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Background and Resources for Module 1 Session Objectives:
Specific Objectives:
Key Concepts:
Activities:
Time: 4 hours, 30 minutes Activity 1: Who Are We? Objectives:
Procedures:
Time: 30 minutes Materials: - Pink, blue, yellow and green cards Discussion: We choose colors and other identity symbols to correspond with (and sometimes to reject) predominant models of femininity and masculinity. Let us reflect together about the ways in which we develop personal preferences and images and how we are educated with stereotypical gender expectations. Traditionally, pink is associated with girls, who are educated to be dedicated mothers and obedient wives in the private domain. The color blue is associated with boys, who are trained to be strong, manage power and lead in the public domain. If a man identifies with the color pink, is he necessarily feminine, or are there other options for identities? Activity 2: Introduction to the Training Objective: Communicate the objectives, content and methodology of the workshop. Procedures:
Time: 15 minutes Materials: - Planning matrix Discussion: Reflect on and reinforce the idea that the success of the workshop depends on the active participation of all and on the sharing and appreciation of each participant's knowledge and experience in the joint construction of concepts and approaches. Activity 3: How Do We Become Men and Women? Objectives:
Procedures:
Activity guide: Distribute a copy of the matrix "How do we become men and women?" to each group, who must fill in the matrix on the basis of their own experiences and observations. On one side they will list physical characteristics of females and males at each age level, and on the other side they will describe what families, schools, media and others tell us, ask us and teach us at each stage of life to encourage us to act like men or women. Participants should reflect on their own experiences and remember. For example, did anyone ever tell them "big boys don't cry!" or "nice girls don't get dirty," or were house keys and late curfews given to adolescent boys while girls were carefully watched? They should compare the expectations placed on a 30-year old woman (which might include that she should be married and raising children) versus a man of the same age (which might include that he should be earning money or establishing a career). When groups meet and present their work, the question guide included with this session can help to orient the reflection and synthesis process. Time: 30 minutes Materials: - Activity matrix: "How do we become men and women?" Discussion: Small group activities permit each person to share and apply his or her experience in order to better understand the relationship between biological and social characteristics in his or her own life. The final discussion among the group as a whole allows for comparison and contrast of men's and women's experiences, as well as those of people from different generations and varying social, racial and ethnic backgrounds. Expected results for participants:
Activity 4: Constructing the Concept Gender Objectives:
Procedures:
Activity guide: Before initiating this session, facilitators should study the section on gender in the conceptual framework and prepare to refer to it during group discussions. Emphasis should be on relating the theoretical and analytical concept of gender to the lived experiences of becoming men and women that were articulated by participants in the preceding activity. Time: 30 minutes Materials: Concept card: Gender Discussion: Gender is a social, cultural and historical system that organizes and gives meaning to many aspects of life in reference to sexual differences. A gender perspective is a conceptual tool that allows us to identify the characteristics, experiences and needs of men and women and to analyze the relationships between them, including the balance of opportunities, power and decision-making abilities. Expected results for participants:
Activity 5: Relations between Gender and Reproductive Health Objectives:
Procedures:
Activity guide: Before leading the session, facilitators should read the section of the conceptual framework that addresses sexual and reproductive health, and refer to it in presentations and group discussions. Time: 1 hour, 30 minutes Materials: Concept card: Sexual and reproductive health Background and Resources for Module 1 Concept Card: Gender Gender is a social, cultural and historic system that assigns certain characteristics and roles to groups of individuals with reference to their sex and sexuality. A gender perspective is a theoretical and methodological approach that permits us to recognize and analyze different identities, perspectives and power balances in the dynamics of interpersonal relations, and supports a critical analysis of sociocultural institutions and socioeconomic, political and legal structures. Teresita de Barbieri (1991) notes that human bodies are biologically sexed, and that we attribute social and cultural meaning to these sexes. Thus, men and women are historical, not natural, beings; we are born in societies where we internalize gender roles, norms and meanings. For Barbieri, sex/gender systems are constellations of practices, symbols, representations, norms and social values that societies elaborate with reference to anatomic and physiological sex differences. Institutions such as schools, governments, churches and families, manage and transmit gender practices. In fact, whole life philosophies are marked by gender. Traditional ideology or new analytical perspective? Marcela Lagarde identifies two basic conceptions of gender in Latin American societies. One is a traditional gender ideology that sustains that all feminine and masculine characteristics are natural, that gender norms and roles are created by divine forces (or by biological evolution) and are, therefore, immutable. This ideology is reinforced by institutions that supervise and sanction behavior, guiding the ways in which people become socially acceptable men and women. In contrast to this gender concept, Lagarde describes another approach to gender that challenges traditional ways of life as a tool for critical analysis. This approach to gender assesses the dominant gender order with the aim of questioning and deconstructing predominant social, psychological and cultural characteristics and relationships. It reveals that attributes of greater and lesser power are not natural, nor genetic; they are socially assigned and, therefore, can be transformed into more balanced relations (Lagarde 1995). Gender relations Gender is a necessary element of all social relations -- domestic, labor, political or economic. Gender organization attributes different values and powers according to sexual identity, which influence interactions and relationships among all persons. Gender identities are not synonymous with sexual dimorphism. Factors