64542 GettinG to equal Promoting Gender Equality through Human Development This publication is a product of the World Bank’s Human Development Network, which generates evidence and policies to deepen the impact of the Bank’s work in education, health, social protection, labor and other human development priorities. ©2011 The International Bank for Reconstruction and Development/The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org E-mail: feedback@worldbank.org All rights reserved. This volume is a product of the staff of the World Bank Group. The findings, interpretations, and conclusions expressed in this volume do not necessarily reflect the views of the Executive Directors of the World Bank Group or the governments they represent. The World Bank Group does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of the World Bank Group concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Cover images: Steve Harris, World Bank; Julio Pantoja, World Bank; Curt Carnemark, World Bank; B Legeller, UN; Jennifer Sturdy. Human Development: The Cornerstone of Gender Equality T o achieve gender equality and empower women, it is essential to invest in human development. The World Development Report 2012: Gender Equality and Development (hereafter WDR 2012) brings the best global evidence to bear on the relationship between gender equality and development. A central theme running through the report is how investments and outcomes in human development—namely health, education, social protection, and labor—shape, and are shaped by, gender equality. This note is designed as a companion to the WDR 2012 and highlights some of the World Bank Group’s recent experience with and impact on promoting gender equality through its work in human development. As discussed in the WDR 2012, gender equality is impacted by the household decisions that women and men make in their daily lives. Notably, these decisions include how many children to have and when, when and how much to invest in the education and health care of their daughters and sons, and how to allocate different responsibilities and tasks inside and outside the household. These choices are influenced by prevailing gender roles, social norms, and social networks. The relative voice and bargaining power of individuals vis-á-vis other family members play a key role in these choices, shaped in no small part by these individuals’ relative health, education, skills, and control over household resources and decision making (box 1). Indeed, higher income alone does not guarantee control over resources and access to services. The status of women and men is shaped by the rules and norms imposed by a range of institutions, including governments; civil society; faith-based organizations; the private sector; and markets for labor, credit, land, and goods (figure 1). Services that promote human development—including programs for lifesaving maternal and child health care, early childhood nutrition and stimulation, formal and informal education, job training and access to labor markets, and social insurance and safety nets—are necessary to improve the lives of disadvantaged groups and can close gender gaps in health, education, and economic opportunities. Yet too often these services may not be equally accessible or affordable to men and women; their impact can be muted by gender norms, discrimination, and market failures. Better understanding of and attention to these gender norms and market failures can strengthen the design and impact of policies and investments in service delivery, thereby providing equal opportunity for all. Gender equality benefits society as a whole. Greater gender equality today shapes the norms and cultures—as well as the constraints and possibilities—of tomorrow’s men and women. A wealth of evidence demonstrates that gender equality begins a virtuous circle of higher productivity, lower poverty, and bet- ter development outcomes for generations to come. 2 G e t t i n G to e q ua l F I G U R Gender outcomes result from interactions between households, markets, and institutions Figure 1 E 1 Gender outcomes result from interactions between households, markets, and institutions R EQUALIT NDE Y po GE lic ies NS ITUTIO MAL INST INFOR ECONOMIC OPPORTUNITIES TS HOUSEHOLDS RKE MA AGENCY ENDOWMENTS FOR MAL INST ITUT I ON S GR OW TH Source: WDR 2012. Source: WDR 2012 team. For all these reasons, gender equality is a key objective countries to achieve the Millennium Development of the World Bank Group (hereafter the Bank), par- Goals (MDGs), enhance productivity and growth, and ticularly in the areas of education, health, social pro- promote the well-being of all their people. tection and labor. The seminal 2001 publication Engen- dering Development through Gender Equality in Rights, Education Resources, and Voice—at the time, the authoritative re- view of the impact of policies, institutions, and markets The Bank’s Education Sector Strategy 2020, Learning on gender equality—provided a framework for much for All, explicitly addresses gender equality. If learning of the Bank’s work in human development and gender and skills are acquired, education helps people become over the past decade. Today, the Bank’s investments in healthier, secure better jobs, earn more, and have greater both knowledge and operations are helping eliminate voice in their affairs. These benefits transmit across gen- persistent gender barriers to accessing quality social ser- erations and communities at large, as more educated vices, entering the job market, and building resilience to people have fewer children and provide their children shocks and volatility. This work includes expanding ac- with better health care and education. Historically, the cess to family planning and reproductive health servic- education gap has favored males—the reason why Edu- es, promoting gender parity in education, providing cation for All mandated a focus on girls’ education over social safety nets and insurance, and helping people ac- 20 years ago. Given increases in enrollments across the quire the resources and skills to secure decent jobs and globe, there has been steady and sustained global prog- provide for their families. In closing gender gaps in hu- ress in closing the gender gap in education at all levels: man development, the Bank is assisting developing primary, secondary, and tertiary. In