Intersectionality and gender mainstreaming in international health: Using a feminist participatory action research process to analyse voices and debates from the global south and north

Abstract

Critiques of gender mainstreaming (GM) as the officially agreed strategy to promote gender equity in health internationally have reached a critical mass. There has been a notable lack of dialogue between gender advocates in the global north and south, from policy and practice, governments and non-governmental organisations (NGOs). This paper contributes to the debate on the shape of future action for gender equity in health, by uniquely bringing together the voices of disparate actors, first heard in a series of four seminars held during 2008 and 2009, involving almost 200 participants from 15 different country contexts. The series used (Feminist) Participatory Action Research (FPAR) methodology to create a productive dialogue on the developing theory around GM and the at times disconnected empirical experience of policy and practice. We analyse the debates and experiences shared at the seminar series using concrete, context specific examples from research, advocacy, policy and programme development perspectives, as presented by participants from southern and northern settings, including Kenya, Mozambique, India, the Democratic Republic of Congo, Canada and Australia. Focussing on key discussions around sexualities and (dis)ability and their interactions with gender, we explore issues around intersectionality across the five key themes for research and action identified by participants: (1) Addressing the disconnect between gender mainstreaming praxis and contemporary feminist theory; (2) Developing appropriate analysis methodologies; (3) Developing a coherent theory of change; (4) Seeking resolution to the dilemmas and uncertainties around the 'place' of men and boys in GM as a feminist project; and (5) Developing a politics of intersectionality. We conclude that there needs to be a coherent and inclusive strategic direction to improve policy and practice for promoting gender equity in health which requires the full and equal participation of practitioners and policy makers working alongside their academic partners.

‘You’re disabled, why did you have sex in the first place?’ An intersectional analysis of experiences of disabled women with regard to their sexual and reproductive health and rights in Gujarat State, India

“…These assumptions were based on notions of their body as impaired, simultaneously drawing on and reinforcing discourses that construct disabled women as non-sexual and, therefore, unable to fulfil the gendered role of a wife and mother [2,8,13,14,28,44]. Although some of our participants challenged these discourses, their opportunities to effectively contest them in their own lives were shaped by intersecting power dynamics including: gender, type and severity of impairment, marital status, and SES [18]. In common with findings from studies with ‘non-disabled’ women [41], disabled women of higher SES in this study described more opportunities to exercise autonomy, challenge constructions of ‘asexuality’, and influence or direct decision-making.…”

“…Rather, gender is one of a number of social inequities (including wealth, class, or caste) that interact to create complex positionalities within a nexus of power relations. These cross-cutting social structures of inequity generate layers of oppression and dominance, as well as spaces for the exercise of agency and resistance that shape disabled women’s expressions of their sexuality and SRH outcomes [18]. In recent decades, this intersectional approach has emerged as increasingly important for interrogating the interaction of social identities with systemic systems of oppression [19].…”

“…An effective intersectional approach is one that is non-additive, resists essentialising, and is concerned with implications for social action [20–22]. Whilst we aim to move away from the dominance of one social category [22–25], we prioritise gender as an analytical entry point in relation to disabled women’s SRH [18]. …”

Social marketing: the state of play and brokering the way forward

“…Yet social marketing practice has a long history in other parts of the world -with family planning programmes in Africa and South East Asia being early examples of social marketing in action (Population Services International, 1977). Furthermore, other disciplines, particularly relating to social change such as human rights (Shaw, 1999) and public health (Tolhurst et al, 2012), have started to recognise ideas and alternative perspectives in relation to gender, cultures and value systems.…”

Men and Gender Equality

“…(EC 2011, 398) The most significant issues for men's health are those based on intersectionality and the social determinants of health (race/ethnicity, class, income, education, ability, age, sexual orientation, immigration status and geography). (Hankivsky 2012;Annandale 2013;Tolhurst et al 2012) Nevertheless, these are compounded by differences in the gendered nature of society and the way these gender expectations have a marked influence on the health challenges facing men.…”