Presented by Val Percival of Norman Paterson School of International Affairs, Carleton University, Canada. Part of a session - 'Context, gender, and sustainability in introducing and scaling-up essential health care packages in fragile and crisis-affected countries' - at the Fifth Global Symposium for Health Systems Research in October 2018. The essential package of health services is a mechanism for expanding equitable coverage of primary health care and essential hospital services in countries recovering from conflict. The session explores the evidence-base on such healthcare packages in different contexts and prioritizes areas for strengthening research.

1. Gender and EPHS:
Exploring the Evidence Base

2. The Presentation
Background
Our Approach to Question of
Gender & Humanitarian Action
Research Approach and
Methods
Findings
Implications

5. Key Findings
Earlier CAP Research
Gender rhetoric, insufficient gender data & analysis;
Focus on maternal health;
Sexual violence against women/girls;
Gender box ticking in Consolidated Appeals – unclear
if this has changed in post CAP period;
Challenges in implementation of ‘gender’.

7. Approach to EPHS
How are ‘gender’ norms
reflected and reinforced
through the delivery of
health services in
humanitarian settings?
Specific focus on EPHS.
What opportunities exist
for health services –
specifically EPHS - to
address gender norms?

8. Why Important?
Grand Bargain & Reliance on
National Actors;
Path dependence of health
interventions – humanitarian-
dev’t nexus/continuum;
Some evidence of ‘plateau’ of
efficacy of reproductive and
maternal health interventions;
Focus on gender.

10. Dr. Denis Mukwege Nadia Murad
NOBEL PEACE PRIZE 2018

11. Methods
Research Questions
• How are gender issues addressed by health service interventions
in humanitarian settings?
• How do these health services reflect and reinforce gender norms?
• Focus on EPHS.
Methods
• Rapid Review – Qualitative Analysis – Google Scholar, PubMed
• Data Extraction Using Common Codes
Articulation of Findings/Themes

12. Theme One:
Technical Approach
Improve effectiveness of services through:
• coordination and leadership;
• better data (sex disaggregated);
• evidence based interventions,
• improved and consistent training;
• Many protocols and tools.
Minimum Initial Services Package for SRH (MISP);
Focus: Maternal and child health, GBV.

13. From: Rachel Cooper, K4D “Maternal, Newborn and
Child Health in Emergency Settings”

14. Theme Two:
Resource Approach
USAID, Essential Packages of Health Services
in 24 Countries, 2017.

15. Theme Three:
Avoid Challenging Gender
Norms
Recognition:
• Gender norms key factor that
influence effective delivery of health
services & health outcomes;
• Community engagement is critical;
• National providers lack support and
knowledge;
Piecemeal efforts, overwhelmed
providers, uncertainty.

16. Bricks and Mortar
EPHS works to provide the
‘bricks’ of health services;
Mortar is social norms,
including gender;
Ignoring mortar means the
walls crumble;
Resilience = resistance?
Locally driven change.

17. Next Steps
Original research – EPHS
and supportive
interventions;
What is a ‘gender
equitable’ EPHS?
Gender equity
benchmarks;
Facilitate knowledge
sharing and discussion
thru innovative methods.