fact, there is evi- Promoting Gender equality through Human Development 3 dence that education gaps are reversing in some coun- tries, especially in higher education. Two-thirds of the Box 1Gender equality leads to better human Bank’s partner countries have reached gender parity in development outcomes for future generations primary education, and girls significantly outnumber Greater control over household resources by women leads to boys in secondary education in over one-third of those more investment in children’s human capital, with dynamic posi- countries (figure 2). These successes result from a com- tive effects on economic growth. Evidence from a range of coun- bination of effective policies and sustained national in- tries (such as Bangladesh, Brazil, Côte d’Ivoire, Mexico, South vestments in education that have expanded the avail- Africa, and the United Kingdom) shows that increasing the share ability of schools even in rural areas and lowered the of household income controlled by women, either through their direct and opportunity costs of schooling, especially for own earnings or cash transfers, changes spending in ways that poorer families. benefit children. In Ghana the share of assets and the share of land owned by women are positively associated with higher food The persistence of gender gaps in education, among expenditures. Improvements in women’s own education and girls or boys, depends increasingly on whether or health also have positive impacts on these and other outcomes not schooling actually produces knowledge and for their children. Better nutritional status of mothers has also skills. Evidence shows that it is what students learn— been associated with better child health and survival. And wom- not the number of years that they spend in school— en’s education has been positively linked to a range of health that leads to growth, development, and poverty reduc- benefits for children—from higher immunization rates to better tion. Moreover, when an education system fails to nutrition to lower child mortality. In Pakistan, children whose deliver learning, the failure is most severe for poor and mothers have even a single year of education spend one extra disadvantaged children and young people, both be- hour studying at home every day and report higher test scores. cause the schools available to them are likely to have fewer trained teachers and fewer learning materials Source: WDR 2012. and because their families and communities are less able to supplement what schools offer. Evidence also indicates that in poorer households, lower quantity and inform the design of policies and programs to and quality of education are often greater obstacles for promote gender equality. girls than for boys. For example, in India and Pakistan, enrollment rates among the richest boys and girls are The Bank has played a key role in advancing girls’ edu- similar, but there is a gender gap of almost five years cation for over 20 years via research, funding, policy among the poorest quintile of the population. advocacy, and partnerships. As one of the founding agencies of the Education for All (EFA) movement, the The Bank’s Learning for All Strategy thus focuses on Bank, along with UN partner agencies, has worked to helping countries improve the capacity of their edu- improve the quality of education and learning for all, cation system to raise not only school attendance, including for women and girls. It also has been a key but also learning outcomes. Efforts to promote gen- contributor to knowledge generation and dissemina- der equality are likely to promote better learning out- tion regarding girls’ education. Finally, the Bank has comes and vice-versa. But in addition to system-wide played a pivotal role in helping shape the policy debate education reforms, targeted programs may be needed in this field. For example, the 2007 global symposium to address the specific constraints of certain demo- and accompanying book, Girls’ Education in the 21st graphic or economic groups. For example, scholar- Century: Gender Equality, Empowerment, and Economic ships and nonformal learning programs may be need- Growth (2008), helped re-energize the global debate on ed to assist out-of-school children, whether they are gender equality in education and accelerate the collec- boys or girls. Likewise, the recruitment and training of tive global response to the persistent challenges of wom- female teachers may be needed in places where a dearth en’s equality and empowerment. A growing number of of trained female teachers deters girls’ enrollment and Bank-supported impact evaluations of education proj- attendance. The Bank aims to help countries analyze ects, such as those in Cambodia, Colombia, Malawi, and the factors that underlie gender gaps in education, as- Pakistan, are shedding new light on the gender impact sess the impact of these gaps on employment options, of scholarships and other demand-side interventions, as 4 G e t t i n G to e q ua l F I G U R E 1.1 Gender parity in enrollments at lower levels has been achieved in much of the world, and Figure 2 Trends in gender parity in school enrollment tertiary enrollments now favor women Primary education Secondary education Tertiary education 100 100 100 men Some African Enrollment gaps dwarf disadvantaged school enrollment, women, gross, % countries lag behind gender gaps school enrollment, girls, net, % school enrollment, girls, net, % 80 80 80 60 60 60 40 40 40 Women are more likely 20 20 20 to participate girls girls than men disadvantaged disadvantaged 0 0 0 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 school enrollment, boys, net % school enrollment, boys, net % school enrollment, men, gross % East Asia and Paci c Europe and Central Asia Latin America and the Caribbean Middle East and North Africa South Asia Sub-Saharan Africa High-income countries Source: WDR 2012 team estimates based on World Development Indicators. Note: The 45° line in each gure above shows gender parity in enrollments. Any point above the 45° line implies that more women are enrolled relative to men. well as on governance reforms that enhance school per- ber of young women do not know their HIV/AIDS sta- formance. In September 2010, the Bank pledged an addi- tus. And although the average total fertility rate (TFR) tional $750 million through 2015 to help countries meet in developing