GENDER

GENDER and
and
REPRODUCTIVE
REPRODUCTIVE
HEALTH
HEALTH
 OBJECTIVES
1. Gain basic concepts and key issues on
gender as they relate to health care;

2. Understand the factors and causes of

gender inequality, in particular the social
construction of gender; and

3. Appreciate the policy and legal

framework of the country for gender
equality and women’s human rights
 Women
Can’t Be
Doctors

• AGREE
• DISAGREE
• UNDECIDED
Woman’s
Destiny

 AGREE
 DISAGREE
 UNDECIDED
Women are beaten because
they nag too much.

 AGREE
 DISAGREE
 UNDECIDED
Women are raped because
they wear sexy clothing.

 AGREE
 DISAGREE
 UNDECIDED
 SEX refers to the biological
characteristics which defines
humans as either male or female
DETERMINANTS OF
SEX MALE
FEMAL
GENITALIA E vagina, penis,
clitoris scrotum
INTERNAL
REPRODUCTIVE uterus, teste
ORGANS ovaries s
CHROMOSOM XX XY
ES

HORMONE estrogen, Testosterone,

S progesteron androgen
e
GENDE
R refers to the differentiated
economic, social and cultural
attributes associated with being
male or female in a particular
point in time and supported by
societal structures

culturally-ascribed
distinguishing
variables c e p t
c e s ex
iff e r en g ic a l
all d ctly biolo
e s t r i
th
GENDE
R
Identifies the characteristics and social behavior
of men and women and the relationship between
them

Gender roles & characteristics are:

- not fixed
- may change over time
- may vary from culture to culture

It is learned or acquired
 SEX GENDE
R
SOCIALLY
BIOLOGICA
CONSTRUCTE
L
D
Born with
Not born with

CANNOT BE CHANGEABL
CHANGED E

e.g., Only women can e.g., Women can do

give birth. Only men traditionally male jobs; men
can supply sperm can take good care of children
as women do
INSTITUTIONS THAT
PERPETUATE GENDER POWER
RELATIONS

FAMILY SCHOOL CHURCH / RELIGION

MEDIA BUSINESS / MARKET STATE

GENDER POWER
RELATIONS

The FAMILY promotes gender stereotyping

through the following processes
• MANIPULATION
• CANALIZATION
• VERBAL
APPELATION
• SEXIST ACTIVITIES
• etc.
GENDER POWER
RELATIONS

The CHURCH or RELIGION as a

gender socializing institution

• BIBLE
• CHURCH HISTORY
• STRUCTURE / HIERARCHY
GENDER POWER
RELATIONS

The MASS MEDIA as a gender

socializing institution

• ADVERTISEMENTS
• RADIO / T.V.
PROGRAMS
• ARTICLES /
HIGHLIGHTS
• SOAP OPERAS
• SONGS
GENDER POWER
RELATIONS

BUSINESS / MARKET as a gender

socializing institution
• BUSINESS
OPPORTUNITIES
• POSITIONS
• WAGE RATES
• TRAFFICKING OF WOMEN
• etc.
GENDER POWER
RELATIONS

The STATE as a gender socializing institution

• LAWS / POLICIES
• POLITICAL PARTICIPATION
AND REPRESENTATION
• etc.
GENDER POWER
RELATIONS

The SCHOOL as a gender socializing institution

• TEXTBOOKS
• LANGUAGE
• CURRICULUM
• TOYS, LEARNING MATERIALS
• CAREER OPTIONS
• SEGREGATION
• ETC.
Because of uneven and unjust
GENDER POWER RELATIONS
women and men are boxed into
situations – which constrain their

Capacity as
individuals…
Gender issues/concerns

are issues, concerns or

problems arising from societal
expectations and perceptions
on the roles of women and
men that impede one’s
opportunities to participate
in the development process
and enjoy its benefits.
GENDER
BIASES
AGAINST Inherently aggressive and
MEN violent
Don’t feel pain/incapable of
experiencing human relations
Inherently expressive in their
sexuality
Don’t need closeness,
reassurance and attention
etc.
Gender
issues
&
biases
affect
women
more
WOMEN’S T IO
N SU
BO
ZA
GENDER A
LI
RD
IN
A
IN VIOLENCE TI
ISSUES M
A
R
G O
N

