Catalogue of Practices

Reproductive Health Services Transformation Project (TRHSP) -  An Example of Mainstreaming Gender in Health System Development

Women's Health Project (NGO) and the Provincial Health Department, (South Africa)

Objective
To transform, strengthen and integrate where appropriate, reproductive health care system for improving reproductive health services.

To incorporate and mainstream gender in the intervention of the transformation project.

Context
The South African efforts towards strengthening health programmes and services gender sensitive and responsive, involves essentially a transformation of the country's reproductive health services within a setting where profound political changes are taking place. The transformation process also involve building the capacity of the health workers to be able to operationalise the system.

The TRHSP concept was presented to the national director for health and to provincial health department after which the project was agreed upon by the women's project and the health department of the three provinces

Scope
The project was introduced at the time when the first democratic elections were held in 1996 and the framework for this transformation was established by the new Constitution. The most significant example in the Constitution is the passing of the choice in the Termination of Pregnancy.

Main Activities
The activities include a one day workshop for senior managers and senior political persons, a set of six change management workshops for health workers (service providers), gender and health sensitization seminars for primary health care staff, and women to women peer education training in reproductive health concerns.


Evaluation Findings.
The project was to a large extent successful and indication of this is the provincial plans following findings from this project have been incorporated into their work plan.
Management Features
  • Strategy:
    • To collect a body of information for health system development towards achieving reproductive health
    • To collect information through a process which facilitates an openness to change among health service personnel
    Capacity Building
    That senior managers and provincial leaders were given gender and health orientation means efforts are being made to mainstream gender in health systems development and getting everyone in the government machinery involved.

    The Women's Health Project trained facilitators employed in the primary health care structure. They in turn ran workshops with primary health care staff. Knowledge about gender in all these training activities has stimulated health workers to make health services more gender sensitive and caring.

    Managerial Leadership
    Because gender consciousness was integrated within overall project (mainstream) and was related to health and health services, it took on a form which people could relate to TRHSP worked on the concept.

    Shared commitment among key players / stakeholders to some extent consolidated provincial support from TRHSP at the senior level. The response to the one day orientation with senior managers gave the project team confidence that the initiate was pitched correctly.