Gender Trends in Southeast Asia: Women Now, Women in the Future

5. Gender Mainstreaming in Health: Mainstream or "Off-Stream"?

73 5 GENDER MAINSTREAMING IN HEALTH: MAINSTREAM OR “OFF-STREAM”? Rashidah Shuib INTRODUCTION The฀evolution฀from฀the฀WID฀(Women฀in฀Development)฀approach฀to฀the฀ GAD฀(Gender฀and฀Development)฀approach฀brought฀the฀political฀language฀ of฀the฀feminist฀discourse฀to฀the฀forefront฀of฀discussions฀in฀the฀international฀ development฀agenda.฀It฀was฀argued฀that฀putting฀on฀the฀gender฀lens฀would฀ result฀in฀a฀clearer,฀more฀realistic฀view฀of฀the฀conditions฀and฀the฀position฀of฀ women฀and฀men฀in฀society.฀In฀the฀area฀of฀health,฀the฀GAD฀approach฀helped฀ to฀widen฀the฀perspective฀on฀development,฀as฀health฀issues฀became฀included฀ as฀integral฀to฀a฀country’s฀development.฀Locating฀the฀issues฀within฀the฀gender฀ framework฀was฀seen฀as฀a฀way฀of฀finding฀answers฀as฀to฀why฀gender฀inequality฀ and฀ inequity฀ exists.฀ The฀ adoption฀ of฀ the฀ word฀ “gender”฀ which฀ replaced฀ “women”฀ is฀ seen฀ as฀ a฀ step฀ forward฀ in฀ gender฀ mainstreaming.฀ Moser฀ and฀ Moser฀(2005,฀p.฀11)฀in฀their฀paper฀reviewing฀the฀success฀and฀limitations฀of฀ gender฀mainstreaming฀since฀Beijing฀have฀evaluated฀the฀progress฀on฀gender฀ mainstreaming฀in฀three฀stages: •฀ adopting฀ the฀ terminology฀ of฀ gender฀ equality฀ and฀ gender฀ mainstreaming ; 05฀GTSEA.indd฀฀฀73 9/9/09฀฀฀2:27:09฀PM 74 Rashidah Shuib •฀ putting฀gender฀mainstreaming฀policies฀into฀place;฀and, •฀ implementing฀gender฀mainstreaming. These฀ stages฀ will฀ be฀ assessed฀ in฀ this฀ chapter฀ in฀ an฀ effort฀ to฀ map฀ the฀ various฀components฀of฀gender฀mainstreaming฀policy฀in฀health฀specifically฀in฀ the฀contexts฀of฀Cambodia,฀Malaysia,฀the฀Philippines,฀and฀Vietnam. The฀ ‘buy-in’฀ to฀ the฀ idea฀ that฀ tackling฀ gender฀ inequality฀ is฀ critical฀ to฀ development฀led฀governments฀across฀the฀world฀to฀accept฀gender฀mainstreaming฀ as฀a฀strategy฀to฀achieve฀gender฀equality฀and฀the฀empowerment฀of฀women.฀ International฀organizations,฀donors,฀United฀Nations฀(UN)฀agencies฀and฀nongovernment ฀organizations฀(NGOs)฀have฀assisted฀many฀countries฀with฀financial฀ and฀technical฀assistance฀and฀capacity฀building฀to฀facilitate฀structural฀changes.฀ Gender฀specialists฀and฀gender฀focal฀points฀were฀“located฀within฀a฀centralized฀ team,฀as฀well฀as฀‘embedded’฀in฀decentralized฀departmental฀and฀regional฀offices”฀ (Moser฀and฀Moser฀2005,฀p.฀14).฀Manuals,฀toolkits฀and฀checklists฀were฀also฀ developed.฀Given฀the฀range฀of฀initiatives฀to฀ensure฀gender฀mainstreaming,฀one฀ would฀have฀imagined฀that฀the฀literature฀would฀be฀rich฀with฀success฀stories฀ and฀best฀practices.