Health Sector by gyvwpsjkko



                           for the
                                     Health Sector

Why a gender policy guidelines for the Public Health
Sector?                                              3
What is the gender policy guidelines for the Public
Health Sector comprised of?                          5
Policy Guidelines                                    6
Implementation Guidelines                            7
Division of departmental responsibilities            8

Gender Focal Points                                 9
       Function and location                        9
       Areas of involvement of the GFPs            10
       Resourcing of Gender Focal Points           12
       Coordination between GFPs,
       departmental directorates and other
       State organs                                13
       Inter-sectoral coordination                 15

Participation by civil society                     16
Gender Policy Goals                                18
Monitoring and Evaluation                          20
Much needed change                                 22
Vision and Mission                                 23
Why a gender policy for the Public Health Sector?

The social norms and values within society that discriminate
against women often have a hidden impact on the quality
and efficiency of the activities of the Department of Health.

Amongst other constrains, women health providers
experience gender discrimination from two sources – at
home and at work. The health service does not take into
account the physically debilitating double shift that women
work – paid employment plus their home and family
responsibilities. Also, women health workers, such as
nurses working alone in clinics at night, face the societal
hazard of violence against women.

Within the health system as a whole, women are at the
bottom of a gendered institution, with rules, procedures
and a culture established without women’s input. The
doctor-nurse relationship perceives nurses as subordinate
– at the receiving end of instructions. Yet, as front-line
health providers, running rural services on their own, their
ability to innovate and make responsive decisions
contributes to the effectiveness of the health system.

The effects of this inequality impact adversely on all
receivers of health services – men as well as women.

                           Page 1
South Africa’s Constitution guarantees equal rights and
opportunities for all, irrespective of race, creed or gender.
The Government’s gender equity policy is spelt out in the
National Policy Framework for Women’s Empowerment
and Gender Equality 2000, which is in keeping with
South Africa’s international responsibilities to the
Convention on the Elimination of All Forms of
Discrimination against Women. All government
departments, and organs civil society as well, are legally
and morally committed to this policy framework.

In addition to its constitutional commitment to promote
gender equacity and equity, the Department of Health has
its own wide-ranging equity commitments, namely to those
who have been previously marginalized and to improve
the productivity and quality of its services to the public.

The benefits of the Public Health Sector gender equacity
equity policy will thus include:
-       Equal rights and opportunities for women and
        men workers at all levels in the Department;
-       Enhanced service delivery through the optimal
        use of all of its human resources;
-       Equitable attention to the health needs of women
        and men, girls and boys, and equal access to
        quality care at all levels of the health system.

                           Page 2
What is the Department’s gender policy comprised

The Department’s gender policy, which applies to public
health institutions at the national, provincial and local
levels, consists of:

-       Policy Guidelines according to which gender-
        related issues must be “mainstreamed” – i.e.
        taken into account in the planning of all actions
        (legislation, policies and programmes);
-       Implementation Guidelines to guide the political
        leadership and administrative arm in the
        establishment of institutional arrangements that
        will ensure successful implementation of the policy;
-       Gender Policy Goals that spell out the specific
        objectives to which those charged with
        implementing the policy must aspire;
-       A Monitoring and Evaluation Process to
        measure the implementation of the policy
        according to short-term and long-term indicators,
        and to monitor the impact of the actions taken.
        The findings will form part of the periodical
        Performance Progress Reports to the Minister of
        Health. They will also be reported to the Office
        on the Status of Women as part of its overall
        monitoring strategy.

                          Page 3
Policy Guidelines

The Gender Policy Guidelines provide the administrative
arm of the Department with a broad scenario of what is
required by the Gender Policy. In brief, the requirement
is to systematise the process of gender mainstreaming –
i.e. to take gender into account in the planning of all actions
(legislation, policies and programmes). The Guidelines
help the Department and all public health institutions to
identify and address gender-related issues. They require
the administrative staff involved to:

-        Create an enabling environment for translating
         the Department’s gender equality commitments
         into reality;

-        Establish an institutional framework within the
         Department and the public health sector to
         advance the status of women and achieve equality
         between women and men;

-        Integrate the empowerment of women and
         transformation of gender relations into policies
         and programmes at all levels of the health system;

-        Promote new attitudes, values and behaviour,
         and a culture of respect and gender equality
         throughout the health system.

