Overcoming Gender Barriers in Ethiopia: A Q&A with Pathfinder's Heran Abebe

Heren Abebe

Heran Abebe is a Senior Gender Advisor for the Integrated Family Health Program (IFHP), a USAID-funded program led by Pathfinder International and John Snow Inc. in partnership with the Consortium of Reproductive Health Associations (CORHA), and other local implementing partners in Ethiopia.

As a part of her work with IFHP, Heran works closely with men and women on gender issues. She is responsible for leading IFHP’s gender activities, with a focus on integration of gender across other program areas. Recently, Heran spoke with our headquarters staff about why gender is important in Ethiopia, how she was first drawn to gender work, and IFHP’s exciting gender initiatives on the horizon.

Why is working on gender important in Ethiopia?
Working on gender is important in Ethiopia because a lot of women and men are victims of socially constructed, harmful gender norms which determine their access, vulnerability, and decision-making power about their own lives. When you look at key statistics in education, employment, asset ownership, decision-making, etc., women lag behind in almost all aspects. Although some improvements can be seen in the past years, equality still has a long way to go. Gender-based violence is also a serious concern as most harmful traditional practices are skewed against women and girls, risking their health and overall wellbeing. Working on gender is critical because it is important not only to improving the quality of life of women, but also serves the interest of men as well.

What inspired you to work on gender?
I was drawn to work on gender and driven by my desire to contribute to changing the lives of women and girls who have been denied opportunities and resources just because they are female. Witnessing the inequality between men and women in so many aspects of life and the suffering that many women and girls undergo because of socially created norms and values is unacceptable to me. Men and boys, although the prevailing gender norms grant them better opportunities, are also forced to behave in certain ways that are not good for themselves and for their families. I try to address these issues in my work on gender.

I was drawn to work on gender and driven by my desire to contribute to changing the lives of women and girls who have been denied opportunities and resources just because they are female. What are some of the issues that you work on under the Integrated Family Health Program?
IFHP supports the implementation of Government of Ethiopia’s integrated model for service provision of family planning/reproductive health; maternal, newborn, and child health; adolescent and youth sexual and reproductive health; HIV; and malaria health services. Gender is a cross-cutting issue across all these program areas. Special attention is given to the prevention of harmful traditional practices (including early marriage and female genital cutting) and obstetric fistula.

In communities, IFHP trains health care managers and providers on gender mainstreaming; creates awareness of harmful traditional practices; works closely with religious and community leaders; increases availability of job aides; and at the federal level, provides technical support to the Gender Directorate.

What kind of barriers do you see to improving gender issues?
When you work on gender, you are challenging a long existing status quo, so there is resistance to change attitudes and beliefs that are deeply ingrained in people’s mind since childhood. Therefore, the process takes time for people to really understand and recognize gender norms and values, and the direct impact those aspects have on how they live and behave.

In some cases, even if people are aware of gender, they may be afraid to fight for a change because they could be perceived as being a deviant. Another barrier is the lack of comprehensiveness of the interventions, which means that changing gender norms not only requires a simultaneous focus on individuals, but also on peers, family, community and society, which is something IFHP tries to address.

Has IFHP been successful in addressing gender in its work?
There are a number of key gender milestones that IFHP has contributed to in Ethiopia. With IFHP support, gender issues are addressed as part of routine health service provision in 85 percent of health centers in IFHP areas.* (Source: Programmatic data from "The Random Follow Up Visit, 2011")

IFHP’s contribution to the decline of harmful traditional practices is also tremendous, which can be observed from our program follow up visits at the household level. For example, in the regions where IFHP works, the age at first marriage has increased from 15.7 years to 16.8 years, while at the same time, there is a declining prevalence in early marriage from 26 percent to 19 percent. Female genital cutting has been reduced from 21 percent to 12 percent and fistula cases have dropped from 15 percent to 8 percent, with more women identified, referred, and treated.* (Source: Programmatic data from "The Random Follow Up Visit, 2011")

As a result of its commitment to gender, IFHP is a member of National Female Genital Mutilation Network and has had key contributions in the network’s development of strategic plans, IFHP also serves as the Secretariat of the National Gender and Health Technical Working Group and plays a visible role in the ongoing development of the National Gender Mainstreaming Guidelines for Health.

You were recently part of the National Gender Mainstreaming Guideline Technical Working Group. Can you share a little bit about your role and involvement in the committee?
In October 2012, the Federal Ministry of Health’s Gender Directorate called a meeting among its health partner NGOs to establish a Gender and Health Technical Working Group. The Integrated Family Health Program was invited to this important meeting and I was selected as Secretariat of the TWG. In the same meeting, a subcommittee consisting of five members was established to help with one of the priority activities of the Gender Directorate. The priority activity was revising the National Gender Mainstreaming Guidelines, which had been developed 10 years ago and was actually on shelf. The Integrated Family Health Program was selected as a member, along with the World Health Organization, Futures Group/Health Policy Project, Population Council, and two representatives from the Government’s Ministry of Women, Children, and Youth Affairs and the Population Directorate of the Ministry of Finance and Economic Development.

The subcommittee provided strong technical backup to the consultant who was responsible for leading the process and writing-up the revised guideline. There were a series of meetings, consultations and experience sharing among committee members to shape the new version of the guidelines. Each of the chapters was constructed through detailed analysis, discussion and technical inputs from the committee members. The collective efforts led to the production of the final document which is currently awaiting endorsement by the Minister.   

Pathfinder International and the Integrated Family Health Program also does work on male engagement. Can you tell me more about that? 
IFHP’s male engagement strategy not only works to sensitize men about gender issues; it sees men as clients of available services, as supportive partners to their wives, and as change agents in redefining harmful male gender norms.IFHP’s male engagement strategy not only works to sensitize men about gender issues; it sees men as clients of available services, as supportive partners to their wives, and as change agents in redefining harmful male gender norms. IFHP engages men by sensitizing its staff and partners on the importance of male involvement on issues of gender. In order to build the capacity of its field officers and government partners, to develop their understanding of the importance of male engagement, IFHP recently conducted two trainings on male engagement in sexual and reproductive health. The program used experts from Pathfinder International’s global project Evidence to Action (E2A) to facilitate the trainings. Evidence-based global experiences were shared during these trainings to demonstrate how projects can engage men in addressing sexual and reproductive health. At the end of the training, participants developed an action plan based on lessons from the trainings on how to engage men in their existing activities and how to look for indicators in order to track progresses.

Is there anything we should look forward to on gender from IFHP?
IFHP is committed to improving and supporting the Government of Ethiopia’s initiatives in the health sector. A number of exciting initiatives are being undertaken that demonstrate the commitment to gender issues. IFHP has been working hard to engage both men and women to reduce gender-based harm in the country and look forward to continue supporting the Government of Ethiopia in addressing gender inequality and improving the lives of both men and women.

*This data shows program performance is not representative and cannot be compared with population based surveys. The data is primarily used to follow trends in the program until population based data are available from IFHP’s endline surveys.

Minal Rahimtoola

Minal Rahimtoola is a Pathfinder International Technical Advisor.

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