About the Women, Health and Development Program

Women, Health and Development (WHD) provides technical co-operation and assistance to all of PAHO's member countries to promote gender equity in the development of health policies and programs. We call for the redistribution of responsibilities and power between women and men in order to improve the physical, psychological and social well-being of the entire population. WHD seeks to identify and reduce the inequities between women and men with regard to health status and its determinants, access to and quality of health care, and participation in decision-making regarding allocation of resources.

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Prevention and Care of Gender-Based Violence
Sexual and Reproductive Health and Rights
Gender Equity in Health Sector Reform
Analysis and Monitoring of Gender Inequities
Male Involvement in Reproductive Health

WHD's work on gender-based violence has received global recognition. This effort has become a success story in 10 countries of the Americas, where networks of community-based organizations have come together to help prevent domestic violence and to offer support to women living in violent situations. In all of these countries the health sector at the national and municipal levels has taken the lead in addressing domestic violence as a priority public health issue.

Symposium 2001

In June of 2001, the Women, Health and Development Program co-sponsored, in co-operation with UNIFEM, UNDP, UNICEF, UNFPA, RSMLAC, Isis International and the Centre for Research in Women's Health, and co-ordinated the Symposium 2001: Gender-Based Violence, Health and Rights in the Americas.

For more information, visit the Symposium Page!

The Integrated Model

The Integrated Model approach to addressing domestic violence against women was developed by WHD in coordination with the 10 countries. The two sub-regional projects include all seven Central American countries (Belize, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Nicaragua and Panama ) and 3 Andean countries (Peru, Bolivia and Ecuador) The Integrated Model consists of the following components:

• Health services are often the initial detection point for women living in violent situations; providers are trained to screen women during routine primary and reproductive health care visits and to apply a protocol to assure quality services and data collection.



• A community task force assesses the prevalence of domestic violence against women and applies the Critical Route that Women Follow when Affected by Domestic Violence instrument to identify organizations and people who help women address their situation.



• Based on this information, health sector workers mobilize community organizations and leaders to form support and service networks. These networks may consist of the police, judicial systems, community leaders, NGOs, women’s organizations, schools, churches, hospitals, etc. The mix varies according to specific community needs.



• Each network plans, implements and monitors activities that address the needs of abused women and their families. Referral and information networks, training programs and support groups are set up to assure that women get quality care within their communities.



• Networks are replicated at national levels with representatives of local networks, and national public and civil sectors to advocate for policies, legislation and resources that address domestic violence at the national, regional and local level.

This project has developed and incorporated the following products: community level assessment instruments, including the "Critical Route" protocol; prototype training modules and materials for community, health, judicial and police personnel; detection protocols, standards for care and registration forms with instruction manuals for each. These tools were developed during regional workshops and are applied and adapted in all Central American and Andean countries . At the national level the project has contributed to efforts that have resulted in legislation against domestic violence in all countries and its incorporation in the national information system of three countries.

During 1998 most countries also started working with men’s groups in addressing the role of male perpetrators in domestic violence against women and in advocating for the incorporation of gender equity and addressing domestic violence in their health sector reform processes. The project also strengthened national and multi-sectoral efforts to launch media campaigns to promote non-violent relations.

The program produced and disseminated a number of publications throughout the Region. These include:

• Final Report: Participatory Evaluation of the Integrated Model (April 2002)



• Achievements of the Project: The Integrated Model (April 2001)



• The World Health Organization's Violence Against Women: A Priority Health Issue Information pack, which was translated into Spanish by WHD.



• Domestic Violence: Women's Way Out (2000)

During 1997-1998 WHD spearheaded opportunities for joint dialogue and collaboration between women’s NGOs, their national and local governments, the United Nations Population Fund (UNFPA) and PAHO, as well as for promoting the participation of men in reproductive health decisions. The Platforms for Action of the International Conference on Population and Development (Cairo 1994) and the Fourth World Conference on Women (Beijing 1995) called for gender-sensitive reproductive health programs. Such programs differ from traditional family planning initiatives in that they take into consideration women as subjects and active participants in reproductive and sexual health decisions. They emphasize the importance of drawing male partners into reproductive health programs so as to promote their role as responsible fathers and partners. Moreover, both these conferences emphasized the role of nongovernmental women’s organizations as key associates with governments in planning and implementing reproductive health programs.

