On March 15, Country Health Information Systems and Data Use (CHISU) hosted their webinar titled, “Integrating Gender in Health Information System Strengthening: Experiences from Burkina Faso, Ghana, and Indonesia.”
Dr. Stephanie Watson-Grant, Deputy Director, CHISU, moderated the webinar with panelists:
- Dr. Godwin Afenyadu, Resident Advisor, CHISU Ghana
- Dr. Andrews Ayim, Deputy Director, Policy, Planning, Monitoring and Evaluation Division (PPMED), Ghana Health Service
- Dr. Rahim Kebe, Resident Advisor, CHISU Burkina Faso
- Ms. Leah McManus, Resident Advisor, CHISU Indonesia
- Ms. Raissa Ouedraogo, Director of Communications, Ministry of Health, Burkina Faso
- Ms. Dian Sulistiyowati, Head of Information System Standardization Working Group, Center for Data and Information Technology, Ministry of Health, Indonesia
Stephanie prefaced the discussion by noting that over the last two years, CHISU has been deliberately and systematically integrating gender in their health information system (HIS) interventions. CHISU developed a gender in HIS considerations guide that allows project staff to identify and select gender-related tasks that can be implemented based on the agreed country work plan.
In Ghana, CHISU does capacity building through training on data quality improvement and also on how to analyze and interpret that data in a way that can inform decision making. Godwin noted, “We try to mainstream gender into our training activities by collaborating or working with our stakeholders to ensure that in the selection of participants, we have some equity in the representation of male and female gender.” In addition to advocating for inclusion of gender in the selection of training participants by the Ghana Health Service, CHISU is building the Ghana Health Service’s capacity to analyze data to understand the impact of interventions on the different genders.
In Ghana, owing to a document produced in 1999 by the Ghana Health Service and the Ministry of Health, promoting gender equity in health and a framework for action, objectives were set for gender mainstreaming in a more significant way, which also led to gender based planning. In response to poor access and utilization of healthcare services, the Ghana Health Service/Ministry of Health looked at the availability of delivery services for the population. Andrews noted, “We needed to look at the policy of community-based health planning services so that a lot more women [would] get access to prenatal care and delivery postnatal care, [and as we] started measuring these two, we [began] to see improvement and increase in access.”
In Burkina Faso, CHISU is engaged in capacity building at different levels of the HIS, including at the community level, and in particular, event based surveillance training. Rahim showcased an example of arranging for breastfeeding breaks for community health workers during their training. He noted that this initiative was welcomed by all actors, in particular, the breast-feeding mothers, who were able to have sufficient time to take care of the babies and actively participate in training. Rahim noted, “This practice is based on Burkina Faso’s labor code, [which specifies that gender should be taken into account] at all levels, and specifically allows work to be adapted so that women can both participate in activities and [fulfill] their roles as mothers.”
In Burkina Faso, gender is a very important topic within the current country policy, and all data related to gender is used to develop different policies, whether it is strategies or programs the government is implementing. The Ministry of Health developed a gender action plan in 2022, which was the first of its kind. Within the Ministry of Health, in the new organogram, the percentage of women has increased in the past few years, and within all ministries, there are a lot of women that are leaders and decision makers. Raissa noted, “It is very important that we all focus on the same vision and the ministry is abiding by it. They require a community health service coverage for all within this program. You will see that gender has a very important place, especially women’s empowerment—we respect gender equality and gender equity, and we respect women above all. We have also developed community health clubs, which are led by women.”
In Indonesia, gender was fully integrated into the Ministry of Health’s digital maturity assessment, which allows for some good metrics to work with to better understand how Indonesia is progressing in its continuous improvement of digital health in the country. Leah noted, “We see integration of gender as well beyond collection of sex disaggregated data, but looking at supporting the Ministry of Health and the overall HIS ecosystem in Indonesia to put a gender lens on planning, policy and regulation development, and promotion of gender parity of participants and decision-making bodies, and the implementation of activity. All of this to really carry forward the digital health transformation.” CHISU has also worked closely with the various units within the Ministry of Health to improve existing dashboards to ensure that data is disaggregated by sex, and also providing guidance on improving interpretation and use of health data to identify and address sex differentials, and gender related issues.
While gender is a consideration in the digital health transformation in Indonesia, the landscape is particularly dominated by men. While there are women involved in the transformation agenda, in general they are not in decision making roles. Dian noted, “If women lack voice in the design and development of the health information system, there will be an inequality of men and women’s influence in the digital transformation. Gender equity is a keystone of sustainable and inclusive growth in a country, and the health sector is a major component of this.”
While all of the speakers touched upon the importance of gender disaggregated data for policy making, they also stressed that we need to go beyond disaggregated data and address equity in planning and policymaking, in capacity building, and also consider and address the different needs of women when designing service delivery. It is very promising to see that in the three countries we covered, while there are variations in how gender is incorporated in HIS strengthening, the constitutions/laws enshrine gender as a critical component of policymaking.