countries declined from about 6 children the education MDGs of universal access and gender parity. per woman in 1960 to 2.6 in 2006, 28 low-income coun- In addition, Bank partnerships such as the global EFA Fast tries—mostly in sub-Saharan Africa—still have fertility Track Initiative and the Bank-Netherlands Partnership rates in excess of 5. More than 200 million women want Program are advancing gender equality in education. to delay or stop having children, but too many cannot access or lack knowledge about contraception, often re- sulting in either unwanted or mistimed pregnancies or HEaltH, nutrition, and population unsafe abortions. Gender equality is also a key goal of Healthy Develop- ment, the Bank’s global strategy for health, nutrition, The challenges are clear: The solutions lie in improv- and population. An estimated 10 to 20 million women ing the ability of country health systems to enhance worldwide suffer from preventable reproductive health the availability and quality of health services, as well illnesses every year. Pregnancy-related complications as transform people’s health-related choices and be- are among the leading causes of death and disability for haviors. With a central focus on improving reproduc- women between 15 and 49, with adolescent girls bear- tive, maternal, and child outcomes, the Bank is address- ing 23 percent of the disease burden. Globally, there are ing the gender dimensions of health through its Healthy over 350,000 maternal deaths each year, 87 percent of Development Strategy (2007–17) and subsequent Re- which are in Sub-Saharan Africa and South Asia (figure productive Health Action Plan (RHAP) 2010–2015. The 3). As of 2009, young women comprised the vast major- RHAP has three main objectives: reducing high fertility, ity (72 percent) of the estimated 5.7 million youth improving pregnancy outcomes, and reducing sexually worldwide living with HIV/AIDS. An even greater num- transmitted infections, including HIV. The RHAP is in- Promoting Gender equality through Human Development 5 creasing Bank support for the 57 countries with the as reflected in a number of recent Country Assistance highest maternal death and fertility rates and aims to Strategies. prevent widespread death and disability among moth- ers and their children. The action plan focuses on The Bank is increasingly using results-based financ- strengthening health systems to achieve better repro- ing (RBF) to promote better health for all, with a spe- ductive health outcomes by improving access to and cial focus on girls and women. RBF is an innovative fi- knowledge of family planning among households; in- nancing strategy that can promote gender equality in creasing antenatal visits and skilled attendance at birth; health by increasing the quantity and quality of health training health workers to prevent or manage pregnan- services used or provided, based on cash or in-kind pay- cy complications and provide better-quality services; ments to providers, payers, and consumers when prede- promoting youth-friendly services; and encouraging termined health results are achieved. Examples include young women to build life skills and delay pregnancy. In supply-side incentives such as paying a bonus to health doing so, it links the strengthening of health systems to service providers for the percentage of women deliver- other development activities that address the socioeco- ing their babies in an equipped health facility, or, de- nomic and cultural barriers to access and utilization of mand-side incentives such as paying pregnant women services. The Healthy Development strategy and the to go to a health facility to deliver. RBF helps focus gov- RHAP also promote multisectoral investments to im- ernment and donor attention on outputs and out- prove reproductive health outcomes, taking advantage comes—for example, the percentage of women receiv- of the link between higher education and lower fertility, ing antenatal care—rather than inputs or processes together with the influence of lower poverty rates on (e.g., training, salaries, medicines), thus linking budgets women’s access to quality health care. Since the RHAP and financing more closely to results. In September was launched in 2010, reproductive health has become 2010, the Bank pledged $600 million through 2015 to reflected more prominently in both the Bank’s overall RBF initiatives to accelerate progress toward the MDGs lending and technical assistance and in policy dialogue, for maternal and child health in countries that have the Figure 3 Maternal mortality rate by region MATERNAL MORTALITY RATE, 2008 < 20 [Very low] 20 – 99 [Low] 100 – 299 [Moderate] 300 – 549 [High] 550 – 999 [Very high] ≥ 1000 [Extremely high] No data this map was produced by the Map Design unit of the World Bank. the boundaries, colors, denominations and any other information shown on this map do not imply, on the part of the World Bank Group, any judgment on the legal status of any territory, or any endorsement or acceptance of such boundaries. iBRD 38820 SePteMBeR 2011 6 G e t t i n G to e q ua l highest rates of fertility and maternal and child mortal- Gender-based differentials in cash payments provide ity. As of mid-2011, a total of $300 million toward this an incentive to reverse patterns of discrimination, pledge had been committed to seven countries to help such as low school enrollment and attendance rates. increase health service utilization, improve service qual- Other programs, such as public works, promote gender ity, and enhance efficiency and equity. equality by ensuring a certain percentage of female or male participation (depending on which gender is dis- In recent years the Bank has made substantial contri- advantaged). Bank-supported social protection pro- butions to global and country knowledge on gender grams also address gender disadvantages by promoting and health issues. For example, the Bank publication, equitable access to social services (e.g., by providing “The Unmet Need for Contraception� (2010), provides a identification cards) or eligibility for insurance or re- better understanding of how to measure and address the tirement benefits. In addition, projects that help demand for contraception and has informed the design strengthen and develop labor market institutions, poli- of reproductive health projects in Mali and Burkina cies, and programs—such