Gender disparities in refugee contexts: Case studies using health indicators

Khassoum DialloSenior StatisticianUNHCR

Global Forum on Gender Statistics, Manila 11-13 October, 2010

ESA/STAT/AC.219/20

SCOPE OF FORCED DISPLACEMENT

Forcibly displaced persons Forcibly displaced persons represent a significant share of represent a significant share of the de facto population of many the de facto population of many countriescountries

Refugees and Asylum-seekers ~ Refugees and Asylum-seekers ~ 16 million end-2009. Internally 16 million end-2009. Internally Displaced People (27 million)Displaced People (27 million)

Daddab refugee camp (300,000 Daddab refugee camp (300,000 people): 4th city of Kenya does people): 4th city of Kenya does not appear in any official not appear in any official statistics or map of Kenyastatistics or map of Kenya

In many countries, In many countries, MDGs or MDGs or other international goals other international goals cannot cannot be achieved without addressingbe achieved without addressing the needs of populations affected the needs of populations affected by conflicts and emergencies, by conflicts and emergencies, especially women and childrenespecially women and children

Share of displaced population vs total population, end 2009

12%

10%

8%

5%

0% 2% 4% 6% 8% 10% 12%

Afghanistan

Colombia

Jordan

Syria

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Demographic patterns

Increasing share of urban refugees (close to 60% in 2009

Between 70-90% of refugees remain in their region of origin

Age & sex distribution

0-4yrs 5-11yrs 12-17yrs 18-59yrs 60yrs+ 0-4yrs 5-11yrs 12-17yrs 18-59yrs 60yrs+

R+AS 5% 9% 7% 24% 2% 5% 10% 8% 27% 2%

IDPs 5% 9% 7% 26% 3% 5% 10% 7% 26% 3%

RET 9% 12% 7% 19% 2% 9% 13% 8% 19% 2%

RDP 11% 13% 6% 25% 1% 10% 10% 6% 17% 1%

Female Male

Category

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Data Sources & methods UNHCR’s Health Information System The Standards and Indicators Programme (over

100 countries, by location) Participatory assessments (over 120 countries, at

least once every year) Routine registration and monitoring system from

Governments & other partners Mix of sources (surveys, censuses, estimation

methods etc.) Data quality assessment and triangulation

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Health Information System

Core health topics: Mortality, morbidity, RH, Nutrition, Access to services 5

Relationships

Conflict Displacement Health

Gender related issues: Women, men, boys and girls impacted differently

• Gender based violence (e.g. rape, domestic violence)

• Reproductive/including maternal health

• Access to health services

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Analyses/ Presentation Methods

Gap and Trends analyses Scorecards Indices: Composite indices,

including the gender parity index

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Illustration using selected indicators

Access to services Women’s empowerment Gender based violence HIV Testing and Counseling

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Access and use of health facilities

% of deliveries at health centers, 2009

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Bangladesh

Burundi

Cameroon

Chad

Djibouti

Ethiopia

Kenya

Nepal

Rw anda

Sudan

Tanzania

Thailand

Uganda

Yemen

Zambia

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Women’s participation in decision making

Percentage of camps which meet the standard of minimum 50% female members in food distribution committees

Camp Indicator

Standard almost met45-50% involved in

distribution are w omen

Standard MetMore than 50% involved in

distribution are w omen

Standard not metLess than 45% involved in

distribution are w omen

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VCT: Tested for HIVVCT: Tested for HIV refugees > 18 years

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

% b

y se

x

female

male

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Measuring performance in health

CRITERIA % of Camps

STANDARD ALMOST MET NOT MET

INDICATOR - CAMP No. of camps

% Standard Met

% Standa

rd almost

met

% Standar

d not met

Yes No Does your office have a Standard Operating Procedure (SOP) for SGBV? 89 92% 8%

100% 90-99% <90% Percentage of SGBV cases who received support (DP) 75 88% 3% 9%

100% 90-99% <90% Percentage of SGBV cases <18 years old who received support (DP) 64 97% 2% 2%

Min 10% 7-10% <7% Percentage of asylum-seekers / refugees who participated in SGBV training 90 23% 6% 71%

Min 10% 7-10% <7% Percentage of UNHCR and partner staff who have completed SGBV training 81 77% 1% 22%

100% 90-99% <90% Percentage of food beneficiaries entitled to food who received food during latest food distribution 82 71% 23% 6%

Min 2,100 2,001-2,001 <2,000 Average number of kilocalories available per person per day 84 48% 6% 46%

Min 50% 45-49% <45% Percentage of female members in food distribution committees 76 68% 4% 28% Max 10,000 10,001-12,000 >12000 No. of persons per primary health care facility 138 52% 7% 41%

Min 50% 40-49% <40% Percentage of live births attended by skilled personnel (excl. TBAs) 128 62% 2% 36%

Max 15% 15-20% >20% Percentage of newborn children with low birth weight (< 2500 gs) (weighed within 72 hrs) 122 97% 1% 2%

Min 90% 80-89% <80% Measles vaccination coverage 95 64% 17% 19% No Yes Have stocks of condoms run out for more than a week? 90 69% 31%

Min 20 L. 18-19 L <18 L Average quantity of water available per person per day (litres) 103 57% 9% 34% Max 80 81-100 >100 No. of persons per usable water tap 82 52% 12% 35%

Max 200 201-250 >250 No. of persons per usable well/hand pump 59 51% 7% 42%

100% 90-99% <90% Percentage of pop. living within 200 m from water point 98 55% 11% 34%

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Gender Parity Index (GPI)

Gender parity index (GPI) 2009 (Ordered)

Indicator

Female Denominat

orFemale

NumeratorFemale

Indicator

Male Denominat

orMale

NumeratorMale

Indicator

GPI(Gender

Parity Index F/M)

Percentage of UNHCR and partner staff w ho have completed SGBV training (RET) 678 400 59.0% 1,160 435 37.5% 1.57Percentage of UNHCR and partner staff w ho have completed SGBV training (CMP) 2,981 799 26.8% 6,577 1,528 23.2% 1.15

Percentage of SGBV cases w ho received support (URB) 2,190 1,733 79.1% 147 110 74.8% 1.06

Percentage of SGBV cases w ho received support (RET) 682 542 79.5% 69 68 98.6% 0.81

GPI Definition Ratio of female to male values of a given indicator. A GPI of 1 indicates parity between sexes.

The gender parity index (GPI): ratio between the female and the male rates (F/M), where: GPI below 1 means disparity in favor of boys/men GPI = 1 means parity (the male and female indicators are equal) GPI above 1 means disparity in favor of girls or

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In conclusion: Lessons learnt from gender analyses

Gender disparities remain high for many health-related indicators in a number of refugee contexts

Difficult to analyze most of maternal health indicators from a gender perspective

Data collection and quality remain a challenge

Post analysis phase: translation of findings

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