Family Planning Decisions, Perceptions and Gender Dynamics among Couples in Mwanza, Tanzania: A Qualitative Study.

Contraceptive use is low in developing countries which are still largely driven by male dominated culture and patriarchal values. This study explored family planning (FP) decisions, perceptions and gender dynamics among couples in Mwanza region of Tanzania. Twelve focus group discussions and six in-depth interviews were used to collect information from married or cohabiting males and females aged 18-49. The participants were purposively selected. Qualitative methods were used to explore family planning decisions, perceptions and gender dynamics among couples. A guide with questions related to family planning perceptions, decisions and gender dynamics was used. The discussions and interviews were tape-recorded, transcribed verbatim and analyzed manually and subjected to content analysis. Four themes emerged during the study. First, "risks and costs" which refer to the side effects of FP methods and the treatment of side -effects as well as the costs inherit in being labeled as an unfaithful spouse. Second, "male involvement" as men showed little interest in participating in family planning issues. However, the same men were mentioned as key decision-makers even on the number of children a couple should have and the child spacing of these children. Third, "gender relations and communication" as participants indicated that few women participated in decision-making on family planning and the number of children to have. Fourth, "urban-rural differences", life in rural favoring having more children than urban areas therefore, the value of children depended on the place of residence. Family Planning programs should adapt the promotion of communication as well as joint decision-making on FP among couples as a strategy aimed at enhancing FP use

Towards building equitable health systems in Sub-Saharan Africa: lessons from case studies on operational research

<p>Abstract</p> <p>Background</p> <p>Published practical examples of how to bridge gaps between research, policy and practice in health systems research in Sub Saharan Africa are scarce. The aim of our study was to use a case study approach to analyse how and why different operational health research projects in Africa have contributed to health systems strengthening and promoted equity in health service provision.</p> <p>Methods</p> <p>Using case studies we have collated and analysed practical examples of operational research projects on health in Sub-Saharan Africa which demonstrate how the links between research, policy and action can be strengthened to build effective and pro-poor health systems. To ensure rigour, we selected the case studies using pre-defined criteria, mapped their characteristics systematically using a case study development framework, and analysed the research impact process of each case study using the RAPID framework for research-policy links. This process enabled analysis of common themes, successes and weaknesses.</p> <p>Results</p> <p>3 operational research projects met our case study criteria: HIV counselling and testing services in Kenya; provision of TB services in grocery stores in Malawi; and community diagnostics for anaemia, TB and malaria in Nigeria. <b>Political context and external influences: </b>in each case study context there was a need for new knowledge and approaches to meet policy requirements for equitable service delivery. Collaboration between researchers and key policy players began at the inception of operational research cycles. <b>Links</b>: critical in these operational research projects was the development of partnerships for capacity building to support new services or new players in service delivery. <b>Evidence: </b>evidence was used to promote policy dialogue around equity in different ways throughout the research cycle, such as in determining the topic area and in development of indicators.</p> <p>Conclusion</p> <p>Building equitable health systems means considering equity at different stages of the research cycle. Partnerships for capacity building promotes demand, delivery and uptake of research. Links with those who use and benefit from research, such as communities, service providers and policy makers, contribute to the timeliness and relevance of the research agenda and a receptive research-policy-practice interface. Our study highlights the need to advocate for a global research culture that values and funds these multiple levels of engagement.</p

Violence against women and the role of gender equality, social inclusion and health strategies

Violence against women is the single most prevalent and universal violation of human rights. It knows no geographical boundaries, no age limit, no class distinction, no cultural or racial differences and it has strong implications for gender equality, social inclusion and health. The elimination of gender-based violence is a priority area of the European Commission’s Women’s Charter adopted in March 2010 and of its Strategy for equality between women and men adopted in September 2010 (1 ), which express the Commission’s commitment to propose an effective and comprehensive strategy to fight violence against women. While the primary responsibility to combat violence against women is of the Member States, the European Union has a strong role to play via Council conclusions (2 ), resolutions by the European Parliament (3 ), funding support, awareness-raising activities and the promotion of exchanges of good practices, to name but a few of its undertakings. In European countries the political commitment to combating violence against women has increased over the last decade, thanks to the strong commitment and actions of the international institutions, women’s movements and NGOs. This is evident in the improvements in both data availability and the legislative and policy measures adopted in the 33 countries considered in this report. However, there are still many weaknesses and loopholes in the way violence against women is presented in the social and political debate and in the ways it is addressed.peer-reviewe

Ethnic minority and Roma women in Europe : a case for gender equality?

The existing evidence suggests that ethnic minority and especially Roma women are the most vulnerable to multiple discrimination and present higher risks of social exclusion and poverty than the women of the native population and minority men. There are, however, differences in the social and economic conditions of women among and within ethnic minorities and across European countries that should be considered in order to frame suggestions for policymaking. This comparative report presents the socio-economic conditions and perspectives of women belonging to disadvantaged ethnic minorities, with special attention to Roma women. The analysis focuses on those ethnic minorities that suffer the most disadvantages in a given national context, mainly in terms of access to education, housing, healthcare, social benefits, and to employment and financial services. The report also presents the main legislative and policy responses developed at the national level to target their social inclusion with some good practice examples. The information in this report is provided by the national experts of the EGGSI Network of experts in gender equality, social inclusion, healthcare and long-term care and covers 30 European countries (EU and EEA/ EFTA) (1 ). The report is organised in two parts: Part 1 (from Chapter 1 to 4) presents the situation of women belonging to disadvantaged ethnic minorities in general, while Part 2 (from Chapter 5 to 8) focuses on Roma women. Some overall conclusions are presented in the final chapter.peer-reviewe

Access to healthcare and long-term care : equal for women and men? : Final synthesis report

While healthcare systems have contributed to significant improvements in health in Europe, access to healthcare remains uneven across countries and social groups, according to socioeconomic status, place of residence, ethnic group, and gender. Gender plays a specific role both in the incidence and prevalence of specific pathologies and also in their treatment and impact in terms of well-being and recovery. This is due to the interrelations between sexrelated biological differences and socioeconomic and cultural factors which affect the behaviour of women and men and their access to services. This comparative report presents the main differences in the health status of women and men in European countries and examines how healthcare and long-term care systems respond to the specific needs of women and men in ensuring equal access. It considers the main financial, cultural and physical barriers to access and provides good practice examples of healthcare promotion, prevention and general treatment programmes, as well as of long-term care. The information in this report is mainly provided by the national experts of the EGGSI network of experts in gender equality, social inclusion, healthcare and longterm care and covers 30 European countries (EU-27 and EEA/EFTA)( 1 ). Available comparative statistical data from Eurostat and OECD sources have also been considered.peer-reviewe