than a medical issue; the module identifies gender as one of these social determinants and promotes an understanding of how gender can shape policies and interventions. The module on gender explains how gender concepts are built, maintained and reinforced, and how they influence development and health in general and reproductive health in particular.

The training module on reproductive rights helps participants to understand what sexual and reproductive rights are, how they can be applied to analysis and action, how they can be ensured by strengthening national and regional partnerships, how their implementation can be monitored and evaluated, and how individuals and institutions can be held accountable for them. The module promotes the ability to use the framework of human rights in improving sexual and reproductive health, and to use a reproductive rights approach to shape research, interventions, services and policy.

The module on research enables participants to apply a gender analysis to health research, to identify data that can be used to improve gender equity in reproductive health, to recognize gender bias in reproductive health research, and to understand international ethical norms for research. The module on policy identifies critical approaches that must be used to make policy decisions as effective as possible while also promoting equality, including gender equality. The module on health systems focuses on the different elements of health systems and how they inter-relate, shows how the way that a health system functions affects the quality of care, and explores the impact of gender relations on planning and organization. 

Pilot courses in four centres The training course is being adapted to be run in four regional training centres in 1999: (i) Key Centre for Women's Health in Society, Melbourne, Australia (5–23 July); (ii) Centre for the Study of State and Society (CEDES), Buenos Aires, Argentina (30 August –11 September); (iii) Yunnan Reproductive Health Research Association, Kunming, China (6–24 September); and (iv) the Centre for African Family Studies, Nairobi, Kenya (4–22 October 1999). Based on the experience of these four courses and the South African course which has now been run three times, an international and regional Core Curriculum on Gender and Reproductive Health will be produced and published in the year 2000. The Curriculum will be published in English, and eventually in Chinese, French, and Spanish.

Programme activities in the WHO Eastern Mediterranean Region "Women's needs and gender perspectives in reproductive health in the Eastern Mediterranean Region" was the title of a meeting between women's health advocates, researchers, service providers and policy-makers which took place in Casablanca, Moroco, in November 1997. Participants agreed on a number of key topics for research, and ways of incorporating reproductive rights into reproductive health policies and practices. In particular, they called for a review of existing laws and regulations, formal and customary, as well as traditional, harmful and other practices related to reproductive health. The Programme is currently identifying existing reviews of laws and practices affecting reproductive health with a view to making this information more widely available.  The report (document No.WHO/FRH/WOM/98.2) of this meeting is now available from the Programme on request. Please write to Editor, Progress, HRP, World Health Organization, 1211 Geneva 27, Switzerland.