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In-Depth Reading Time: 7 minutes

Insights from Season 3 of Inside the FP Story

Strategies for Gender Integration in Family Planning Programs

Season 3 of the Inside the FP Story podcast explores how to approach gender integration in family planning programs. It covers the topics of reproductive empowerment, gender-based violence prevention and response, and male engagement. Here, we summarize key insights shared by the season’s guests.

Overview of Season 3

The Inside the FP Story podcast explores the fundamentals of designing and implementing family planning programming. Season 3 was produced by Knowledge SUCCESS in partnership with Breakthrough ACTION and the USAID Interagency Gender Working Group. It covered gender integration in family planning programs. We explored key concepts, like gender transformative programming, and discussed strategies for implementing family planning programs in a way that addresses gender inequality.

Our first episode introduced key terms and concepts and then further explored the concept of reproductive empowerment. The second episode delved into the intersection of family planning and gender-based violence (GBV), with examples and recommendations for integrated programming. Our last episode explored male engagement as an important strategy in family planning programs and services. Over the three episodes, our guests offered practical examples and specific guidance on strengthening gender integration and supporting gender equality within their family planning programs, including:

  • What works.
  • What does not work.
  • Recommended actions.

Key Considerations for Gender Transformative Family Planning Programming 

Below (in no particular order), we summarize key considerations that emerged from discussions with this season’s guests—along with recommended tools and resources. These considerations can help us develop more gender-aware family planning policies and programming.

1. Understand and Address Gender and Social Norms

Nearly every guest mentioned the importance of conducting a thorough exploration of gender and social norms. These shape attitudes, beliefs, and values regarding family planning use and access. Not only do these norms affect women and girls and men and boys, but they affect them in different ways. Understanding gendered differences in power, access, and control is critical. It challenges and transforms gender-inequitable norms, institutions, and structures. This, in turn, improves gender equality and health equity within family planning programs. Several guests recommended conducting a gender analysis. This would provide a systematic way to identify and understand gendered differences in power, access, and control regarding family planning access and use. The gender analysis lessons can then be used to inform the design and implementation of more gender-transformative family planning programs that respond to challenges and opportunities in a given setting. 

Resources:

“At the heart of what I think is a part of [a] gender transformative program is to alter traditional gender norms that reinforce gender inequalities that would compromise women and girls’ control over their own body or opportunities to achieve their life choices or their goals.”

Anita Raj, director of the Center on Gender Equity and Health, University of California at San Diego

2. Partner with a Range of Sectors and Go Beyond the Health System

Two hands meet in a fist bump with thumbs up.The real-life examples of gender-transformative family planning programs all included some form of cross-sectoral partnership. Several guests stressed the importance of working with the community beyond the health system (from governing bodies to faith-based institutions to agriculture and commerce).  This ensures that gender issues are being identified and addressed through a more comprehensive lens. As several of our guests explained, we cannot rely on the health system alone to increase reproductive empowerment for women, girls, and others in a given setting. Multi-level, multi-component strategies and approaches are needed to foster and sustain an enabling environment for reproductive empowerment. This is particularly true for youth engagement in family planning. 

Resources:

“Empowerment comes from so many different areas. It’s not just within the reproductive health realm … building that reproductive empowerment does require us to go into different sectors and work with different partners … I’m thinking of building men’s reproductive empowerment. One of the aspects we’re looking at is that often men feel that health facilities and family planning, or like a woman’s perspective, it’s a woman’s place … So working in the agricultural sector or working with the employment sector to build that agency into their own programming is an area that you can think about to build in some of that multi-sectoral programming aspects and reaching men to build that empowerment in different areas that you might not already think about.”

Erin DeGraw, senior associate for Family Planning and Reproductive Health, Plan International

3. Meet People Where They Are

Our guests shared a common denominator among successful gender-transformative programs. Whether it comes to integrating GBV prevention and response into family planning services, or engaging men and boys in family planning, they meet people where they are in terms of experiences, needs, priorities, and preferences. Service integration is one way in which we can meet people where they are by reducing logistical and other barriers to accessing critical information and services. In the second episode, guests discussed how integrating services for family planning and GBV acknowledges the existing intersection of these two health issues. It allows individuals and families to receive timely information and support in a single location.

Resources:

“… If you integrate family planning and GBV, you are actually leveraging the resources and you are able to reach a good number of women—the very same women who are family planning users, but the same women who are also facing challenges of gender-based violence.”

Msafiri Swai, head of programs, Afya Plus, Tanzania

“One of the things we do is reach men outside their traditional spaces. So for example, in South Africa, places like the, we call them a taxi park, where you are going to be either waiting for a taxi or the ones who are sitting around calling, you engage them in those spaces.”

Mabel Sengendo, regional unit manager, Sonke Gender Justice

4. Use a Life Course Approach

A grandmother and grandson smile lovingly at each other. They sit in front of a computer in a field of greenery.Several guests mentioned the life course approach as being important for addressing gender and social norms across genders and also engaging men and boys in particular. This approach entails:

  • Understanding the experiences, needs, priorities, and preferences across the lifespan.
  • Identifying strategic turning points at which interventions can be implemented. 
  • Implementing those interventions to promote gender-equitable norms and healthy behaviors in support of improved health outcomes and gender equality. 

When programs actively engage all genders in family planning from an early age and across life stages, they contribute to an enabling environment. This promotes gender-equitable norms and behaviors, including shared responsibility for family planning and its outcomes.

Resources:

“If you are able to shift norms around male engagement in family planning amongst 15-year-olds, those same 15-year-olds, when they’re 35, are more likely, hopefully, to be more engaged and to have led lives that were more in keeping with what they wanted to do.”