฀A฀cursory฀look฀at฀the฀literature฀on฀gender฀mainstreaming,฀ however,฀shows฀that฀it฀is฀peppered฀with฀words฀such฀as฀“defanged”,฀“gender฀ fade฀ away”,฀ and฀ “gender฀ evaporation”,฀ giving฀ the฀ impression฀ that฀ gender฀ mainstreaming฀as฀a฀mechanism฀in฀achieving฀gender฀equality฀is฀“weak”,฀has฀ “evaporated”,฀and฀“lacks฀bite”฀or฀that฀the฀implementation฀of฀this฀concept฀is฀ mere฀“tokenism”.฀The฀question฀then฀is฀to฀ask฀whether฀these฀words฀describe฀ the฀reality฀or฀are฀they฀mere฀weapons฀of฀the฀critique฀of฀gender฀mainstreaming฀ as฀argued฀by฀some฀(Moser฀and฀Moser฀2005;฀Ravindran฀and฀Kelkar-Khambete฀ 2007;฀North฀2008;฀Kalyati฀2008). This฀chapter฀aims฀to฀visit฀gender฀mainstreaming฀in฀health฀issues฀in฀a฀ select฀number฀of฀countries฀in฀Southeast฀Asia฀in฀order฀to฀assess฀whether฀gender฀ mainstreaming฀ as฀ envisioned฀ by฀ the฀ feminist฀ movement฀ is฀ still฀ palpable฀ and฀“on-course”฀or฀whether฀it฀has฀gone฀“off-course”,฀as฀has฀been฀the฀fate฀ of฀some฀policies฀and฀strategies฀adopted฀by฀governments.฀To฀offer฀a฀deeper฀ understanding฀of฀the฀issues฀in฀hand,฀the฀chapter฀begins฀by฀retracing฀briefly฀ the฀historical฀context฀to฀gender฀mainstreaming฀and฀the฀philosophy฀which฀ underlies฀the฀term.฀The฀chapter฀also฀examines฀the฀term฀“gender฀mainstreaming”฀ which฀has฀been฀argued฀by฀some฀to฀be฀problematic.฀ The฀chapter฀is฀divided฀into฀several฀sections.฀The฀main฀section฀of฀this฀ ฀ chapter฀examines฀gender฀mainstreaming฀against฀the฀backdrop฀of฀the฀geopolitical ฀and฀socio-economic฀scenario฀in฀Southeast฀Asia,฀especially฀sexual฀and฀ reproductive฀health฀and฀rights฀issues฀which฀are฀rife฀with฀controversies,฀and฀the฀ nature฀of฀the฀implementation฀of฀the฀concept฀of฀gender฀mainstreaming฀in฀the฀ 05฀GTSEA.indd฀฀฀74 9/9/09฀฀฀2:27:09฀PM Gender Mainstreaming in Health: Mainstream or “Off-Stream”? 75 countries฀of฀Cambodia,฀Malaysia,฀the฀Philippines,฀and฀Vietnam.฀It฀must฀be฀ noted฀that฀these฀countries฀were฀chosen฀for฀two฀reasons:฀(a)฀the฀availability฀of฀ literature฀on฀gender฀mainstreaming฀in฀health฀in฀the฀Southeast฀Asian฀region;฀ and,฀(b)฀my฀experiences฀of฀having฀been฀involved฀in฀capacity-building฀efforts฀ [for฀health฀practitioners]฀in฀two฀of฀the฀four฀countries.฀Lastly,฀the฀chapter฀ presents฀ my฀ reflections฀ and฀ observations฀ of฀ capacity-building฀ efforts฀ and฀ strategies฀adopted฀in฀gender฀mainstreaming฀based฀on฀my฀own฀involvement฀ in฀gender฀and฀rights฀training฀on฀health฀issues฀in฀Cambodia฀and฀Malaysia.฀ The฀chapter฀concludes฀by฀arguing฀that...