We have seen and heard this all before: every time there is a pandemic, multiple stories and articles appear about the impact on women and girls. We hear that girls are vulnerable to violence, unwanted pregnancy, early marriage, not returning to school and other negative outcomes. Many of us know this is true because we have seen it firsthand with Ebola and other health and humanitarian crises. It begs several questions: why do the same stories keep appearing? Are we learning all that we should be learning from every previous pandemic and challenging traditional gender norms in every aspect of our work? Are we effectively incorporating those learnings into how we design and deliver programs?
What do we know already?
What do we know already? Not as much as we should: less than one percent of published research on Ebola and Zika crises explored the gendered impact and implications of the outbreaks and responses. Still, there have been good attempts to catalogue the role gender played in the Zika and Ebola epidemics. A key lesson learned is that gender bias plays an important role in the delivery and uptake of health services. Public health advice cannot be designed in a vacuum. If girls lack the autonomy and economic, social, and legal or regulatory standing to take advantage of whatever public health advice or assistance is provided, the battle is already lost. Leaving structural inequalities out of the design of programs to address the health, social and economic risks of COVID-19 makes programs far less effective.
Understanding the role of gender in pandemics is essential to crafting effective and sustainable short-term responses to address the spread of COVID-19 infection. It is also crucial for longer-term interventions to support the creation of more resilient health systems that consider the health status of the entire population and more effective, equitable and therefore, more sustainable economic recovery.
What actions should we be taking to address this need?
An obvious one is around data. Data being collected on both the needs of the communities and the impact of the responses, have to be disaggregated by gender and age. The reality adolescent girls face is quite different from that of women. Simply understanding gender differences may not be enough. But good data collection requires a deep understanding of the realities of those you are trying to reach. This means that voice matters. Women and girls need a seat at the table; this is where it gets more complicated.
In humanitarian crises, women and girls are often excluded from community-level decision-making processes; they are not part of governance structures that shape the response strategies. Adolescent girls, in particular, are often ignored and marginalized. “Social norms and gender roles often restrict women’s ability to participate in decision-making processes, and this impacts the degree to which their specific needs are taken into consideration, both during the response itself and later, during the design and implementation of economic relief packages, new services, or other support systems.” As late as 2018, only 56% of the monitored crisis contexts directly consulted with local women’s or girls’ organizations in the humanitarian planning process.
But we need more than women and girls having a seat at the table when designing, executing, and monitoring and evaluating responses. We need women and girls in the driver’s seat. This is not about consultation but power, agency and autonomy. At Plan International, we know that when we put girls not just in the center but in control of the consultation, data gathering and design processes, we get better designs and better execution. In a recent program design session with adolescents in Zimbabwe, we had several assumptions from project staff, and local leaders challenged. This included that bikes could be a method of transportation to help girls regularly attend secondary school. They quickly informed us of the reality that male family members would take bikes for their own use. This type of engagement is more complex, particularly in emergency responses. It may be harder, but it is necessary.
And success requires that responders look in the mirror to face their own biases. All too often, researchers and those charged with designing responses have little or no understanding of how gender norms and expectations shape girls’ and women’s roles in these types of emergencies. When health emergencies arise, questions of gender tend to be forgotten, or at best seen as a side issue. This cannot continue. Nor is it useful to silo gender work. Understanding the gender aspects of a pandemic is not just work for the “gender specialists” within the various institutions. It is everyone’s business.
How do we achieve this?
Organizational culture matters. We should be intentional about not just how we design responses but how we recruit and mobilize the response teams. A culture of diversity, equity and inclusion among first responders – from doctors, government officials, to the military – and in all humanitarian actors is not just a nice-to-have but a must-have if we are to address gender data gaps and develop effective sustainable programs.
Bottom line: building gender-awareness into operational responses to complex health emergencies is not enough. We need to consider whether and how efforts to address emergencies can also help transform norms and expectations about gender roles that are seriously impairing the effectiveness of response design and execution. Unless we face these entrenched biases – including our own organizations, not just in the communities where we work – head-on, we will continue to research, design and execute programs that are only half effective.