Jeff Edmeades, senior research analyst, Demographic and Health Surveys Program

5. Promote and Strengthen Couple Communication

The promotion and strengthening of gender-equitable couple communication is critical, with men and boys increasingly recognized and engaged as important actors in family planning. This is central to gender transformative family planning programs. To counteract the effects of inequitable gender and social norms evidence shows that more couple communication can contribute to improved family planning outcomes. Couple communication is something that can and should continue throughout a relationship. It must evolve with different life stages and events, such as the birth of a child. If supported broadly in our family planning programs, this process can also contribute to systemic changes on a broader scale. 

Resources:

“[We discuss] couple communication, decision-making practices, consenting, and then if, especially with, in married or first-time parents, we talk about positive parenting practices, caring and in engagement in, during pregnancies and before pregnancy and after.”

Prabu Deepan, Asia regional head, Tearfund

6. Measure and Monitor

A black pen sits atop an empty notebook with grid paper.A final consideration from our guests was the importance of monitoring and evaluating gender integration in family planning programming. They mentioned the need for stronger monitoring systems at all levels—from the individual level to the district and national level. Guests in episode 1 mentioned ways to measure reproductive empowerment. Those in episode 2 discussed ways in which they measured quality of care around GBV and family planning services. 

In episode 3, our guests discussed ways that men are often included in monitoring and evaluation efforts, noting their inclusion is usually focused on their role as family planning clients. The strong lack of indicators around men as family planning users, partners, and agents of change may be preventing us from having more nuanced information. These are needed to engage with men and boys around these other roles. Guests also made suggestions for specific indicators that can be useful for measuring how men engage as partners, such as the percentage of men who share in reproductive decision-making with their intimate partner. To measure men’s engagement as agents of change, programs could look at attitudes toward specific gender and social norms or national advocacy campaigns that address gender equity.

Resource:

“[There are] a number of different indicators out there that have been already identified for male engagement. But incorporating areas such as joint decision-making, but not just like how many people are actually doing joint decision-making, but how many programs are actually working with clinicians to support joint counseling …”

Erin DeGraw, senior associate for Family Planning and Reproductive Health, Plan International

“We need to be stronger with data … We don’t have enough studies that associate academically—especially by reputable academic institutions—the strong relation between reproductive health and GBV, between adolescents and GBV, between early marriage, adolescents, GBV … it’s all there in data and figures, in storytelling, it’s all in the centers, but there [aren’t] enough studies that were done to make the link stronger.”

Hala Al Sarraf, founder and executive director, Iraq Health Access Organization

How to Listen to Inside the FP Story

Inside the FP Story is available on the Knowledge SUCCESS website, Apple Podcasts, Spotify, and Stitcher. You can also find relevant tools and resources, along with French transcripts of each episode on the series’ webpage.

For More Information About this Topic

See our FP insight collection for all the resources featured in this blog post—plus others mentioned in season 3 of Inside the FP Story.

Sarah V. Harlan

Partnerships Team Lead, Knowledge SUCCESS, Johns Hopkins Center for Communication Programs

Sarah V. Harlan, MPH, has been a champion of global reproductive health and family planning for nearly two decades. She is currently the partnerships team lead for the Knowledge SUCCESS project at the Johns Hopkins Center for Communication Programs. Her particular technical interests include Population, Health, and Environment (PHE) and increasing access to longer-acting contraceptive methods. She is a co-founder of the Family Planning Voices storytelling initiative (2015-2020) and a co-author of several how-to guides, including Building Better Programs: A Step-by-Step Guide to Using Knowledge Management in Global Health.

Natalie Apcar

Program Officer, KM & Communications, Knowledge SUCCESS

Natalie Apcar is a Program Officer at the Johns Hopkins Center for Communication Programs, supporting knowledge management partnership activities, content creation, and communications for Knowledge SUCCESS. Natalie has worked for a variety of nonprofits and built a background in planning, implementation, and monitoring of public health programming, including gender integration. Other interests include youth and community-led development, which she got the chance to engage in as US Peace Corps Volunteer in Morocco. Natalie earned a Bachelor of Arts in International Studies from American University and a Master of Science in Gender, Development, and Globalization from the London School of Economics and Political Science.

Danette Wilkins

Program Officer, Johns Hopkins Center for Communication Programs

Danette Wilkins (she/they) is a Program Officer with the Johns Hopkins Center for Communication Programs and a member of the Population and Reproductive Health team for Breakthrough ACTION, USAID’s flagship social and behavior change program. In their current role, they provide technical assistance and support to Breakthrough ACTION colleagues and partners across the areas of family planning, gender-based violence, men’s and boys’ engagement, provider behavior change, health equity, social determinants of health, and gender mainstreaming and integration.

Joy Cunningham

Director, Research Utilization Division, Global Health, Population and Nutrition, FHI 360

Joy Cunningham is the Director of the Research Utilization Division within Global Health, Population and Nutrition at FHI 360. Joy leads a dynamic team that works to advance evidence use globally by engaging with donors, stakeholders, researchers, and policymakers. She is a co-chair of USAID’s Interagency Gender Working Group GBV Task Force and has a technical background in adolescent sexual and reproductive health and gender integration.

Reana Thomas

Technical Officer, Global Health, Population and Nutrition, FHI 360

Reana Thomas, MPH, is a Technical Officer in the Global Health, Population, and Research department at FHI 360. In her role, she contributes to project development and design and knowledge management and dissemination. Her areas of specialization include research utilization, equity, gender, and youth health and development.

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