Gender-responsive monitoring and evaluation (M&E) for health and health systems interventions and programs is vital to improve health, health systems, and gender equality outcomes. It can be used to identify and address gender disparities in program participation, outcomes and benefits, as well as ensure that programs are designed and implemented in a way that is inclusive and accessible for all. While gender-responsive M&E is most effective when interventions and programs intentionally integrate a gender lens, it is relevant for all health systems programs and interventions. Within the literature, gender-responsive M&E is defined in different and diverse ways, making it difficult to operationalize. This is compounded by the complexity and multi-faceted nature of gender. Within this methodological musing, we present our evolving approach to gender-responsive M&E which we are operationalizing within the Monitoring for Gender and Equity project. We define gender-responsive M&E as intentionally integrating the needs, rights, preferences of, and power relations among, women and girls, men and boys, and gender minority individuals, as well as across social, political, economic, and health systems in M&E processes. This is done through the integration of different types of gender data and indicators, including: sex- or gender-specific, sex- or gender-disaggregated, sex- or gender-specific/disaggregated which incorporate needs, rights and preferences, and gender power relations and systems indicators. Examples of each of these are included within the paper. Active approaches can also enhance the gender-responsiveness of any M&E activities, including incorporating an intersectional lens and tailoring the types of data and indicators included and processes used to the specific context. Incorporating gender into the programmatic cycle, including M&E, can lead to more fit-for-purpose, effective and equitable programs and interventions. The framework presented in this paper provides an outline of how to do this, enabling the uptake of gender-responsive M&E.
Rosemary Morgan, Anna Kalbarczyk, Michele Decker, Shatha Elnakib, Tak Igusa, Amy Luo, Ayoyemi Toheeb Oladimeji, Milly Nakatabira, David H Peters, Indira Prihartono, Anju Malhotra, Gender-responsive monitoring and evaluation for health systems, Health Policy and Planning, Volume 39, Issue 9, November 2024, Pages 1000–1005, https://doi.org/10.1093/heapol/czae073
Given the many approaches to and definitions of gender responsive monitoring and evaluation (M&E) for health programs and interventions there is a lack of clarity on how to operationalize it including what to measure and how to measure it. We conducted a scoping review to understand what makes M&E gender responsive. We included 31 studies and conducted two rounds of extraction to delineate ways in which gender was integrated into M&E. Twelve articles described the use of theory to guide M&E though most were not related to gender. Twelve articles employed a gender score in data collection, most of which measured Likert scale responses related to gender equity. Even though most studies did not use a specific gender framework, most incorporated gender domains in their analysis. Seven studies used participatory methods in the design and implementation of M&E. Most studies conducted M&E on programs or interventions that were designed to be gender intentional and related to gender issues. Gender responsive M&E intentionally integrates gender into the M&E process, regardless of how gender-intentional the program or intervention is. Gender dimensions can be identified through gender theories, models, scores, and frameworks to inform tool development, data collection, analysis, and stakeholder engagement processes.
Kalbarczyk et al (2025) Towards a common understanding of gender-responsive monitoring and evaluation for health programs and interventions: Evidence from a
scoping review. https://doi.org/10.1016/j.ssmhs.2025.100059
This brief is an overview using PMA (Performance Monitoring for Action) Ethiopia data. Women-friendly respectful care is essential for reducing maternal and child mortality, and fulfilling women’s rights. Ethiopia has made tremendous progress in saving women’s lives during childbirth by increasing the proportion of women delivering in facilities. The maternal mortality ratio has decreased drastically from 953 in 2000 to 267 per 100,000 live births in 2020, largely due to a substantial increase in the percentage of women delivering in a facility, from 10% in 2011 to 48% in 2019. However, too many women are still dying in childbirth with approximately half still not delivering in facilities. Women may not be delivering in facilities because they lack access or because of prior or perceived poor experience in the quality of care that diminishes women’s trust in health facilities for this important life experience.
To reduce maternal deaths, therefore, policy makers need to ensure the quality as well as the availability of facilities. One element for good quality maternity care includes clinical standards and skills. An equally critical element is women’s perceptions and trust of facilities regarding how they are treated during this defining and important event in their lives. While access to more and better facilities is an essential starting point, women will continue using them only if they have a positive birthing experience in these facilities.
During this one hour webinar we discussed the launch of our new study to document the impact of women’s leadership in RMNCAHN and immunization across sub-Saharan Africa. Funded by the Global Financing Facility and Gavi, this study seeks to move beyond the barriers that women leaders face, and focus on the impact they’ve had in spite of these barriers! We provided an overview of the study, shared results from a scoping review, and discussed the importance of this work.