Integration of gender into MEASURE Evaluation activities
Seven Steps to Use Routine Information to Improve HIV/AIDS Programs
The Seven Steps to Use Routine Information to Improve HIV/AIDS Programs offers concrete steps and illustrative examples to facilitate the use of routine health system information as a part of the decision-making processes guiding program design, management, and service provision. This guide was designed to help address barriers to using routinely-collected data. The MEASURE Evaluation gender team worked with the Guide’s authors to integrate gender into the tool as described below:
- An information box explains why gender is important to HIV/AIDS programming and monitoring to help users of the tool understand how gender influences HIV outcomes (page 10).
- Gender was incorporated into several of the guide’s illustrative examples of using routine information to ask and answer questions to improve HIV/AIDS programs by following along the seven steps outlined in the guide.
- The “HIV Counseling and Testing” case study (pages 31-40), focused on using routine information to investigate if clinics were serving youth adequately. Gender was accounted for by demonstrating how the results would look and be interpreted by when youth data was disaggregated by sex. Gender was added into the analytic steps and calculations needed to identify and transform the data into useable information to interpret and draw conclusions about whether or not the clinics were serving male and female youth equitably.
- This method of integrating gender into examples by highlighting possible questions regarding gender, obtaining necessary information, carrying out calculations, and interpreting results was repeated for the “Support and Care: People living with HIV/AIDS” case study (pages 60-65).
Gender integration into an HIV/AIDS assessment tool
Priorities for Local AIDS Control Efforts (PLACE) is a rapid assessment tool used to monitor and improve AIDS prevention program coverage in areas where HIV transmission is most likely to occur. PLACE works to identify gaps in HIV prevention programs that do not reach the most at-risk populations.
Gender is recognized as a driver of the HIV/AIDS epidemic, and the PLACE method highlights and integrates gender in several ways. The PLACE method focuses on areas where people engage in high risk behavior such as meet new sexual partners, including men who have sex with men (MSM), male and female sex workers, and transgender people. The assessment tool integrates gender in the following ways:
- PLACE is culturally competent because it can be adapted to different societies, cultures, and gender norms. Researchers pilot test PLACE questions in order to capture the appropriate language of local culture. For example, in Jamaica, researchers found there were several different subgroups of men who have sex with men, and this was captured in pilot testing and included in the final questionnaire.
- Several MEASURE Activities using PLACE, including China and Jamaica, offered participants the opportunity to self-identify their gender or sexuality.
- A PLACE study in China includes self-selected gender identification with a transgender option instead of offering identification by sex as male or female. This characterization of an individual’s gender goes beyond acknowledging biological differences between the sexes and empowers participants to take control of their gender identity, which may slowly transform gender norms and expectations. Participants are also offered the opportunity to self-identify if they consider themselves to be sex-workers or not.
- PLACE is being used with the MSM community in Jamaica, a marginalized population faced with stigma and challenges surrounding gender norms, that also has a higher risk for HIV/AIDS acquisition. PLACE is able to gather data for the local AIDS epidemic while being sensitive to gender norms, once again allowing individuals to self-identify their sexuality and gender, and obtaining crucial information to identify gaps in current HIV prevention efforts.
- PLACE looks at the male to female ratio at the venues, as part of Step 3, and coordinates the male to female ratio of interviews in Step 4. This ensures that researchers are aware of gender differences and interview patrons accordingly. This step helps highlight gender differences and experiences that could be overlooked if researchers did not consider the number of interviews in accordance with the sex ratio of patrons at a venue.
- Finally, PLACE captures the interviewer’s gender in an attempt to analyze whether interviewer gender has an effect on participant responses.
PLACE is another excellent illustration of efforts to exemplify the GHI gender equality principle in all activities.