Promoting Gender Equality in India
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August 2015 PROMOTING GENDER EQUALITY IN INDIA Three Approaches to Scale-up This publication was prepared by Sara Pappa, Arundati Muralidharan, Radhika Dayal, and Madhumita Das. HEALTH POLICY PROJECT Suggested citation: Pappa, S., A. Muralidharan, R. Dayal, and M. Das. 2015. Prom oting Gender Equality in India: Three Approaches to Scale-up. W ashington, DC: Futures Group: Health Policy Project. ISBN: 978-1-59560-111-7 The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. It is implemented by Futures Group, in collaboration with Plan International USA, Av enir Health (formerly Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA). Promoting Gender Equality in India Three Approaches to Scale-up AUGUST 2015 This publication was prepared by Sara Pappa, 1 Arundati Muralidharan, 2 Radhika Dayal, 2 and Madhumita Das.3 1 Health Policy Project, Futures Group, 2 Public Health Foundation of India (PHFI), 3 International Center for Research on W omen (ICRW ) The information prov ided in this document is not official U.S. Gov ernment information and does not necessarily represent the v iews or positions of the U.S. Agency for International Dev elopment. CONTENTS Acknowledgments ....................................................................................................................... iv Abbreviations ................................................................................................................................ v Introduction ................................................................................................................................... 1 Background ....................................................................................................................................1 Context...........................................................................................................................................1 Rationa le ........................................................................................................................................3 Aim................................................................................................................................................3 Methodology ................................................................................................................................. 5 Findings: Gender Equity Movement In Schools (GEMS) .......................................................... 6 Background ....................................................................................................................................6 Key Intervention Components..........................................................................................................6 Scale-up Process .............................................................................................................................6 Outcomes of Scale-up......................................................................................................................8 Findings: PRACHAR ....................................................................................................................... 9 Background ....................................................................................................................................9 Key Intervention Components and Results ........................................................................................9 Scale-up Process ........................................................................................................................... 10 Outcomes of Scale-up.................................................................................................................... 12 Findings: Avahan ........................................................................................................................ 13 Background .................................................................................................................................. 13 Key Intervention Components........................................................................................................ 13 Scale-up Process ........................................................................................................................... 14 Outcomes of Scale-up.................................................................................................................... 16 Comparative Analysis................................................................................................................ 17 Scalability .................................................................................................................................... 17 Partnerships and Resource Mobilization ......................................................................................... 18 Adaptation and Expansion ............................................................................................................. 20 Institutionalization ........................................................................................................................ 21 Monitoring and Evaluation ............................................................................................................ 22 Sustainability ................................................................................................................................ 23 Conclusion................................................................................................................................... 24 References................................................................................................................................... 25 iii ACKNOWLEDGMENTS This report has been undertaken with support from the United States Agency for International Development (USAID) in India and Washington, DC. We would like to acknowledge and thank the following people for their contributions to this report, as well as their thoughtful comments and suggestions to further strengthen the analysis: Elisabeth Rottach and Nancy Yinger (Health Policy Project), Jessica Fehringer and Mahua Mandal (MEASURE Evaluation), and Ravi Verma (International Center for Research on Women). We value the input of key informants who participated in this report and are grateful for the suggestions, support, and encouragement provided by our colleagues at the Health Policy Project, Public Health Foundation of India, the International Center for Research on Women (ICRW), and MEASURE Evaluation. The authors also thank Lory Frenkel, Niki Wood, and Brent Franklin for editing and formatting the document. iv ABBREVIATIONS ASHA Accredited Social Health Activist BMGF Bill & Melinda Gates Foundation CBO community-based organization CERT Council of Education, Research and Training CORO Committee of Resource Organizations for Literacy DoHFW Department of Health and Family Welfare FP family planning FP/MNCH family planning and maternal, neonatal, and child health FSW female sex worker GBV gender-based violence GEMS Gender Equity Movement in Schools GOB Government of Bihar GOH Government of Haryana GOI Government of India GPM Gender, Policy and Measurement Program HPP Health Policy Project ICRW International Center for Research on Women IDU injecting drug user IEC information, education, communication IRB Institutional Review Board KII key informant interview LMIC low- and middle-income country MDG Millennium Development Goal MNCH maternal, neonatal and child health MOWCD Ministry of Women and Child Development MPSP Maharashtra Prathamik Shikshan Parishad MSI Management Systems International MSM men who have sex with men NACO National AIDS Control Organization NACP National AIDS Control Program NGO nongovernmental organization NRHM National Rural Health Mission PHFI Public Health Foundation of India RMNCH+A reproductive, maternal, neonatal, child and adolescent health SBCC social and behavior change communication SDG Sustainable Development Goal SRH sexual and reproductive health STI sexually transmitted infection TI Targeted Intervention TISS Tata Institute for Social Sciences TSU Technical Support Unit UNICEF United Nations Children’s Fund USAID United States Agency for International Development WHO World Health Organisation v INTRODUCTION Background The Gender, Policy and Measurement (GPM) program, funded by the Asia bureau of the United States Agency for International Development (USAID), is collaborating with USAID and other partners in the Asia region to strengthen programs for scale-up in Family Planning and Maternal, Neonatal, and Child Health (FP/MNCH). GPM works to address gender inequality and implement supportive policies and systems that augment the sustainability and foster the scale-up of effective programs. As a part of this effort, the GPM program, under the USAID-funded Health Policy Project (HPP), along with partner institutions in India—the International Center for Research on Women (ICRW) and the Public Health Foundation of India (PHFI) —sought to examine how successful gender-integrated health programs (identified through a systematic review of gender-integrated health programs in low- and middle-income countries [LMICs])1 have been scaled up, with a focus on programs that were scaled up through government structures in India.