as minimum wage, employ- Faso. The publication, “Gender-Based Violence, Health, ment services, training, and retraining programs—also and the Role of the Health Sector� (2009), has also in- improve employability and earnings opportunities for formed the development of a health system strengthen- both women and men. And social investment funds im- ing project in El Salvador and a Country Gender Assess- prove gender equality in voice, participation, and deci- ment in Bangladesh. In Africa, Bank analysis of sion making by requiring, for example, that women community-based health interventions for women and comprise 50 percent of project management committee children was used by officials in The Gambia to scale up members and participate on an equal basis with men in the provision of a package of simple interventions to im- community development activities. prove maternal and child health and nutrition. And in The Bank is devoting considerable attention and re- Eastern Europe and Central Asia, Bank assessments of sources to helping protect vulnerable populations— the quality of maternal and neonatal care and of the re- including women and girls—in times of crisis and vol- productive health content of medical and nursing edu- atility. The recent global financial, food, and fuel crises cation curriculums is shaping national policies to im- have demonstrated the importance of taking gender dif- prove the quality of these health services. ferentials into account when designing crisis response programs, as women and girls are more likely to be pulled Social protEction and labor out of school or suffer health impacts as households cope and ration their resources in the face of such shocks. Gender is a critical dimension of the Bank’s social Gender-focused support from the Bank in crisis situa- protection and labor programs, as men and women tions has included, for example, addressing the increase face different consequences of risks and shocks and in gender-based violence in post-earthquake Haiti, and fare differently in the labor market. The Bank’s social improving the nutrition of pregnant and lactating wom- protection work spans social safety nets, social insur- en and children under the age of two in food-insecure ance, and labor programs that provide human devel- areas of The Gambia and Tajikistan. opment and economic opportunities, build resilience, and foster social inclusion and gender equality. For in- The Bank also produces many reports that analyze the stance, the Bank has helped many countries introduce gender aspects of social safety nets, social insurance, conditional cash transfers (CCTs), which often aim to and labor market institutions and policies. The find- improve children’s school attendance and mothers’ ac- ings and recommendations of these studies inform and cess to basic preventative health care for themselves often influence policy and institutional development at and their children. By design, women are almost al- the country and global level. For example, the Bank’s ways the recipients of cash benefits, as evidence shows country-specific labor market reports have examined that they are much more likely to use these resources the gender aspects of labor force participation and the to improve their family’s welfare. Their control of these factors that contribute to the significantly lower global additional resources in turn improves their power to labor force participation of women in comparison to influence household decisions. men (figure 4). A major Bank report, Conditional Cash Promoting Gender equality through Human Development 7 Transfers: Reducing Present and Future Poverty (2009), While considerable progress has been made, impor- provides policy makers and practitioners with global tant challenges remain in mainstreaming gender in evidence on the impact of CCTs on girls and women and social protection and labor programs, particularly for has informed the design and implementation of a grow- women’s participation in the labor market. Across the ing number of these programs. The landmark study, For world, women experience significantly lower labor mar- Protection and Promotion (2008), has become an indis- ket participation rates than do men (figure 4) and there pensible guide for policy makers and practitioners seek- also remains a significant gender gap in earnings. This ing to improve social safety net institutions, policies, and situation is explained in part by gender relations and practices in ways that promote gender equality. The first- social norms. Working women are often employed in ever World Report on Disability (2011) produced by the lower paying jobs, in part as a result of being streamed WHO and the Bank provides powerful evidence on the into certain occupations or fields of study. Institutional discrimination and barriers that both men and women and regulatory failures also preclude women’s participa- with disabilities face in their everyday lives and is in- tion in the labor market and influence their earnings, forming country-specific policy responses. such as a lack of child support, constraints to mobility, Labor force participation by gender (30 largest developing countries) Figure 4 Labor force participation by gender of the 30 largest developing countries 0 10 20 30 40 50 60 70 80 90 100 China India Indonesia Brazil Russian Federation Pakistan Bangladesh Nigeria Mexico Vietnam Philippines Iran, Islamic Republic of Egypt Turkey Thailand Ethiopia Ukraine Myanmar Congo, Democratic Republic of South Africa Colombia Argentina Sudan Algeria Tanzania, United Republic of Morocco Kenya Peru Venezuela, Bolivarian Republic of Uzbekistan Male Female Source: World Bank staff, based on ilo estimates. source: ILO estimates, key indicators of the labor market 2009 8 G e t t i n G to e q ua l or options for part time work. Where minimum wages are helping development specialists learn what does and are set at levels that are too high relative to average earn- does not work and guides future policy and program ings, women are more likely to suffer job losses or be design. Many of the examples highlighted in this note driven to informal sector jobs with less pay and oppor- come from Bank-sponsored impact evaluations. tunity. And women are less likely to be covered by social insurance programs, such as pensions and unemploy- The Bank is also consolidating and analyzing data on