                            Page 4
Implementation Guidelines

The purpose of the Implementation Guidelines is to provide
those responsible for developing the Policy Guidelines
with specific details of what is required of them in setting
about the development of the system.

Firstly, the Implementation Guidelines set out the division
of departmental responsibilities – “who is responsible for

Then they go into detail on the Gender Focal Points
(GFPs) – where in the departmental structure they should
be located, their areas of involvement, and how they
should be resourced.

Finally, the Implementation Guidelines spell out the
relationships between GFPs and the various directorates
in the Department, and between GFPs on the national,
provincial and local levels of government. The
Implementation Guidelines also look to the coordination
of efforts with civil society, such as NGOs, the health
professional associations and practitioners of
complementary and traditional medicine.

                           Page 5
Division of departmental responsibilities

-      Senior management, whose role it is to build
       understanding of the gender policy and
       commitment by health providers to promote gender
       equality as an integral part of health service
       provision, and also to monitor the progress of the

-      Human Resources Directorates, whose role it
       is to implement the policy guidelines as they apply
       to the internal workings of the Department, to
       build the understanding and commitment of health
       officials to promote gender equality in the process
       of managing health services, and to monitor the
       progress of the their efforts;

-      Gender Focal Points, which play an advocacy
       role for gender equity in the Department and
       public health institutions, support senior
       management with information and expertise in its
       gender equity functions, and monitor the
       implementation and impact of the gender policy.

    A Performance Management System is in place to
    monitor service delivery by all the implementers

                         Page 6
Gender Focal Points (GFPs)

Function and location

The Gender Focal Points (which function at national and
provincial levels, and also at local level if the size of the
local authority warrants it) do not manage the gender
equity programme vertically within the Department or
organisation. They function horizontally – i.e. their task is
to influence decision-making and support officials at
management level across the organisation, thereby to
guide them in their task of instituting the required
organisational transformation.

For this reason, the GFPs are located at the heart of
management and management decision-making, that is,
in the office of the Head of Department at provincial level
and Director-General at national level. This is as stipulated
in the National Policy Framework for Women’s
Empowerment and Gender Equality.
The gender policy guidelines require changes in attitudes
and behaviour, and the reviewing of policies and
programmes, throughout the department. For this reason,
it is required that national and provincial GFPs be full-
time positions (at local level too depending on the size of
the local authority and the scope of work required) – and
not “add-on” tasks of staff engaged in line functions.

                           Page 7
Areas of involvement of the GFPs

•      Gender-based analysis
•      Policy formulation
•      Programme design and planning

Gender mainstreaming
•     Statistical analysis
•     Gender-based analysis
•     Training skills
•     Research skills
•     Planning

Coordination and Planning
•      Strategic planning
•      Communication skills
•      Quantitative and qualitative
•      Evaluation skills
•      Coordination

                           Page 8
•     Social and economic skills
•     Research/analytical skills
•     Planning
•     Training
•     Monitoring and evaluation

Liaison Networking
•      Communication
•      Grasp of stakeholders’ interests
•      Organisational skills
•      Reporting skills

Capacity Building
•      Management skills
•      Facilitation skills
•      Analytical skills
•      Insight into social situation

                          Page 9
Resourcing of Gender Focal Points

For Gender Focal Points to be able to optimally play their
intended role, they need to be equipped with sufficient
financial and human resources. To this end, thus, the
policy guidelines recommend the executive and legislative
structures at national and provincial level to:

•   Allocate financial and human resources to enable
    GFPs to implement the policy guidelines;

•   Allocate resources, including information technology,
    and personnel to facilitate coordination, capacity
    building of GFPs, communication, networking and

•   Provide the national, provincial and local GFPs with
    regular technical, mentoring and advisory services;

•   Enable GFPs to function effectively towards the goal
    of women’s empowerment and gender equality by
    providing institutional infrastructure, disseminating
    information, monitoring and evaluation.

It is thus clear that government is “putting its money where
its mouth is” in respect of gender equity.

                           Page 10
Coordination between GFPs, departmental directorates and other
State organs

There is a clear distinction between the line functions of
the Maternal, Child and Women’s Health (MCWH)
directorates and the functions in which the Gender Focal
Points are involved.