In close collaboration with UNFPA, WHD documented lessons learned in promoting and carrying out activities related to reproductive health and gender equity with 23 NGOs in 13 countries. This report was the result of joint deliberations with these NGOs, UNFPA and PAHO, and led to a regional meeting on NGO collaboration in sexual and reproductive health and rights in Quito, Ecuador, in 1997. WHD initiated follow-up in seven countries to bring NGOs working in reproductive health together with ministries of health to design collaborative work plans to further reproductive health and gender equity.

• Collaboration between Non-Governmental Organizations and the United nationas Population (UNFPA) Fund in the Area of Sexual and Reproductive Health and Rights in Latin America (1994-1996) (in Spanish only)



• NGO Contributions to Sexual and Reproductive Rights in Latin America

The objective of this initiative is to work with member countries in the incorporation of gender equity in the formulation, execution, and evaluation of health sector reform policies.

PAHO's technical cooperation on inter-sectoral work and the active involvement of civil society, particularly of organized groups of women is directed towards three main objectives :

• Generation and dissemination of information on gender inequities



• Advocacy for the formulation of gender equitable policies



• Development of institutionalized participatory mechanisms for policy formation and monitoring that ensure sustainability

For more information refer to the PAHO/WHO Subcommittee on Women, Health, and Development 1999 Documents

• Towards Gender Equity in Health Sector Reform Policies



• Women's Needs and the Response of the Health Sector Reform Process in Ecuador



• Women's Needs and the Response of the Health Sector Reform Process in Chile



• Addressing Violence against Women in Health Sector Reform Policies in Central America

Recognizing gender equity as essential to sustainable human development is a phenomenon that is making headway in academic and political circles worldwide. At the same time, the need for statistics that are disaggregated by sex, indicators of gender inequality, and monitoring systems to evaluate the changes in the health situation of women and men has figured prominently in the declarations of the international forums of the past decade.

The Subcommittee on Women, Health, and Development issued a series of recommendations aimed at laying the groundwork for an interdivisional and interprogrammatic plan of action on gender information, coordinated by the Program on Women, Health, and Development (HDW). The purpose of this plan would be to implement mechanisms for the evaluation and monitoring of health from a gender equity perspective, taking socioeconomic diversity into account. These recommendations have only been partially fulfilled; the countries still have a long way to go, with serious obstacles to overcome and important opportunities to take advantage of.

For more information refer to the PAHO/WHO Subcommittee on Women, Health, and Development 2001 Documents

• Analysis and Monitoring of Gender Equity in Health and Development: Why and How



• Analysis and Monitoring of Gender Equity in Health and Development: Experience of Ecuador



• Analysis and Monitoring of Gender Equity in Health and Development: Production of Gender Statistics in Mexico



• Experiences with the Inclusion of Sexual Violence Indicators in Health Information and Surveillance Systems of Bolivia, Ecuador, and Peru



• Domestic Violence Surveillance Systems in Central America

The topic of male participation in reproductive health has attracted interest from health planners and providers, cooperating agencies, and women's groups since the International Conference on Population and Development (Cairo, 1994) and the Fourth World Conference on Women (Beijing, 1995).

The principle reasons for this growing interest are:

• Women's request to involve their partners and husbands in reproductive health programs


• Men's growing interest in improving their own reproductive health as well as their sexual partners' and family's health


• Acknowledgement that gender inequalities affect the health of both men and women in multiple ways


• Recognition of the important role men play in making decisions regarding sexuality and reproduction


• Recognition of the negative effects men's high risk behaviours can have on women and children


• Prevention of unwanted or unplanned pregnancies


• Prevention of STIs, including HIV


• Lack of norms of men attending health services

In 1998 WHD developed a proposal to promote men's participation in reproductive health programs in seven Central American countries. In collaboration with PAHO's Division of Health Promotion and local men's organizations, WHD will implement pilot programs and operations research on involving men in their own and their family's reproductive health needs.

Expected results are:

1. Information about the attitudes, needs, perceptions, and practices of men's sexual and reproductive health collected, analyzed, published, and disseminated to the community level, health personnel, political decision makers, and health and education institutions, and the media


2. Two models that foster the participation of men in reproductive health activities, in health service settings and in the workplace or social setting developed and tested.


3. Protocols, guidelines, methodologies, and training materials created in order to increase the male participation in reproductive health activities in health service settings and the workplace or social setting, distributed and promoted to the community level, political decision makers, health and education institutions, and the media throughout these countries.

This project will begin in early 2002. Keep checking this page for updated information!

Check out WHD's Bibliography on Men and Gender Differences in Health (pdf file)