ment benefits, given women’s greater tendency to be ei- gender-specific indicators of human development ther self-employed or involved in family enterprises. In across countries. For example, EdStats, the Bank’s many countries, women do not benefit from basic widely used platform for national data on education, worker protection measures, such as maternity leave provides data on gender gaps in enrollments, dropout and anti-discrimination laws. Moreover, reforms in- rates, completed education levels, and test scores. An- tended to improve the financial sustainability of social other key data tool is the ADePT software, which gen- programs, such as increasing the retirement age or cal- erates automated analysis of microlevel data from de- culating benefits according to life expectancy, are likely mographic, health, and labor force surveys. By to negatively impact women more than men. These re- providing gender-disaggregated data on various indi- forms help address fiscal imbalances, but can leave cators, ADePT enables better understanding of the women with inadequate coverage in old age and at risk gender dimensions of human development. of poverty unless governments also take proactive steps to address the host of issues that hold women back from With better knowledge and data, the Bank is also equal participation in labor markets, equal pay, and adopting a more holistic and systemic approach to its equal social benefits. work in human development that promotes gender equality. Life-cycle data reveal that gender gaps due to The Bank’s new Social Protection and Labor Strategy, poverty and social norms can appear early in life and expected in 2012, will further emphasize gender equal- lead to gender-based disadvantage in adulthood. This ity as a key outcome of well-designed social protection argues for investments in human development that ad- systems. The strategy will highlight the need for institu- dress the sources of early gender gaps because these in- tions, policies, and programs to close gender gaps. An vestments will yield positive returns throughout young important objective of the new strategy will be to re- people’s lives. The Bank’s Skills Toward Employment think social insurance programs and labor regulations and Productivity (STEP) Framework (2010) illustrates in order to expand the coverage of women. Improving this approach. It contains five critical, interlinked “steps� gender equality in labor market outcomes requires bet- across the life cycle to promote productivity and eco- ter integrated packages of training, access to credit, and nomic growth and the gender dimensions of each. The advisory services to help governments increase worker five steps are: (1) investing in early childhood develop- productivity and improve mobility for women and ment, (2) ensuring that all students learn, (3) building men. For those seeking employment, the Bank’s new job-relevant skills, (4) encouraging entrepreneurship strategy will aim to help countries customize active la- and innovation, and (5) facilitating labor mobility and bor market programs, including the revamping of such job matching. The framework also shows that greater components as counseling, intermediation, skills certi- gender equality in one dimension of human develop- fication, and retraining services to address gender-spe- ment benefits other dimensions as well. Indeed, the sys- cific needs. tems approach at the center of each of the Bank’s global strategies for education, health, social protection, and KnowlEdgE and innovation labor highlights the importance of linked or integrated acroSS SEctorS investments across multiple sectors, ensuring that gen- der inequalities in one area do not undermine progress The Bank continues to produce new tools, data, and in another. research that generate new knowledge about the links between gender equality and human development. A The WDR 2012 identifies four ways in which human growing number of rigorous impact evaluations of pro- development policies and programs can foster gender grams in education, health, social protection, and labor equality, in the public and private spheres and at the Promoting Gender equality through Human Development 9 macro and micro levels. The Bank is making important delivery of basic social services that men and women contributions in all of these areas by: need over the course of their lifetimes—at birth, in n Improving services to reduce gender gaps in human school, in the labor market, and during parenthood and capital. old age—need to be improved. For example, expanding the access of expectant mothers to skilled birth n Making markets work better for human develop- attendants and improving the availability of clean water ment. to households (a task that tends to fall on the shoulders n Breaking normative barriers. of women in many countries) would go a long way n Influencing household incentives to achieve gender toward closing gender gaps in mortality. Similarly, equality. education policies need to focus on increasing the access of population groups that are currently disadvantaged The following sections document examples of Bank- by poverty, ethnicity, caste, race, or rural geography, supported programs and knowledge contributions in thereby addressing “gender inequality traps� that each of these four areas. disproportionately affect poor and excluded women and girls (box 2). In a wide range of programs, the Bank improving SErvicES to rEducE gEndEr is explicitly addressing the drivers of gender inequality gapS in Human capital in health and education, such as bringing excluded women and girls into the process of program design In order to reduce gender gaps, or disadvantages, in and implementation. Key elements for more effective health, education, skills, and job competitiveness, the and equitable service delivery include stronger Box 2 Expanding social services for women and children Saving lives in Guatemala The Bank-financed Maternal Infant Health and Nutrition Project in Guatemala reduced the indigenous-nonindigenous maternal mortality ratio in project intervention areas from 3.2 in 2006 to 2.55 in 2009, a reduction of 20 percent. This result significantly surpassed the end-of-project target of a 10 percent reduction. The share of institutional deliveries increased in the intervention areas from 22 percent in 2006 to 32 percent in 2010, a 43 percent