OPS Representación ECUADOR: Avances y desafíos en la transversalización del enfoque de género en el sector salud Area técnica: Representación Ecuador

Avances Proceso interno en la Representación OPS Ecuador Trabajo en 4 niveles: Proceso interno en la Representación OPS Ecuador Apoyo al Ministerio de Salud Publica para el inicio de la transversalización de género A nivel de los Proyectos Sinergias con proyectos apoyados por UNIFEM u otros ámbitos de trabajo (ej. ONUSIDA) What was the vision in the approach of the LLGRB work in the Andean Region to local development – what did you seek to achieve and in what ways you have defined areas that would result in this change (theory of change)?   On the local level, UNIFEM has prioritized its work with participatory budgets. In participatory budgets process - Women have traditionally been excluded from these spaces for multiple reasons (absence from the public sphere, time limitations, etc.) - When they participate, sometimes is to defend the “community”, or “the others” interests Therefore, UNIFEM works to: - Strengthen women’s participation in participatory processes, (raise their awareness of the discrimination they face, work to generate common agendas to strategically position gender issues, thereby improving their abilities to negotiate in these spaces and advocate for their proposals) - Incorporate the gender perspective in the process itself example: changes in the way community representatives make decisions, in order to promote the participation of more women, instruments that can be used to incorporate the gender perspective in the set of proposals that is presented, etc.)

Proceso interno en la Representación OPS Ecuador Avances (2) Proceso interno en la Representación OPS Ecuador Diagnostico del trabajo en género en la Oficina de OPS ECU y socialización del mismo Plan de Inicio de transversalización de género de la Oficina aprobado por la Representante Taller de sensibilización y capacitación sobre género y salud para el Personal de la Representación Inserción de género en CCS y apoyo técnico a Ministra para Consejo Directivo OPS Inicio de un trabajo en género y comunicación How has this approach addressed women’s rights? What particular measures were undertaken to achieve this?   The first right that we are dealing with is women’s right to participate ( on the political level and in community-level decisions). In other words, by promoting women’s participation, a right is being fulfilled. However, in an indirect way, gender budgets have the potential to contribute to women’s rights through the effective allocation of public resources for their fulfillment Example: In Villa El Salvador, on the district level, women’s efforts resulted in the approval of a shelter to support women victims of violence in the participatory budget

Avances (3) Apoyo al Ministerio de Salud Publica para el inicio de la transversalización de género 2 proyectos pilotos: AIEPI y salud de adolescentes indígenas, tras solicitud de apoyo desde MSP Proceso de conformación de un equipo interinstitucional sobre indicadores de género en salud (MSP, INEC, SENPLADES y OPS son lideres) Taller regional sobre indicadores e información de género en salud: visibilizar el tema  What institutions served as entry points for implementing this approach? Local governments – particularly the departments that work jointly with women’s areas to carry out participatory processes (As a matter of fact, in municipalities like Villa El Salvador, where a women’s area previously did not exist, the program contributed toward its creation)   NGOs, women’ s and feminist organizations, that have previous experience carrying out advocacy efforts related to public policies on the local level, and with recognized experience working with women on the community level Grassroots women’s organizations (that will be involved in the participatory processes) Female municipal authorities committed to gender equality In some municipalities, dialogue spaces between government and civil society (councils, etc.)

A nivel de los Proyectos AIEPI Avances (4) A nivel de los Proyectos AIEPI Cursos de capacitación sobre género y salud con énfasis en AIEPI Comunitario para la gestión de proyectos con enfoque de género: nivel central y provincias ENTENDER Elaboración perfil de salud de niños/as con datos desagregados por sexo, etnia, edad (neonatal, infantil) y situación socio económica con énfasis en brechas de género y etnia y análisis de resultados e implicancias para la salud de la niñez (cuantitativo y cualitativo) CONOCER Incorporación del enfoque de género en recopilación, procesamiento y análisis de la información estratégica: taller nacional y salas situacionales SABER HACER One of the principal challenges has been developing a common understanding about what effectively constitutes “expense for gender equality.” Many times, this was taken to mean any amount spent on women, but sometimes programs focused on women do not generate any kind of change in gender relations, nor on women’s social position.   Another challenge has been the need to not only carry out advocacy efforts in the formulation of budgets, but also to keep an eye on its implementation. A final challenge is related to the reach of current efforts. Despite the fact that the participatory budget is a tool for exercising civil rights and that it allows women to become familiar with the public budgeting process, it is a limited sphere, as normally only about 5% of the budget is discussed in this sphere. 5

Avances (5) Adaptación y producción de materiales para promoción de estrategia AIEPI y para sensibilización sobre Chagas a nivel de los servicios de salud y en la Comunidad que garanticen el enfoque de género e intercultural DIFUNDIR/SENSIBILIZAR Incorporación de género en instrumentos de monitoreo y selección indicadores sensibles al género para proyecto y EVALUACION con enfoque de género MEDIR What was the vision in the approach of the LLGRB work in the Andean Region to local development – what did you seek to achieve and in what ways you have defined areas that would result in this change (theory of change)?   On the local level, UNIFEM has prioritized its work with participatory budgets. In participatory budgets process - Women have traditionally been excluded from these spaces for multiple reasons (absence from the public sphere, time limitations, etc.) - When they participate, sometimes is to defend the “community”, or “the others” interests Therefore, UNIFEM works to: - Strengthen women’s participation in participatory processes, (raise their awareness of the discrimination they face, work to generate common agendas to strategically position gender issues, thereby improving their abilities to negotiate in these spaces and advocate for their proposals) - Incorporate the gender perspective in the process itself example: changes in the way community representatives make decisions, in order to promote the participation of more women, instruments that can be used to incorporate the gender perspective in the set of proposals that is presented, etc.) 6

