Invest in the Future: Strengthen Malaria Programs with Gender Data
Abby Cannon, MEASURE Evaluation Gender Specialist
Mosquitoes don’t discriminate when they bite. Anyone in a malaria-endemic locale – men, women and children – is fair game for the mosquito. But evidence paints a different picture on how vulnerable they may be to contracting malaria. Many people know that children and pregnant women in areas with high levels of malaria are biologically more susceptible to infection. Fewer know that gender differences also affect who gets infected and who gets malaria prevention.
Gender is what it means to be male or female in a given society and time. Being a man or a woman comes with different responsibilities, expectations, and economic and decision-making power within families and communities. These gender norms affect access to all types of health care, risk of HIV infection, family planning use, maternal and child health, and malaria.
On April 25, World Malaria Day, MEASURE Evaluation encourages all public health workers and decision makers to consider the impact of gender on treating one of the world’s worst killers and to make the commitment to increase and improve gender-related data collection to assist in strategy and planning for effective malaria prevention and response. MEASURE Evaluation, funded by USAID, is playing a key role at the global level to develop policy and guidelines and at the country level to strengthen data systems that allow us to measure progress and detect gaps in access to malaria prevention between male and female.
The call for such data is growing, but more should be done. Kenya, for example, is currently examining what gender-related data it needs. A recent study by ICF in Nigeria yielded evidence of gender disparity in the use of insecticide-treated bed nets (ITN), with males less likely to use them, especially those between ages 15 and 25. The study calls for further research to identify whether the traditional targeting of pregnant women and children should be expanded to also include young men, with campaigns including gender-sensitive messages for that audience so that young males benefit equally.
“The malaria community needs reliable data to identify and address target groups as it strives for eventual malaria elimination,” says Dr. Yazoume Ye, senior malaria advisor with MEASURE Evaluation. “Part of this data collection is tracking sex, which allows program managers to know whether rates of malaria infection vary between men and women and whether there are disparities in access and use of malaria interventions.”
However, incorporating sex-disaggregated data into a country’s health information system and research agenda is often a lengthy process. Yet, the need is great enough that MEASURE Evaluation gender specialists recommend some immediate steps health programs can take to gather information about gender disparities regarding malaria and perhaps discover hidden needs that can be addressed even today:
Malaria Indicator Surveys (MIS), which is a repository of national surveys of key malaria indicators that collect data on ITNs, prompt and effective treatment of fever in children, and prevention of malaria in pregnancy. The data from these surveys are sex-disaggregated and can be analyzed to explore gender differences in malaria prevention behaviors and treatment.
And the Demographic Health Survey (DHS) program, collects nationally representative and sex-disaggregated data on health issues including malaria, which show ITN use, prevalence, and prompt treatment of fever in children.
These data compilations are opportunities for program managers and researchers in any country to examine gender differences in malaria prevalence and treatment in their own context. We encourage all to use this currently available data, draw inferences from it, and report to their colleagues and decision makers what insights it may offer.
Further, as public health officials worldwide move towards recognizing the importance of gender in malaria (see WHO article), all in the field – especially at ministries of health, malaria control units, and gender offices and working groups – need to be both investigators and advocates for the collection and use of sex-disaggregated and gender-related malaria data. We need to investigate what gender information is available in community-based health information systems, at health facilities, in routine health information systems, and in national surveys, while continuing to describe the effectiveness of such data for strategic planning and to advocate for its essential role in combatting this killer.
 Authors: Ashley E Garley, Elizabeth Ivanovich (now with the UN Foundation), Erin Eckert (now with USAID PMI), Svetlana Negroustoueva (now with Development and Training Services, Inc.) and Yazoume Ye.