such as life cycle, socioeconomic and ethnic identity crosscut gender systems, which include multiple sexual and gender identities. Gender and health Gender organization and meanings manifest themselves in science, religion, education, politics, economics and the environment and influence sexual and reproductive health, as well as the ways in which we perceive it. This organization legitimizes values, beliefs and practices in relation to the sexual and reproductive lives of individuals in ways that can strengthen or hamper the health of certain groups. Applying a gender approach to sexual and reproductive health allows us to go beyond a biological focus on women's bodies. It allows us to better understand the socially constructed identities of men and women, and thereby approach the social relationships, which influence the sexual and reproductive health of each person. Health services and providers can better respond to user needs if they recognize that women and men live and perceive sexuality and reproduction in different ways and that the visions with which we approach our work as health professionals are also conditioned by gender factors embedded in our cultures and related to our own sexual identities. In Bolivia, for example, gender symbols associated with masculinity and femininity influence the choice, use and discontinuation of contraceptive methods and practices on the part of each man and women. Gender relations influence negotiation, decision-making and contraceptive use. Gender roles also play an important part in the relationships between providers and users and affect health outcomes for men and women. Finally, analysis of power and knowledge relationships within health programs and institutions allows us to identify and transform unequal and stereotypical relations that interfere with quality care. A gender perspective helps us to recognize and respect differences within populations of providers and users and helps us analyze the dynamics of power, knowledge and decision-making within couples and families, between providers and users, and between governments and health institutions and the populations they serve. Health services that consider and respond to these realities, and that broaden their focus to encompass multiple dimensions of sexual and reproductive health of all gender groups, achieve greater success in the goal of improving the sexual and reproductive health of the entire population. Concept Card: Sexual and Reproductive Health The concept of sexual and reproductive health expresses a change from a biomedical focus on health and illness toward a more comprehensive approach to well-being that incorporates the social sciences and the ethical bases of human rights. In this concept, biological, psychosocial, cultural and legal aspects of sexual and reproductive health are intimately interrelated, and sexual and reproductive health is understood as a life process which influences and is influenced by a variety of other factors (WHO 1997). Traditionally, health policies and programs have centered on biomedical aspects of reproductive health and, especially, on fertility control. In recent decades, however, we have begun to understand that personal and cultural experiences of sexuality are intimately linked with the health of the reproductive system. The two dimensions develop interdependently during each person's life cycle and affect each other in multiple ways. For example, the physical and psychosocial stress of closely spaced births can limit a woman's sexual expression and have negative affects on her sexual health (Bassu 1997). Similarly, a sexually transmitted disease can lead to problems in the reproductive system, including infertility. The Cairo definition The International Conference on Population and Development held in Cairo in 1994 established a new vision of reproductive health that explicitly incorporates sexual health:
Sexual and reproductive health services According to this vision, sexual and reproductive health services can include, but are not limited to: voluntary fertility regulation; prenatal, birth and postpartum care; tetanus vaccines; support for breastfeeding; infertility treatment; prevention, screening and treatment of STDs, including HIV-AIDS; gynecological examinations; prevention and treatment of breast and cervical cancer; treatment of complications from abortion; nutrition programs; production and dissemination of educational and informative materials; education and counseling about sexuality; protection against violence; training of extension workers; personal and couple counseling; and diverse activities that empower users to take greater control and responsibilities for their own health (Dixon-Mueller 1993; Hardee and Yount 1995). Gender and sexual and reproductive health The gender roles played out by men and women in our societies have significant influence on their health. In many parts of Latin America, values associated with machismo emphasize men's sexual prowess, measured by the daringness of their sexual conquests and the number of sexual relations (Barker and Loewenstein 1996). This type of symbolic system motivates men to take risks with their own health and sets the stage for unwanted pregnancies, abortions, and the spread of STDs (Zeidenstein and Moore 1996). In Bolivia, women seek and obtain health services with greater frequency than men due to their reproductive biology, as well as gender norms that discourage men from seeking health care and assign women social responsibility for the health of others, including children, parents, sick friends and relatives. There is a growing consensus that a more balanced participation, including both men and women, would contribute to improved health for all. One of the Cairo recommendations highlights the importance of involving men more fully in sexual and reproductive health issues. "Innovative programmes must be developed to make information, counseling and services for reproductive health accessible to adolescents and adult men. Such programmes must both educate and enable men to share more equally in family planning and in domestic and child-rearing responsibilities and to accept the major responsibility for the prevention of sexually transmitted diseases." (ICPD, Programme of Action, Paragraph 7.8, 1994) Thus, working from a gender perspective means putting more emphasis on men as well as on women. To date, there is still a predominant emphasis on care and treatment for women and on advocacy for women's health rights and services. Many of those who design health policies and provide health care have not yet accepted the idea that sexual and reproductive health takes two; that men as well as women have sexual and reproductive health needs, expectations and rights. Activity Matrix: How Do We Become Men and Women? How Do We Become Men?
How Do We Become Women?
Question Guide for Group Discussion
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