NEGATIVE
EFFECTS ON
PERSONHOOD

EN
D
ST AGAINST R
G U
ER EN WOMEN B
EO DE
P LE
TY R I
PI LT
N U
G M

Manifestations of
gender biases
Manifestation of Gender
Bias

MARGINALIZATIO
N
• unequal pay for work of equal value
• limited opportunities
• less access/control over resources
& benefits
• non-recognition & non-
valuation of work
• etc.
 Manifestation of Gender
Bias

SUBORDINATION
• few women in decision-making
• no power-sharing
• non-recognition of capabilities
• etc.
Manifestation of Gender
Bias

GENDER
STEREOTYPING
• sexist childrearing
• sexist language
• stereotyped images
• etc.
Manifestation of Gender
Bias

MULTIPLE
BURDEN y”
le -d a
“d o u b rd e n”
u b le-bu
“d o

• sexual division of labor in the home

• no sharing of financial responsibilities
• lack of support systems for women
• etc.
The Public-Private
DIVIDE

PRODUCTIV REPRODUCTIV
E E

Care & maintenance of

Production of goods & services the household

Done outside the home; public Done inside the home; private
Not recognized as work;
Recognized as work
invisible
Valued; paid Not valued; unpaid

No fixed hours; often

Usually 8-hrs. job
simultaneous tasks
Men’s sphere Women’s sphere
Manifestation of Gender
Bias
VIOLENCE AGAINST
WOMEN
• all forms of gender violence
• women constantly in fear of abuse
• freedoms curtailed
• legal & judicial systems not gender-sensitive
• discrimination: any practice, policy or procedure
that denies women equal treatment and status
because they are female (i.e. in labor force
participation, laws, cultural biases)
 Health Outcomes of VAWC:
Non-fatal
• Injury
• Unwanted pregnancy
Physical Outcomes • Gynaecological problems
• STDs including HIV
• Miscarriage
• Pelvic inflammatory disease
• Chronic pelvic pain
• Headaches
• Permanent disabilities
• Asthma
• Irritable bowel syndrome
• Self-injurious behaviors
(smoking, unprotected sex)
 Health Outcomes of VAWC:
Non-fatal

Mental health • Depression

• Fear
outcomes
• Anxiety
• Low self-esteem
• Sexual dysfunction
• Eating problems
• Obsessive-compulsive
disorder
• Post traumatic stress
disorder
 Health Outcomes of VAWC:
Fatal Outcomes

• Suicide
• Homicide
• Maternal mortality
• HIV/AIDS
Manifestation of Gender
Bias

NEGATIVE EFFECTS ON
PERSONHOOD

• no self-determination & self-actualization

• low self-esteem / lack of self-confidence
• inability to set higher goals
• etc.
Gender issues are deterrents to
development.
Thus, it important to address them in all
spheres of life
What is Gender &
Development?
GAD is about recognizing that
gender biases impede development
because:
They prevent people from attaining their full potentials
They exacerbate social inequity and inequality
They distort the understanding of social realities
GAD is about being faithful to
the principle that

Justice and equity demands that

everyone in society, whether
male or
female, has the right to the
same
opportunities to achieve a full,
satisfying and peaceful life.
So what is GENDER SENSITIVITY
on a broader analysis?
A perspective

A way of thinking; a manner of viewing

things

Conscious of the gender issue - that the

other half of humankind is unable to
enjoy life to the fullest because of gender
bias