increase (which also greatly exceeded the end-of-project target of 20 percent). Communities were consulted to ensure that health facilities were culturally responsive to women, especially with regard to indigenous practices (e.g., vertical birthing chairs for certain com- munities). The project also promoted the active involvement of communities, making efforts to include fathers and midwives in both monitoring and promoting health and nutrition activities for women and children. Protecting women and families in Jordan With support from the Bank-financed project, Pension Reform: An Agenda for Jordan, a new social insurance law was passed in Jordan in Decem- ber 2009. In addition to reforming the main parameters of the pension program to ensure its long-term sustainability, the new law adopted an integrated approach to social insurance and introduced new maternity, unemployment, and health insurance benefits. This benefit package was designed to addresses difficulties in access to health care services, including on the part of women. The benefit package was also extended to employees in firms of less than 5 workers, which were excluded from the previous social security law. The benefit package addresses gender equality by, for example, transferring the cost of maternity benefits to the payroll of all workers. The new financing modality for this benefit is expected to increase the demand for female employees by reducing the cost differential of hiring men and women. Enrolling more girls in school in Yemen Yemen has made significant progress toward universal primary education over the past decade, including increasing girls’ enrollment from 49 percent in 1999 to 78 percent in 2009. Despite this growth, many girls from rural areas remain out of school—and those who are enrolled tend to be over-age, with most dropping out before completing the primary cycle. With financing from the Bank’s Fund for the Poorest and the Interna- tional Development Association, the Basic Education Development Program aims to increase school enrollment in the country (with a particular focus on gender equality in impoverished districts) and improve the quality of teaching. As of 2009, the project had built almost 4,000 classrooms and trained over 90,000 teachers. To close the gender gap in education, the project has provided conditional cash transfers to more than 30,000 girls from the most underprivileged rural households, starting in 2008. It has also focused on recruiting and training female teachers to make girls’ education more culturally acceptable. The gross primary school enrollment rate in the country rose from 68 percent to 87 percent over the period 1999–2009, with larger gains for girls than for boys. This improvement in overall basic education also contributed to a considerable rise in the grade 6 completion rate for girls, from 38 percent in 2001 to 51 percent in 2009. Source: World Bank staff. 10 G e t t i n G to e q ua l regulations; supply-side incentives for service providers that was not tied to performance. Facilities supported to become more accountable to policymakers, by the P4P scheme experienced a 23 percent increase in beneficiaries, and the public; demand-side incentives the number of births that took place in a staffed health for consumers to access and utilize available services; facility, remarkable increases in the number of preven- and measures to strengthen the voice of women and tive health care visits by children under age 2 (56 per- men to hold service providers and policy makers cent) and between the ages of 2 and 5 (132 percent), and accountable for delivering quality. significant improvement in the quality of health care services. These results suggest that paying health centers EnSuring HEaltHy motHErS for performance is a feasible and effective way to im- prove both health system performance and health out- and cHildrEn in rwanda comes for poor women in rural areas, and that incen- Following the 1994 genocide, health outcomes in the tives for accountability are crucial for success. areas of mother-child healthcare in Rwanda ranked among the worst in the countries of eastern and south- ern Africa. The government moved to address signifi- maKing marKEtS worK for cant challenges in the health system by introducing gEndEr Equality community-based health insurance and piloting pro- Improving gender equality is typically regarded as a grams that gave primary health centers financial incen- government responsibility because it benefits society as tives to focus on key maternal and child health out- a whole, not only those who directly benefit from the comes. In 2005, the government sought help from the elimination of discrimination and disadvantage due to Bank to expand a pay-for-performance (P4P) scheme gender. In addition to directly providing services, gov- in the health care sector. The scheme measures health ernments have other tools for expanding supply, im- center performance using 14 maternal and child health proving the quality of services, and influencing demand indicators, including the actual use of key health ser- for those services. Market-friendly forces can be power- vices (such as prenatal care and family planning) and ful tools for mitigating the factors that cause gender dis- the quality of institutional delivery. A rigorous, prospec- parities, such as living in remote areas, entrenched pov- tive impact evaluation compared P4P health centers to erty, and discriminatory practices. Appropriate pricing centers who received an equivalent amount of funding policies, investments that remove information barriers, and interventions that increase the role of the private sector in service delivery are among the market-orient- ed solutions that can reduce gender disparities (box 3). Where government is unable to meet fully the need for services, it can encourage the private sector to fill supply gaps through incentives such as a cost subsidy for pro- viders or a consumer subsidy for the users of privately provided services. At the same time, these financial in- centives can be used to actively counter gender discrim- ination in the private sector by making discriminatory practices more costly. Even when services are generally available to all, market signals for services may be muted for certain segments of the population. This is the case, for example, when information about the availability