The MCWH directorates are responsible for their
programmes which address health issues pertaining to
motherhood, children and women. This includes
responsibility for health promotion events targeting these
groups. The GFPs are not involved here.

As a separate issue, ALL directorates throughout the
Department and health care institutions have the
responsibility for identifying and addressing gender inequity
or inequality in their structures and activities. They must
incorporate gender awareness into their programming –
and HERE it is that the GFPs carry responsibility, namely
to provide support.

Within the Department of Health, each directorate at
national level will work with and support its equivalent at
provincial level in implementing these policy guidelines;
and likewise at provincial in relation to local levels. The
national GFP will likewise work with the provincial GFPs
and, through these, with local GFPs to build their capacity
for implementation.

                            Page 11
The Department’s gender policy provides for the Gender
Focal Points to liaise with specific committees and offices
to ensure that gender issues receive the required attention.
These include:

• MINMEC, a committee composed of the Minister and
  the nine provincial MECs for Health, their top officials,
  and representatives of the SA Local Government
  Association and the SA Military Health Services
• PHRC (Provincial Health Restructuring Committee),
  composed of the Director-General of Health and top
  officials of the national and provincial health
  departments, local government and the SAMHS;
• The Minister and the Director-General of Health, whose
  offices liaise with the Presidency on gender issues;
• The Office on the Status of Women; and
• The Workplace Gender Forum which is mandated to
  provide strategic direction for the effective
  implementation of the Health Sector Gender Action
  Plan. At national level, the Workplace Gender Forum
  is comprised of provincial GFPs, and at provincial level
  it is comprised of provincial, local and district GFPs.

                             Page 12
Inter-sectoral coordination

The Gender Focal Points also have an inter-sectoral
coordination function to promote implementation of the
gender equity policy among key external role players
(outside of the State health sector). This is in line with the
framework stipulated in SA’s National Policy Framework
for Women’s Empowerment and Gender Equality.

The coordination process is centred in the Presidency,
through the Office on the Status of Women. Other bodies
involved are the Commission on Gender Equality, the
Health Sector Coordinating Committee, and the GFP
Social Sector Cluster (comprised of GFPs in the
Departments of Agriculture, Education, Health, Home
Affairs, Housing, Justice, Land Affairs, Social Development,
and Sport & Recreation, and the SA Police Services).

                              Page 13
Participation by civil society

The National Framework recognises further that

“The national machinery alone cannot shift public policy agendas for
women without the participation of organisations of civil society”.

A further important coordinating role of the Gender Focal
Points is thus in respect of civil society organisations, the
private sector and international development agencies.

Valuable partners will be the various non-governmental
organisations (NGOs), which have extensive experience
of advocacy involving the identification of key decision-
makers, preparation of position papers, lobbying, using
the media and press conferences.

Health professional associations should also be involved
in advocacy because their members are likely to be among
the first to be affected by the changes brought about by
these policy guidelines. A coordinated approach by these
associations and NGOs representing different
constituencies is thus needed.

                               Page 14
NGOs should thus support GFPs in mobilizing community
support and presenting ideas and information to community
members, thereby forging linkages between communities
and policy makers. Of particular importance is networking
with women’s organisations. It is crucial that women move
into decision-making positions at the district level.

Many NGOs have already developed training programmes
in gender sensitivity which can easily be adapted to take
account of the special needs of the health sector. Health
professional associations will also need to sensitise their
own members as they play a crucial role in providing
health services at all levels.

The support of the private sector, including pharmaceutical
companies and private clinical services, will be sought to
collaborate in ensuring quality care and access to services,
particularly for poor women.

Involvement will also be sought of practitioners of
complementary and traditional medicine, for whom codes
must be established to prevent practices that violate
human rights and especially the rights of women and

Active community involvement is essential to ensure that
the voice of all, in particular women, is heard in designing
health services and monitoring action plans.

