2. Case study: PROCOSI

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Headshot of Joanna Breems, Clinical Assistant Professor
Joanna Breems
Clinical Assistant Professor
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In Bolivia,
women suffer from higher rates of poverty, illiteracy, unemployment, and gender-based violence, and lower rates of political participation than men.

Healthcare clinics often overlook the inequities between women’s and men’s lives, including power, decision-making capacity, and access to resources, as well as varying communication patterns. These inequities limit women’s ability to access and use reproductive health services.
PROCOSI is a network
of 24 Bolivian non-governmental organizations that coordinates and implements health programs.

In 2001–2003, 17 of the PROCOSI member organizations implemented a program to incorporate a gender perspective into existing reproductive health programs and to assess the costs and effects of doing so.
The intervention began

with a gender analysis, which you will learn more about in the last session of this course.

PROCOSI used a framework adapted from an International Planned Parenthood (IPPF) tool, to evaluate quality of care from a gender perspective in:

    • Institutional policies and practices
    • Practices of providers
    • Client satisfaction
    • Client comfort
    • Use of gendered language
    • Information, communication and training
    • Monitoring and evaluation
Once the organizations
conducted the baseline evaluations and analyzed the results, each team set priorities to decide which areas the organization should improve on and developed an action plan for each indicator.
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Each organization designed and implemented its own activities to address gender in quality of care. Each team's action plans were different, but some examples of activities included:

    • hiring doctors of both genders for each specialty so clients could select the provider they felt most comfortable with;
    • developing algorithms to review clients' needs and offer appropriate services;
    • and even moving visiting rooms and offices to improve client flow.

 

Support was provided in the form of a packet of print materials and videos related to gender and reproductive health for distribution to clients and providers.

PROCOSI‘s Project Coordinator visited the participating units twice to follow up on their progress, answer questions on the methodology, suggest activities to improve indicators, collect data, and gather information on costs.

This intervention was evaluated using a mixed-method, pretest-posttest design. The evaluation showed that the intervention resulted in significant improvements in reproductive health outcomes, including reductions in unmet need for family planning and more positive interactions between women and health providers. It also improved gender equality outcomes, such as improved attitudes among women and men toward shared decision-making, couples’ communication, and gender-based violence.

Married, Non-pregnant Women with Unmet Family Planning Needs. Source - Rottach et al., 2009; Palenque et al., 2007.Affirmative Answers on Variables Related to Gender Roles. Source - Rottach et al., 2009; Palenque et al., 2007.

Return to Gender terms and concepts

Continue to Knowledge recap: Gender terms and concepts

A note

These materials were adapted from the Global Health eLearning Center, U.S. Agency for International Development.

Image credits

Unless otherwise noted, images are from Adobe Stock.

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