and quality of services is not accessible to all. Inequality in access to information can result in unequal invest- ments in human development. In these cases, financial incentives and market responses can help boost both supply and demand to improve gender equality. Photo: Jennifer Sturdy Promoting Gender equality through Human Development 11 Box 3 Market-based approaches to advancing gender equality Contracting NGOs to improve the health of women and children in Afghanistan One of the most daring and successful ventures in public-private partnerships in health care in recent years has been the large-scale con- tracting of nongovernmental organizations (NGOs) to deliver essential health services to the population of Afghanistan—a conflict-affected setting where the government has weak capacity for service delivery. Building on the work of local and international NGOs, the Bank’s Health Sector Emergency Reconstruction and Development Project financed implementation of a basic package of health services in 11 provinces. In 8 of these provinces, implementation took the form of contracts between the Ministry of Public Health and NGOs. To address the critical shortage of female health workers in remote areas, the project supported a community program to train local women in midwifery. The project also used innovative approaches to attract female health workers to remote areas, such as hiring their husbands and paying bonuses. As a result, the number of health facilities tripled from 148 in 2002 to 421 in 2008. Roughly 20,000 community health workers—half of them women—have been trained and deployed, increasing women’s access to family planning and boosting childhood vaccinations. The number of facilities with trained female health workers also rose from 25 to 85 percent. Over this period—despite worsening security conditions— the number of facility-based deliveries assisted by trained health workers rose from 6 to 23 percent, and the number of pregnant women who received at least one prenatal care visit increased from 8,500 to 188,670. The quality of care also improved, as measured by an indepen- dent third party. Preliminary results from a 2010 survey indicate that the maternal mortality ratio has been reduced by more than two-thirds, and the mortality rate for children under age 5, by more than half. Targeting youth in the Dominican Republic Launched in 2006, the Bank-supported Youth Development Project in the Dominican Republic aims to improve the employment opportunities and reduce the risky behavior of unemployed, at-risk youth. The program provides classroom-based vocational and life skills training, followed by an internship at a private-sector firm and a small stipend to cover transportation costs. The training is demand-driven and training providers are competitively selected. The principal beneficiaries of the program are youth aged 16 to 29 who have not finished secondary school, are unemployed, and live in poor households. Preliminary evidence covering the period 2009–10 suggests that the life skills component of the pro- gram plays a central role in improving the employment outcomes of young women. Approximately 12 to 18 months after completing the pro- gram, this group experienced a higher likelihood of having a job, higher wages, and higher job satisfaction. Young women participating in the program were also more likely to delay pregnancy and have fewer children than the control group. Designing and implementing a minimum wage policy in Malaysia The Bank has helped the government of Malaysia assess the suitability and best design for a national minimum wage policy. The government’s primary objective is to offset gender disparities in the Malaysian labor market and the weak bargaining power of low-skilled workers, many of whom are women and youth. Women’s participation in the labor market in Malaysia is nearly half that of men, who, on average, earn 13 percent more than women. Due to family responsibilities and cultural practices, women are less mobile than men, have a narrower set of employment options, and are more vulnerable to employers’ demands. The Bank’s analysis provided concrete evidence to the Malaysian government on the best policy design features (e.g., coverage and wage levels) and the potential impact of the policy. The Bank’s recommendation was to set a minimum wage between 900 and 1,000 Malaysian Ringitt per month that applied equally to men and women, but with a provision for a different level for youth. The recommended wage would not only raise income levels for both genders to an equal starting point—thus narrowing the gender wage gap for low-skilled workers—but also incentivize the increased participation of women in the labor market. Tapping into the potential of women in Turkey One of the salient features of the labor market in Turkey is the distinctly low and declining participation rate of women in the labor force—just 23.5 percent in January 2009. A report by the Bank and the State Planning Organization of Turkey, “Female Labor Force Participation in Turkey: Trends, Determinants, and Policy Framework,� examines the causes of this low participation rate and outlines policy options that could help the country reap the substantial social and economic dividends associated with greater participation of women in the labor force. Urbanization and decline in agricultural employment have contributed to a decreasing share of women having or seeking jobs in Turkey. Women have migrated from a high-participation rural environment (where they engage in unpaid agriculture) to a low-participation urban environment (where many of them stay at home). Low-skilled women also face important economic and cultural barriers to employment in urban settings, such as low salaries, lack of affordable child-care, long working hours, and family or social demands to remain at home. The research points to an “under- participation trap,� whereby poorly educated women in urban areas are not likely to participate in the labor force as they would only be able to get low-paying, low quality informal jobs. As families anticipate these outcomes, they tend to underinvest in girls’ education, thus perpetuating low participation of women in the labor force. To encourage more formal employment for women, the Turkish government introduced a pro- gram that subsidizes employers’ social security contributions for newly hired women for up to five years. With Bank support, the government also launched a comprehensive evaluation of the National Employment Training Agency with the goal of rapidly expanding its coverage and improving the targeting and training content of its programs to better serve the needs of women. Subsidized child-care, sustaining investments on education, and programs that promote formal employment of women with low levels of education as they transition from school to work are approaches likely to increase the rate of employment among women. Source: World Bank staff. 