                           Page 15
Gender Policy Goals

The Gender Policy Guidelines comprise broad objectives,
each of which are spelt out with accompanying objectives,
activities and indicators. In brief, the goals are as follows:
Goal 1:     To incorporate gender analysis into all public health
policies and programmes

The objectives that relate to this goal are:
• To gain senior management’s commitment and build
   its capacity to promote, implement and monitor gender
•   To facilitate senior managers’ integrating of gender
    analysis into the strategic planning and business
    planning processes of their directorates or institutions;
•   To build an understanding and commitment throughout
    the health system to address the impact of gender-
    based discrimination;
•   To ensure input from civil society, and particularly from
    beneficiaries of health services;
•   To integrate gender concerns into the department’s
    overall plans, and to monitor them accordingly.

                             Page 16
Goal 2: To promote gender equity in organisational development

The objectives that relate to this goal are:
• To eliminate gender-based discrimination in human
   resource procedures such as appointments,
   promotions, pay, conditions of employment and
   disciplinary procedures;
• To ensure equal balance between the sexes in decision-
   making positions;
• To ensure that institutional rules and culture promote
   participatory decision-making and an environment that
   is supportive of gender equity;
• To build understanding of the purpose of the gender
   policy and ensure commitment to them by political
   leadership and senior management;
• To sustain gains made in building commitment and
  capacity for addressing gender inequity as new people
  are recruited to the department;
• To build the capacity of managers and other personnel
  to conduct a gender analysis of their policies and
  programmes and to use the findings to improve the
  quality of health policies and services;
• To build the capacity of Human Resources Directorates
  to offer gender training at all levels so that all staff
  understand and are committed to addressing gender
  inequity in their area of work.

                            Page 17
Monitoring and Evaluation

An integral part of the policy will be the monitoring of its
implementation and evaluation of its impacts. The results
of this process will be assembled from local to provincial
to national level by the respective Gender Focal Points,
and ultimately form part of the regular Performance
Progress Reports to the Minister of Health.

They will also be submitted to the Office on the Status of
Women (in the Presidency), as part of its overall monitoring
strategy of the National Policy Framework for Women’s
Empowerment and Gender Equality.

The GFPs are also responsible for compiling reports to
meet international gender equality monitoring efforts.

It is thus essential, for monitoring and evaluation purposes,
that all health policies developed by directorates and
clusters within the Department of Health and other public
health agencies include gender issues in their strategies.
This will enable service providers to measure the impact
of the policy on women and men in their roles as both
users and workers.

                           Page 18
The monitoring strategies will establish short-term and
long-term indicators. The short-term indicators will assess
the gender equity situation as it is, and whether the
processes for identifying and addressing gender inequality
are functioning. The long-term indicators will measure the
impact of changed policies. These indicators can therefore
only be specified once the initial activities have taken

A programme has been compiled according to which
information must be assembled to establish the required
the short-term indicators. It is on the basis of this that the
long-term programme will be established.

                            Page 19
Much needed change

The Gender Policy Guidelines will go a long way in helping
the Department of Health to maintain its focus and
strengthen its impetus for much needed change in respect
of gender equity in the public health sector.

All users (male and female) of public health facilities –
and also users of privately operated health facilities – will
benefit from the restructuring of the health sector through
the greater efficiencies that will arise from optimal utilisation
of the available human resource. The Department of
Health’s Gender Policy Guidelines thus deserve the active
support of all – health workers and users alike.

The gender restructuring of State, provincial and local
authority health facilities will be driven by the Government’s
equity policies. While privately operated health institutions
and practices are not structured into this initiative, they
will no doubt perceive (where they have not already done
so) that it is in their own interests, too, to apply full gender
equity. They are therefore invited to participate in the

Organs of civil society – NGOs, community organisations
and women’s organisations in particular – are likewise
invited to join hands with the public health sector in helping
to advance the role of women in this important sector of
South African society.

                             Page 20
Vision: A caring and humane society in which all South Africans
have equal access to affordable, good quality health care.

Mission: To create an effective enabling framework to guide
the process of developing, implementing and monitoring laws,
policies, programmes, procedures and practices which will serve
to mobilise for

•        Equitable attention to the health needs of women and
         men and girls and boys and equal access to quality of
         care at all levels of the health system; and

•        Equal rights and opportunities for both women and
         men within the Department of Health and the Public
         Health Institutions.

                            Page 21
Published by: The Department of Health
          Private Bag X 828,
      Pretoria, 0001, South Africa.

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