Making the invisible visible: gender, data, and evidence for development
Every day health-related decisions are made based on available data, yet gaps in data impede governments and development partners from planning and delivering effective social programs. These groups and others are clamouring for more data, but will more of the same help us achieve the Sustainable Development Goals pledge of "leaving no one behind"? Unlikely.
Current health data systems and other data related to civil registration and vital statistics (CRVS) systems are falling short when it comes to making all people "visible". Registration of vital events — including birth, marriage, death, and cause of death — is an essential step to establish legal identity, access social protection programs, and exercise human rights. “Being counted” also means being visible at the policy and program level, but power, geography, and politics often determine who is counted and who is not. For the underserved and hard to reach, the majority of whom are women and children, these are more than just technical matters, they are matters of identity, dignity, and equality.
At IDRC we believe rigorous locally-driven implementation research projects play a critical role in reducing the invisibility gap. Thinking about gender and the related social categorizations such as class, ability, age, nation, and race when designing data collection and analysis tools can help shine a light on historical and emerging pockets of invisibility. It starts with counting men, women, girls, and boys, but extends to issues of differential power, access, and opportunity. The results can help to design practical strategies to improve services and systems to leave no one behind.
Take for example IDRC-supported research in the Thai Nguyen province of Vietnam. The Institute of Population, Health and Development improved the visibility of ethnic minority women and their health needs through an initial ethnographic study, targeted information provision using mobile phones, and a dedicated focus on gender relations. In a culture where maternal and infant health have traditionally been considered solely a woman’s issue, the project made breakthroughs in intra-familial communications.
Today the women who participated in the research are discussing health information with their husbands, many of whom have expressed interest in receiving messages specifically generated to help support their wives. Women receiving the targeted maternal health information also report higher levels of confidence when interacting with health workers. Shifts such as these can lead to a transformation in women’s knowledge, agency, confidence, and positive behaviours, as well as their demand for quality prenatal care. These women, who belong to a traditionally marginalized group, are now counted, and as a result, their needs are more likely to be counted when health authorities allocate funds and develop new policies.
This research in Vietnam is part of a cluster of IDRC-supported health systems strengthening projects that employ digital health. Other projects in the cluster produced compelling results related to gender equality. These include addressing health conditions among pregnant refugees in Lebanon; providing care to pregnant women and people living with HIV in rural Burkina Faso; empowering female health workers in Ethiopia; and creating a maternal health record for indigenous women in Peru that links to CRVS systems.
Analyses of gender and power are no longer a luxury — they must permeate the way health information and CRVS systems are designed and used. The Sustainable Development Goals will not be achieved by gender invisibility in one system or partial attention in another. Intentionality and consistency within and across data and information systems is key to sound planning, responsive policies, and effective programming. In its absence, our efforts run the risk of exacerbating existing inequities and contributing to new ones. By making the invisible visible, we can begin to address some of the deep-rooted injustices that lead to people being left behind, and give voice to those who often go unheard.
Chaitali Sinha is a senior program officer for IDRC’s Maternal and Child Health program.
This article is adapted from a blog post published on the Global Digital Health Forum website. IDRC is sponsoring this conference and organizing the panel “Towards Closing the Gender Gap in Data and Digital Health: Lessons Learned from the Field”.