Actively promotes gender equality and

equity.
 Due to continuous
exposure and
reinforcement of gender
differences

Gender roles and relations

are resistant to change
BUT THEY
DO CHANGE
 BASIC ASSUMPTION

Both women and men have

a stake in the struggle for
gender equality.
 ISSUES
• Who is a woman- friendly & gender
responsive health care provider?
• Is there such a thing as gender related
health problems?
• What are examples of gender biases?
 A woman friendly & gender
responsive health care provider
• Client – empowering • Dignity and respect
• Non- judgmental • Privacy
• Non- blaming • Use of language
• Informed choices • Client centered
• Openness/ • Sensitivity
acceptance • Facilitative
• Confidentiality • Supportive
 3 Types of Gender – related
Health problems
General Health Problems Special Health Problems
• Diseases which a person • Women: Pregnancy,
can have regardless of labor, Puerperium, Cx
sex, e.g. lung ds, HPN CA,
Myoma)
• Men: prostate CA
Gender Health Problems
•Those related with low status (e.g. spouse abuses,rape)
•Those associated with women’s traditional role as givers
( e.g. vulnerability to contagious diseases, stress)
• Those associated with gender stereotypes (anorexia
nervosa, complications of surgical reconstruction )
Gender Bias in Medical Practice
Research
• Assumes that males & females are
physiologically the same in all aspects apart
from reproductive systems
• Result: biased knowledge where preventive and
curative strategies are applied to women when
they have been tested only in men ( heart ds &
HIV AIDS)
Gender Bias in Medical Practice
DELIVERY OF HEALTH CARE
• Women have less access especially the
poor
• Lack of culturally appropriate care,
resources, transport, alternative care, no
permission from husband
• Scarcity leads to females being last priority
in the family
• Women report distressing and demeaning
experiences from health care workers
• Decision making about her health is either
left to the doctor or the husband
Am I a gender sensitive health
care provider?
Reproductive Health Law
The Long and Winding Road
Reproductive Health
A state of complete physical,
mental and social well-being
and not merely the absence
of disease or infirmity, in all
matters related to the
reproductive system and to
its functions and processes.
ICPD, 1994
Reproductive choice

being able to
make your own
decisions about
abstinence,
contraception,
and childbearing
according to your
own conscience.
Goals of reproductive
health
Every sexual act
consensual, pleasurable
and infection-free

Every pregnancy
intended and safe

Every birth safe and

wanted
 REPRODUCTIVE HEALTH
FRAMEWORK
Integrates/ Deals
From To Address
with

Maternal Mortality
VAWC
Gender Power
RTIs
Sexuality
Prevention of
Quality of Life
Reproduction Abortions/Complications
Life Cycle Approach
Population Infertility
Male Responsibility
Family Planning Cancers and other
Women Centered
Diseases
Socio-economic
Maternal and Child
Cultural
Health
Values and Ethics
Adolescent RH
Rights
(10 Elements)
PLATFORM FOR ACTION:
WOMEN’S CONFERENCE 1995

“ The human rights of women

include their right to have control
over and decide freely and
responsibly on matters related to
their sexuality, including sexual
and reproductive health, free of
coercion, discrimination and
violence.”

Paragraph 96
 RH Bill now a Law
• December 21, 2012 – President signed the bill as a
law after submission of the report from the
Bicameral Conference Committee
 But the fight was not over yet
• 14 petitions for Status Quo Ante Order was filed vs
the RH Law
• March 19, 2013 – SC issued a SQAO for 120 days
• FOR SQA: Presbitero Velasco Jr., Teresita de Castro, Arturo Brion,
Diosdado Peralta, Lucas Bersamin, Roberto Abad, Martin Villarama Jr., Jose
Perez, Jose Mendoza, and Bienvenido Reyes.
• AGAINST SQA: Chief Justice Ma. Lourdes Sereno, Antonio Carpio,
Estela Perlas-Bernabe, Mariano Del Castillo, and Marvic Leonen
 Oral Arguments Set
• June 19, 2013 – First • ANTI RH: right to life,
Schedule of Oral autonomy of LGUs,
Arguments freedom of religion,
• July 9, 2013 – freedom of
Second Schedule of expression
OA (SQA extended • PRO RH: population
indefinitely) management,
• August 27, 2013 – OA maternal mortality,
ended health as a human
right
 TH SC Decision

• April 8, 2014: SC Declared RH Law as

NOT Unconstitutional except for 8
provisions
 Salient Features of the RH Law
• Declaration of Policy
– Guarantees the human rights of all including
right to reproductive health and right to
choose in accordance with one’s religion
– Gender equality, gender equity and women’s
empowerment
 Salient Features of the RH Law
• Guiding Principles
– The right to make free and informed decisions
– provision of ethical and medically safe, legal,
accessible, affordable, non-abortifacient, effective
and quality reproductive health
– promote and provide information and access,
without bias, to all methods of family planning,
including effective natural and modern methods
– recognizes that abortion is illegal and punishable
by law
– reproductive health program addresses the needs
of people throughout their life cycle.
 Reproductive Health Care
(Sec. 4 (q)
• Maternal, infant and child • Prevention of RTIs/STIs
health and nutrition • Elimination of VAW
• Promotion of • Sexuality Education
breastfeeding
• Treatment of breast
• FP information and cancers and
services gynecological conditions
• Prevention of abortion • Male involvement in RH
and management of post
abortion complications • Treatment of Infertility
• Adolescent and youth • RH Education for the
health youth
 Professionals for maternal
health and skilled birth
attendants(Sec. 5)
• Every city and municipality shall
endeavor to employ adequate number
of midwives, nurses or other skilled
attendants to achieve a minimum
professional to patient ratio
Health Care Facilities (Sec. 6)

