Executive Summary

The United Nations Population Fund (UNFPA) Bangladesh has designed its country programmes in conjunction with the government in order to complement and supplement the GOB health programmes. The programmes mainly focused on the major areas of reproductive health, population and development strategies and advocacy, where gender has been seen as a crosscutting issue. Several ministries including MOHFW have been involved in implementing programmes. UNFPA decided to design and incorporate gender equality and women empowerment issues in all aspects of Reproductive Health and Population Development. In order to realise the comments made in ICPD POA. UNFPA therefore decided to undertake a systematic thematic review of gender issue not only for UNFPA’s programme but also other programmes that addressing gender issues. The review tried to assess the overall gender and women empowerment situation in Bangladesh and identify effective strategies and interventions for minimizing the gaps. Special recommendations have been made for UNFPA and other partners so that the forthcoming UNFPA’s country programmes would be not only gender sensitive but also gender responsive.

A team was formed by UNFPA with a national consultant and UNFPA staff and an international consultant to conduct the review. The review team reviewed the current programmes and literature so far available and had wider consultations with GOB gender focal points, individual and group consultations with stakeholders, individual in-depth interviews with selected key GOB and DPs and field visits to some project sites that directly address gender issues.

The review identified that Gender inequality is recognised in Bangladesh as one of the root causes of women’s and girls poor health status directly affecting the overall development of the nation. Over the past decade, collective efforts have been made by Government, development partners and NGOs to address the issues of gender inequalities resulting in some positive changes especially in improved gender parity in enrolment in primary education, women’s increased employment, change in their health-seeking behaviour and participation in different economic activities.

However, in-depth analysis indicates that currently, drop out rates of girl students are much higher than boys and a large number of girls are not enrolling at secondary levels. Though women’s participation in the labour force has increased, their participation at management levels continues to remain low. Women continue to face gender specific inequity at their workplace both due to absence of gender sensitive policies and discriminatory behaviour by men. Women also receive lower wages than men for the same work. Although access to health services has increased to some degree, indicators related to MMR, IMR, maternal morbidity, malnutrition and violence against women remain high. Due to unequal gender relations adolescents girls and women enjoy negligible fulfilment of their reproductive rights with little power to negotiate their specific rights within marriage, family planning and access to treatment. Most of these issues are related to the patriarchal social structures and systems that prescribe lower status for women and girls than men and boys. All these clearly indicate that consistent long-term efforts are required to establish gender equality and sustainable development of Bangladesh.

The Constitution of Bangladesh guarantees equal rights to men and women in all spheres of life. In addition Bangladesh’s commitment to ICPD, CEDAW and other human rights instruments provide a strong ground for gender equality and empowerment of women. Despite these legal guarantee and international commitments and little positive changes in women’s status has taken place. The review concluded that there are positive changes taking place with legal framework and environment and with collective effort from Government, NGOs and DPs, however, still a long way to go for achieving gender equality.

The review identified the key challenges are as follows:

• Low status of girls and women and inadequate reforms of discriminatory laws.
• Less value for girls and women's rights within homes and a lack of security in communities and in the public domain including VAW.
• Largely Biological and Medical Approach to Health and gender accountability is not a core part of the health personnel orientation, practice or behaviour.
• Lack of responsiveness of capacity building interventions to stereotypical socio-cultural factors.

Specific challenges as identifies for UNFPA are as follows:

• Promoting more powerful advocacy strategies for revision of discriminatory Laws impacting girls and women’s strategic needs and unequal status:
• Introducing a shift from project mode to strategic programming by making adolescents a priority focus and a core part of the Country Programme.
• Responding largely to biological and medical approach of GOB – more holistic gender and social development approach required.
• Supporting a comprehensive gender mainstreaming process to build capacity of UNFPA staff and GOB/NGOs functionaries.
• Changing gender stereotypical norms, practices and values within the health sector services.

The review report made detailed recommendations to address the challenges under three priority areas. The recommendations in brief are as follows.

Priority I: HOLISTIC RESPONSIVENESS TO YOUNG PEOPLE:
Securing the reproductive and sexual health and rights of adolescent girls and boys.

The long-term need: Girls and boys to be fully informed, protected, have easy access to information and services and would be able to decide on their well beings.

The immediate need: Social protection for girls from gender based violence, abuse and early marriage and access for girls and boys to safe, gender specific friendly services, counselling and information.

Priority II: REDUCING MATERNAL DEATHS:
Reducing maternal deaths; improved access to gender responsive services and rights

The long-term need is for social transformation, which redefines the status of women and girls and provides more equitable access to rights and services to women and other disadvantaged communities.

The immediate need is the transformation of systems and structures and attitude of service providers to make them more gender responsive and create the enabling environment for bringing in comprehensive and holistic health service delivery at community level.

Priority III: TRANSFORMING HEALTH SERVICES:
Building capacity of service providers for improved gender and social responsiveness

Long term need: The systems and structures of the health and family planning services are more holistic and gender responsive and less biological and medical in approach.

Immediate Need: Government training within health services at all levels invests in service providers to transform the working culture make both male and female staff more gender responsive for providing comprehensive and holistic service delivery.

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