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Expert Group Meeting on Women and Health Mainstreaming the Gender Perspective into the Health Sector Tunis (Tunisia) 28 September to 2 October 1998

Aide -M閙oire

Introduction

The Division for the Advancement of Women is organizing jointly with the World Health Organization (WHO), the United Nations Population Fund (UNFPA) and in association with the Commonwealth Secretariat, an Expert Group Meeting on "Women and Health - Mainstreaming the Gender Perspective into the Health Sector", which will take place in Tunis (Tunisia) from 28 September to 2 October 1998.  In the follow-up to the Fourth World Conference on Women, the United Nations'Commission on the Status of Women will consider "Women and Health", one of the critical areas of concern in the Beijing Declaration and Platform for Action (1995), as a priority theme at its forty-third session in March 1999. The Expert Group Meeting will contribute to the discussion of the Commission on the Status of Women in this area and elaborate action-oriented recommendations.

I. Background

Women experience disease and disability differently from men, owing to societal and biological factors. An analysis of women's health conditions over the life cycle and under various circumstances indicates that women continue to be discriminated against at many levels of the health sector, including the health care delivery system, access to and availability of quality services, allocation of resources, decision-making and research.

The Platform for Action, adopted at the Fourth World Conference on Women in Beijing (1995) identified "Women and Health" as one of the critical areas of concern and defined five strategic objectives: Increase women's access throughout life cycle to appropriate, affordable and quality health care, information and related services; strengthen preventive programmes that promote women's health; undertake gender-sensitive initiatives that address sexually transmitted diseases, HIV/AIDS, and sexual and reproductive health issue; promote research and disseminate information on women's health; increase resources, and monitor follow-up for women's health. The Platform emphasizes the importance of a holistic and life-cycle approach to women's health.

There is a need for greater gender sensitivity in the health field, as suggested in the Agreed Conclusions of the Economic and Social Council 1997/2, which stated that "mainstreaming a gender perspective is the process of assessing the implications for women and men of any planned action, including legislation, policies and programmes, in any area and at all levels." The key to successful implementation of the Platform's recommendations and to improved health for women and men is the mainstreaming of the gender perspective. A gender approach to health care and health care delivery would take full account of existing gender differences in health care provision, at all levels. It would include the integration and institutional mechanisms that support women's participation in the health system.

In the follow-up to the United Nations' global conferences, in particular the Fourth World Conference on Women (1995) and the International Conference on Population and Development (1994), a number of Governments and international organizations have started to implement the recommendations related to women and health and endorsed them in their health policies. Many national action plans prepared in the follow-up to the Fourth World Conference on Women contain, inter alia, concrete action-oriented proposals for the health sector. However, many countries face difficulties and are asking for assistance in designing a comprehensive national action plan for the health sector that would be gender-sensitive. As a result of reforms in the economic and social sector in many countries, far reaching reforms are being introduced in the health sector in order to make health systems more relevant, sustainable, efficient and cost-effective. While providing an opportunity to restructure the health sector in a genuine way that would include gender as an integral component of the health system, the new frameworks may risk sacrificing some of the principles adopted at the global level such as the access to appropriate, affordable and quality health care.

Recently efforts have been made to consider health in the framework of human rights. When health is considered as a human right and not a social good, rights and responsibilities need to be defined accordingly. The Committee on the Elimination of Discrimination Against Women is preparing a General Recommendation on Women and Health which will elaborate the meaning of women's right to health as outlined in Article 12 of the Convention on the Elimination of All Forms of Discrimination against Women. It will thereby provide States parties with clear indications of steps required to fulfill their obligations with regard to the Convention. This work will be going on in parallel to the consideration of the critical area of concern "Women and Health" by the Commission on the Status of Women.

II. Objectives

Following on the work undertaken by a number of organizations, including the Commonwealth Secretariat in the development of gender management systems for the health sector, the Expert Group Meeting will discuss and develop a framework useful in the design of national health policies with an integrated gender perspective. Recommendations of the meeting should address both content of such policies and the processes through which governments could develop their national gender approaches to health care. The meeting will also aim at raising gender awareness of the key actors in the health field (policy makers, health professionals, non-governmental organizations, civil society, private sector and international community). The Expert Group Meeting will focus on the necessity of defining strategies for institutional reforms and a multi-sectorial approach to health care. Such a framework could be developed in a long-term perspective going beyond the consideration by the Commission on the Status of Women.

The Expert Group Meeting will focus on two major issues:

1. Analysis of existing health policies

- analyze selected health areas/programmes (e.g. reproductive health, environmental health, tuberculosis and mental health) and health related topics (e.g. health technology, health financing) from a gender perspective;

- draw conclusions relevant for gender-sensitive policy-making in the health sector.

2. Development of a framework

- integrate the gender perspective into health care policies, programmes and research, which would provide guidance and support to countries;

- discuss the implications of a gender approach for institutional change and allocation of resources.

III. Methods of Work

The Expert Group Meeting will look into the various topics and develop a framework for a gender approach to health care that will be forwarded to the forty-third session of the Commission on the Status of Women in 1999. Experts will be invited to prepare inputs on specified issues or case studies in line with their expertise. The Expert Group Meeting will work in plenary session and in smaller working groups based on the major issues identified.

IV. Profile of Participants

The Expert Group Meeting will be attended by 10-12 experts appointed by the Secretary-General of the United Nations as well as observers from Governments, entities of the United Nations system, intergovernmental organizations and non-governmental organizations. The United Nations will provide travel and daily subsistence allowance for the experts. In selecting the experts, the criteria of geographical and gender balance will be respected. The participants will be drawn from a variety of fields and include experts from the health sector, public and private health care delivery systems, finance and policy making, medical education and research, anthropology and technology.

V. Documentation

The documentation for the meeting will include papers prepared by the Division for the Advancement of Women and the World Health Organization outlining the major issues to be discussed and inputs prepared by the experts on the various topics identified. Observers will be invited to contribute inputs from their own perspectives. The Expert Group Meeting will be conducted in English and French. The documentation will also be in English and French.