• LGU to establish or upgrade hospitals

and facilities with adequate and
qualified personnel, equipment and
supplies to be able to provide
emergency obstetric and newborn care
 SEC. 7. Access to Family
Planning.
• – All accredited public health facilities shall
provide a full range of modern family
planning methods, which shall also include
medical consultations, supplies and
necessary and reasonable procedures for
poor and marginalized couples having
infertility issues who desire to have
children
 SEC. 9. The Philippine National
Drug Formulary System and
Family Planning Supplies
• . – The National Drug Formulary shall
include hormonal contraceptives,
intrauterine devices, injectables and
other safe, legal, non-abortifacient and
effective family planning products and
supplies
 SEC. 10. Procurement and
Distribution of Family Planning
Supplies
• The DOH shall procure, distribute to
LGUs and monitor the usage of family
planning supplies for the whole country
 SEC. 12. PhilHealth Benefits for
Serious .and Life-Threatening Reproductive
Health Conditions.

• – All serious and life-threatening reproductive

health conditions such as HIV and AIDS, breast
and reproductive tract cancers, and obstetric
complications, and menopausal and post-
menopausal-related conditions shall be given
the maximum benefits, including the provision
of Anti-Retroviral Medicines (ARVs), as
provided in the guidelines set by the Philippine
Health Insurance Corporation (PHIC)
 SEC. 13. Mobile Health Care
Service.
• – The national or the local government
may provide each provincial, city,
municipal and district hospital with a
Mobile Health Care Service (MHCS) in
the form of a van or other means of
transportation appropriate to its terrain,
taking into consideration the health care
needs of each LGU.
SEC. 14. Age- and Development-Appropriate
Reproductive Health Education.
• – The State shall provide age- and
development-appropriate reproductive health
education to adolescents which shall be taught
by adequately trained teachers informal and
nonformal educational system and integrated
in relevant subjects such as, but not limited to:
– values formation; knowledge and skills in self-protection against
discrimination; sexual abuse and violence against women and
children and other forms of gender based violence and teen
pregnancy; physical, social and emotional changes in adolescents;
women’s rights and children’s rights; responsible teenage behavior;
gender and development; and responsible parenthood
 SEC. 15. Certificate of Compliance

• . – No marriage license shall be issued by the

Local Civil Registrar unless the applicants
present a Certificate of Compliance issued for
free by the local Family Planning Office
certifying that they had duly received
adequate instructions and information on
responsible parenthood, family planning,
breastfeeding and infant nutrition.
 SEC. 16. Capacity Building of
Barangay Health Workers (BHWs).
• – The DOH shall be responsible for
disseminating information and providing
training programs to the LGUs. Provided,
…national government shall provide additional
and necessary funding and other necessary
assistance for the effective implementation of
this provision including the possible provision of
additional honoraria for BHWs.
 SEC. 18. Sexual and Reproductive
Health Programs for Persons with
Disabilities (PWDs).

• – The cities and municipalities shall

endeavor that barriers to reproductive
health services for PWDs are
obliterated
 SEC. 19. Duties and
Responsibilities
• (a) Pursuant to the herein declared
policy, the DOH shall serve as the lead
agency for the implementation of this
Act
 SEC. 20. Public Awareness.
• – The DOH and the LGUs shall initiate and
sustain a heightened nationwide multimedia-
campaign to raise the level of public awareness
on the protection and promotion of reproductive
health and rights including, but not limited to,
maternal health and nutrition, family planning and
responsible parenthood information and services,
adolescent and youth reproductive health,
guidance and counseling and other elements of
reproductive health care under Section 4(q)
 10 Good Reasons Why RH Law is Good
– RH will:
• Protect the health and lives of mothers
• Save Babies
• Respond to the majority who want smaller families
• Promote equity for poor families
• Prevent induced abortions
• Support and deploy more public midwives, nurses and
doctors
• Guarantee funding for and equal access to health facilities
• Give accurate and positive sexuality education to young
people
• Reduce cancer deaths
• Save money for more social spending
Maraming
Salamat!
 Requirement

Present a policy paper on

promoting gender equality?