Gender counts: A systematic review of evaluations of gender-integrated health interventions in low- and middle-income countries

ABSTRACT

As a result of new global priorities, there is a growing need for high-quality evaluations of gender-integrated health programmes. This systematic review examined 99 peer-reviewed articles on evaluations of gender-integrated (accommodating and transformative) health programmes with regard to their theory of change (ToC), study design, gender integration in data collection, analysis, and gender measures used. Half of the evaluations explicitly described a ToC or conceptual framework (n = 50) that guided strategies for their interventions. Over half (61%) of the evaluations used quantitative methods exclusively; 11% used qualitative methods exclusively; and 28% used mixed methods. Qualitative methods were not commonly detailed. Evaluations of transformative interventions were less likely than those of accommodating interventions to employ randomised control trials. Two-thirds of the reviewed evaluations reported including at least one specific gender-related outcome (n = 18 accommodating, n = 44 transformative). To strengthen evaluations of gender-integrated programmes, we recommend use of ToCs, explicitly including gender in the ToC, use of gender-sensitive measures, mixed-method designs, in-depth descriptions of qualitative methods, and attention to gender-related factors in data collection logistics. We also recommend further research to develop valid and reliable gender measures that are globally relevant.

KEYWORDS:

• Gender
• evaluation
• systematic review
• gender-integrated health programmes

Acknowledgements

We thank our colleagues, Elisabeth Rottach and Sara Pappa, at the Health Policy Project (HPP) and Sangeeta Singh of PHFI for their roles on the evidence review committee during an earlier phase of the study. We acknowledge the following people for assisting with data abstraction during an earlier phase of the study: Kaveri Mayra of PHFI; Ashley Marshall, Bridgit Adamou, Emily Mangone, Amy Handler, and Zahra Reynolds of MEASURE Evaluation; Lakshmi Gopalkrishnan and Micaela Arthur, formerly with MEASURE Evaluation; Bethany O'Connor, Madison Mellish, Rachel Kiesel, Mariela Rodriguez, and Taryn Couture of HPP; and Roshi Rai and Sancheeta Ghosh of ICRW. We also thank Elizabeth T. Robinson of MEASURE Evaluation at the University of North Carolina for her feedback on and editing of the manuscript. The views expressed in this publication do not necessarily reflect the views of USAID, or the United States government.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the US Agency for International Development (USAID) under the terms of MEASURE Evaluation cooperative agreement GHA-A-00-08-00003-00, which is implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill, with Futures Group, ICF International, John Snow, Inc., Management Sciences for Health, and Tulane University.