Research for stronger health systems during and after crisis

Developing an online learning resource for European Commission health delegates: process and reflections

Posted on Monday, 13 Nov 2017

By Sally Theobald, Joanna Raven and Nick Hooton


Sally Theobald and Joanna Raven from ReBUILD and RinGs, have recently been working with the European Commission to develop a new open access online learning resource on Gender and Health Systems, drawing on the experiences and insights from ReBUILD’s gender research, and case studies developed as part of the Building Back Better resource. In this blog they reflect on this collaborative process, and the importance for galvanising gender analysis in the policy and practice activities of health systems stakeholders.

The Learning Resource – Gender and Health Systems – can be downloaded here.

As well as its research objectives to better understand gender issues in health systems, the RinGS programme also has objectives to galvanise gender analysis in the policy and practice activities of health systems stakeholders. We recently had an opportunity to work with the European Commission – a major funder of health systems strengthening initiatives globally, to help expand their resources available on gender and health (as part of the EU’s second Gender Action Plan 2016-2020). Working with Dr. Maryse Simonet of the EC’s DEVCO B4 team, Sarah Hawkes (University College London and  member of the RinGS advisory panel),  Sally Theobald and Joanna Raven (ReBUILD and RinGs) and Rosemary Morgan (RinGs) worked with EC health staff both centrally and from country offices to develop resources to inspire and support further action on gender equity. We worked collaboratively to consider a range of health responses to promote gender equity which EC delegates could operationalise within their complex portfolios of health systems strengthening projects. This has now led to the development of a new open access online learning resource on Gender and Health Systems.

The online learning resource defines key gender concepts and links to relevant open access tools, resources and frameworks which can be applied to support gender analysis in different contexts and across different health systems issues. The health systems approach and frameworks provide opportunities to institutionalize gender equality in a sustainable manner and to enhance policy synergies amongst the four pillars of the EU second gender action plan:

  • Ensuring girls' and women's physical and psychological integrity

  • Promoting the social and economic rights / empowerment of girls and women

  • Strengthening girls' and women's voice and participation.

  • Shifting the institutional culture to more effectively deliver on EU commitments.

The online learning resource is supported by case studies, which explore how gender influences rates of risk exposure to common drivers of ill-health, patterns of health-care seeking for women and men, analysing and assessing the implications for health systems and global health institutions.

A specific component, drawing from our Building Back Better work, illustrates how gender analysis applies to specific health systems contexts – those which are fragile and conflict affected, drawing learning from across the health systems building blocks and identifying the attributes and processes required for a gender equitable health system. Additional case studies present health systems challenges from a gender perspective in Zimbabwe and Guinea Bissau.

It was an interesting process to collaboratively develop these case studies, working with the health specialists, teaming with the gender focal persons, in various EU delegations in in charge of health development projects, mostly in low resource settings. Through reflective practice and shared learning, we developed deeper understanding of the realities of these different contexts. We also had input from EC delegates from Nigeria and Tunisia to enable discussion on the extent to which challenges (and solutions) identified were context specific or had a wider applicability. A seminar was held with delegates to discuss the case studies and resources which triggered a range of reflections and critical questions: on strategies and approaches to ensure gender analysis also include a focus on men and boys; the importance and challenges of fostering intersectoral collaboration to promote gender equity in interventions such as those addressing gender-based violence; the challenges of fast paced change and multiple players in conflict affected contexts; and the importance of gender indicators,  collecting and using sex disaggregated data and gender analysis to resist the “evaporation” of a gender  focus in policy and practice at all levels of the health system. 

As well as the learning support tool now being used by the DEVCO unit to inform its own decision making, open options for introducing practical gender interventions in project design and help shape priorities throughout its health and gender programmes, it is now available as an open access resource for anybody to use.  Other resources developed to support gender-sensitive health responses in DEVCO’s operations include a video and an internal  brief from the interactive health thematic seminar held with EC delegates.

This venture has also benefitted from the ability to bring context-specific findings from ReBUILD – one of RinGs’ constituent research consortia – and the broader learning from RinGs as a collaborative initiative, to provide complementary evidence to support policy and practice. ReBUILD – including through the Building Back Better resources – has informed specific elements around the issues of gender considerations in fragile and conflict-affected settings, while the broader learning from RinGs brought approaches and learning which are broadly applicable in all settings, to galvanise priority for addressing gender inequities and supporting intersectional analysis through sharing of open access resources, tools and approaches.

We would like to congratulate the European Commission for developing a gender action plan and making key strides to ensure that gender is part of their core work and enabling exchange between different contexts.  We were very happy to be part of the process and learned a lot through it, and we hope you find the online learning resource helpful. We also hope that the French version, in the making (thanks to the EC), shall trigger exchange and broaden involvement of EUDs and partners, especially in countries, with health systems in development or under stress.