General
SOURCE: WHO Africa
Universal Health Coverage (UHC) is based on principles of equity. As such, in renewed efforts to strengthen equity and gender responsive health systems in Nigeria, the World Health Organization (WHO) is supporting the Federal Ministry of Health (FMOH) to develop guidelines and policies that will aid in addressing key gender issues in the country.
“Gender inequality remains a critical challenge in the health sector and UHC can only truly be achieved if gender and other drivers of inequalities within the health systems are actively considered and addressed”,said Dr Olumuyiwa Ojo, a WHO Technical Officer during a retreat for all key stakeholders in the health sector organized by WHO in Abuja, December 2021.
Dr Ojo further stated that “the development of the policies and guidelines is critical as health systems are not gender neutral; structures and processes of oppression and discrimination that exist in society are reproduced in health systems. UHC efforts must focus on reaching the most vulnerable people whom health services are not reaching, such as marginalized, stigmatized and geographically isolated people of all ages.”
Gender equality in Nigeria was reported at 0.33333 % in 2020, according to the World Bank. Also in the report released by the World Economic Forum (WEF), in 2018, Nigeria ranked 133 among 149 countries surveyed for gender gap reduction. In the 2020 report, Nigeria rose to 128 out of 153 countries. In 2020, global gender gap index for Nigeria was 0.63 index. Though Nigeria global gender gap index fluctuated substantially in recent years, it tended to increase through 2006 - 2020 period ending at 0.63 index in 2020.
According to WHO, Sex and gender are increasingly recognized as important determinants of health for women and men. Beyond the biological differences, gender roles, norms and behavior have an influence on how women, men, girls and boys access health services and how health systems respond to their different needs. The different and often unequal abilities of women, men, girls and boys to protect and promote their health require recognition.
WHO recognizes that gender is an important determinant of health in two dimensions: gender inequality leads to health risks for women and girls globally; and addressing gender norms and roles leads to a better understanding of how the social construction of identity and unbalanced power relations between men and women affect the risks, health-seeking behavior and health outcomes of men and women in different age and social groups.
“It took me two days to access healthcare when I was raped, the reason was I was scared of being judged by the healthcare workers and also not knowing the exact place to go. Centers that address such cases should be commissioned by the government and publicized so that survivors of GBV will be able to access help as soon as the need arises” says 27-year-old Hauwa Bukar who was raped at the age of 25.
Gender-Based Violence (GBV) including Female Genital Mutilation (FGM), gender norms, roles, and inequalities change with time, hence the need to review and update and policies to actively address them. Be it issues with decision-makers, communities, and the society at large.
Director of GASHE Department of Family Health FMoH, Dr Christopher Ugboko mentioned that bridging gender gaps is essential especially now that that new trends of gender violence keep evolving, things like these need our attention “our objectives are to develop the terms of reference for the Gender in health National technical working group and to validate the draft concept note for the development of the National Action Plan on the Health sector response to GBV which will help in dealing with gender issues appropriately when the need arises.”
To this end, WHO is providing technical support to ensure the health sector which is able to provide quality gender-sensitive services. The health sector generally lacks the required capacity to provide care for survivors. To solve this, WHO supported trainings on gender mainstreaming for health managers; adaptation of the WHO clinical handbook on response to women and girls subjected to violence and the training manual. Over 40 health managers were trained in the training of trainers in September 2021 using the newly developed GBV training manual, and WHO led the advocacy for a coordination platform for GBV and other gender equity issues in the health sector. In December 2021, WHO facilitated a two-day retreat for all key stakeholders in the health sector to set up the technical working group on Gender in Health sector.
In the past years, WHO has sensitized over 5 000 people including women, men, girls and boys across nine selected IDP camps on GBV and its consequences, sensitization workshop on GBV across 24 health facilities across the Borno, Adamawa and Yobe (BAY) states by 30 CSO in collaboration with State Primary Health Care Development Agency and State Ministry of Health, WHO also aired radio Jingles on GBV across the BAY state and motorized campaigns at hot spot location for GBV, advocacy meeting with health facility manager and Protection unit on data strengthening and harmonization.