Gender Analysis for Vaccine Response: Toolkit for Risk Communication and Community Engagement Actors

"As public health agencies around the world work to ensure that everyone has access to vaccines, risk communication and community engagement (RCCE) actors must recognize and address the different ways in which gender can impact vaccine acceptance and uptake."

This toolkit from Breakthrough ACTION offers stakeholders working on vaccine response a guide to conduct a gender analysis. It leads professionals through a process to identify gender-related barriers to vaccine services and uptake, including: access to information, technology, and formal education; local healthcare provider attitudes; individual biases and preferences; ability to make decisions and control resources; and inequitable policies, laws, and regulations. The toolkit draws on existing gender analysis and risk communication and community engagement (RCCE) resources and offers a case study example and template matrices to collect, organise, and analyse information, with the goal of highlighting opportunities that can be leveraged to enable a gender-equitable vaccine response that increases coverage for all.

While Breakthrough ACTION developed this toolkit based on improving uptake of COVID-19 vaccines, it is applicable for any vaccine response. Routine immunisation programmes can also use the steps and associated activities to identify and respond to gender-related barriers to increase demand and uptake of immunisation services.

Gender analysis, informed by both primary and secondary data, explores and highlights the relationships of women and girls, men and boys, and people of other gender identities - and the inequalities in those relationships - by examining 5 key domains and questions:

1. Patterns of decision making: Who decides? Informs who has, who can acquire, and who can expend authority to make decisions.
2. Access to and control over resources/assets: Who has access to and control over what? Explores gender differentials regarding access to and control over tangible and intangible (e.g., knowledge, education, and information) resources necessary for a person to be productive.
3. Practices and participation: Who does what? Captures information on the gendered division of labour and everyday practices, including men's and women's different roles, their responsibilities and the time needed to complete them, and how these factors affect people's participation in health, economic, political, and social activities.
4. Beliefs and perceptions: How are values defined? Provides a better understanding of cultural beliefs or norms, such as what being a man or woman means in a specific society. These beliefs affect men's and women's behaviours, participation, and decision-making capacity. They also either facilitate or limit men's and women's access to services.
5. Laws, policies, and institutional practices: What is the contextual/structural environment? Focuses on information about men's and women's different formal and informal rights and how men and women are differently affected by policies and rules governing institutions, including RCCE responses.

The toolkit includes:

• Evidence on the importance of considering gender in a vaccine response
• Step-by-step guidance and tips for conducting a gender analysis
• Worksheets to collect, organise, and analyse information and make recommendations across 3 RCCE pillars: RCCE systems for emergencies, risk communication, and community engagement
• An illustrative gender analysis based on a country's COVID-19 vaccine response
• Additional resources for integrating gender in RCCE activities

After information on the toolkit itself and an explanation of why it is necessary to consider gender in a vaccine response, the resource examines 10 steps in conducting gender analysis for vaccine response:

• Step 1: Prepare for Conducting the Gender Analysis
• Step 2: Select Questions for Your Gender Analysis
• Step 3: Identify Existing Sources of Information
• Step 4: Collect and Organize Data in the Gender Analysis Matrix
• Step 5: Complete the Data Synthesis Matrix
• Step 6: Make Recommendations
• Step 7: Organise a Gender Analysis Validation and Action Planning Workshop
• Step 8: Document Your Gender Analysis and Action Plans
• Step 9: Disseminating Findings and Recommendations
• Step 10: Monitor and Evaluate Progress

Annexes include Definitions of Gender Terms and Related Concepts (Annex 1) and Illustrative Gender Analysis Questions for Each RCCE Pillar (Annex 2).