Avances (6) Proyecto Salud de Adolescentes Indígenas Análisis de situación sobre salud de población adolescente indígena de zonas priorizadas por el proyecto que tome en cuenta género y con recomendaciones para la acción: estudio cualitativo y cuantitativo (sobre percepciones). Desarrollo modelo integral de servicios de salud de los y las adolescentes en concordancia con estrategia de manejo integrado del adolescente y sus necesidades (IMAN) y con normas nacionales. Desarrollo actividades de prevención, tratamiento, apoyo y atención para VIH, TB y embarazo adolescente que incluyen métodos innovadores para aumentar la cobertura de las intervenciones en comunidades indígenas del proyecto y reducir sus barreras de acceso a servicios. How has this approach addressed women’s rights? What particular measures were undertaken to achieve this?   The first right that we are dealing with is women’s right to participate ( on the political level and in community-level decisions). In other words, by promoting women’s participation, a right is being fulfilled. However, in an indirect way, gender budgets have the potential to contribute to women’s rights through the effective allocation of public resources for their fulfillment Example: In Villa El Salvador, on the district level, women’s efforts resulted in the approval of a shelter to support women victims of violence in the participatory budget 7

Sinergias con proyectos apoyados por UNIFEM u otros ámbitos de trabajo Avances (7) Sinergias con proyectos apoyados por UNIFEM u otros ámbitos de trabajo Trabajo sobre vínculo entre VIH y Violencia Trabajo con organización de MVVS Participacion en ONUSIDA: poner de realce el enfoque de género en salud Ampliar el trabajo de UNIFEM a Salud en general y no sólo VIH  What institutions served as entry points for implementing this approach? Local governments – particularly the departments that work jointly with women’s areas to carry out participatory processes (As a matter of fact, in municipalities like Villa El Salvador, where a women’s area previously did not exist, the program contributed toward its creation)   NGOs, women’ s and feminist organizations, that have previous experience carrying out advocacy efforts related to public policies on the local level, and with recognized experience working with women on the community level Grassroots women’s organizations (that will be involved in the participatory processes) Female municipal authorities committed to gender equality In some municipalities, dialogue spaces between government and civil society (councils, etc.) 8

Fortalecimiento conocimientos y capacidades en género y salud Para el futuro… Dentro de la Oficina, algunas áreas más motivadas y comprometidas: Inmunizaciones, FCH, gestión de desastres, Comunicación y Administración que tienen planes para trabajar con enfoque de género, tras el Taller para el Personal Fortalecimiento conocimientos y capacidades en género y salud Participacion activa en grupo sobre indicadores de género en salud Mayor soporte al Ministerio de Salud One of the principal challenges has been developing a common understanding about what effectively constitutes “expense for gender equality.” Many times, this was taken to mean any amount spent on women, but sometimes programs focused on women do not generate any kind of change in gender relations, nor on women’s social position.   Another challenge has been the need to not only carry out advocacy efforts in the formulation of budgets, but also to keep an eye on its implementation. A final challenge is related to the reach of current efforts. Despite the fact that the participatory budget is a tool for exercising civil rights and that it allows women to become familiar with the public budgeting process, it is a limited sphere, as normally only about 5% of the budget is discussed in this sphere. 9

Buenas practicas o factores positivos Compromiso fuerte de la Representante Fortalecimiento del Personal de la OPS debería servir para fortalecer al MSP Alianza estratégica entre UNIFEM y la OPS/OMS en Ecuador Compromiso del MSP Dedicación 100% del tiempo de una técnica y compromiso fuerte PFG Apoyo del nivel regional, de GEH Voluntad de basar la acción en la evidencia: investigaciones Una respuesta multifacética What was the vision in the approach of the LLGRB work in the Andean Region to local development – what did you seek to achieve and in what ways you have defined areas that would result in this change (theory of change)?   On the local level, UNIFEM has prioritized its work with participatory budgets. In participatory budgets process - Women have traditionally been excluded from these spaces for multiple reasons (absence from the public sphere, time limitations, etc.) - When they participate, sometimes is to defend the “community”, or “the others” interests Therefore, UNIFEM works to: - Strengthen women’s participation in participatory processes, (raise their awareness of the discrimination they face, work to generate common agendas to strategically position gender issues, thereby improving their abilities to negotiate in these spaces and advocate for their proposals) - Incorporate the gender perspective in the process itself example: changes in the way community representatives make decisions, in order to promote the participation of more women, instruments that can be used to incorporate the gender perspective in the set of proposals that is presented, etc.) 10

Límites y desafíos Falta de tiempo, conocimientos y destrezas en Personal Las actividades de fortalecimiento no siempre se aprovechan Falta de sensibilización y capacidad en el Ministerio de Salud sobre este tema Retos Disponer de herramientas para el trabajo del día a día Estudiar lo que pasa para los hombres (interés del Personal) Involucrar a Hombres en todo proceso de ciclo de proyecto ¿Cómo trabajar Género y Comunicación? Involucramiento del conjunto de la Oficina, fortalecer a un equipo Concepto de género: tomar en cuenta diversidad y concepto de identidad de género How has this approach addressed women’s rights? What particular measures were undertaken to achieve this?   The first right that we are dealing with is women’s right to participate ( on the political level and in community-level decisions). In other words, by promoting women’s participation, a right is being fulfilled. However, in an indirect way, gender budgets have the potential to contribute to women’s rights through the effective allocation of public resources for their fulfillment Example: In Villa El Salvador, on the district level, women’s efforts resulted in the approval of a shelter to support women victims of violence in the participatory budget 11

GRACIAS!