12 G e t t i n G to e q ua l improving Education accESS and low-cost private schools that serve almost one million quality tHrougH privatE ScHoolS students from lower-income quintiles. in paKiStan Another Bank-supported project promoting gender Pakistan faces significant challenges in public education: equality in education in Pakistan is the Sindh Education 30 percent of primary school-age children are still not in Sector Project (SEP), which supports a government re- school, the primary school gender parity index (GPI) is form program that directly affects the schooling condi- 0.8, and half of the country’s population is less than 17 tions of 3.8 million students. Since 2007 (the baseline for years old. At the cost of just a dime a day per student, the the project), the primary net enrollment rate has in- government is subsidizing private schools as a promising creased from 50 to 54 percent, or an additional 600,000 solution to these challenges. In Punjab, the largest prov- children, and the ratio of female-male primary net en- ince and home to 60 percent of the country’s total popu- rollment in rural areas rose from 61 to 76 percent. The lation, the Bank is helping expand access to quality educa- government program also includes a public-private part- tion and promote better governance and accountability in nership program that offers subsidies for individuals or the education system. The Punjab Education Sector Proj- organizations to set up and operate free, coeducational, ect (PESP) is a performance-based project that supports primary schools in underserved rural communities, with the government’s reform program, which aims to increase subsidies tied to quality-related standards. Preliminary school enrollment and completion rates, reduce gender results from the first year showed large gains in getting and urban-rural disparities in school participation, and children into school and even larger gains for girls, eras- strengthen the measurement of student learning. Under ing the pre-existing gender gap. The program counted the government’s program, over 400,000 eligible girls re- among the cheapest interventions in developing coun- ceive targeted monthly stipends pegged to school atten- tries for generating enrollment gains. Both the public- dance in the 16 lowest literacy districts. In addition, the private partnership programs in Punjab and Sindh prov- government financially supports approximately 2,000 inces have also generated significant achievement gains in program schools; in the case of Sindh, achievement gains in the target communities have been as large as two standard deviations in a span of two academic years. A previous, similar pilot project in Balochistan province also resulted in substantial increases in school enroll- ment, with the gains for girls well exceeding those for boys. brEaKing normativE barriErS to gEndEr Equality Gender-based stigma and discrimination are deeply rooted in the social norms that influence the roles and status of men and women in the household and the larg- er community. Social norms are socially shared beliefs that are enforced by both formal means and informal social sanctions. These norms in turn influence laws and regulations, access to quality social services, education and employment options, and income levels. Women and men internalize and are affected by social norms and expectations in ways that have an impact not only on their own aspirations, behaviors, and preferences, but also those of their children—gender relations and roles in the family and the workplace are transmitted across generations. For example, when women do not work Photo: Curt Carnemark, World Bank Promoting Gender equality through Human Development 13 outside the home, their daughters are less likely to do so side economic opportunities, such as developing job as adults and their sons are less likely to marry women skills training and occupational matching services. who work outside the home. Leadership on the part of Third, increases in individuals’ ability to control resourc- policy makers, markets, and institutions are all instru- es strengthen their voice and choices. For example, in mental in helping break these normative barriers to gen- contexts where women do not have their own income, der equality. Social norms do change in a number of evidence shows that giving young women a financial in- ways (box 4). First, change occurs as the result of legal centive can discourage risky behavior such as having un- frameworks and institutional functions, such as new protected sex with older men. In addition to financial laws against discrimination and violence or changes that incentives, better access to information, such as educat- address gaps in the law to provide women equal power ing both men and women on the benefits and proper use in accessing services. Second, norms can change along- of contraception, also results in more beneficial choices. Box 4 Breaking normative barriers to empower women and girls Closing the earning gap for women in El Salvador Beginning in 2010, the Bank’s El Salvador Income Support and Employability Project (PATI) has been helping narrow differences in access to economic opportunities and earnings between women and men. The project supports the country’s Temporary Income Support Program, which aims to guarantee a minimum level of income to extremely poor urban families and provide beneficiaries with experience in social and productive activities at the municipal level. PATI provides training modules that enhance beneficiaries’ basic technical skills, including innovative “life skills� training that aims to increase their employability over the medium term. PATI targets young adults in urban areas as well as female household heads; in the program’s first round, 77 percent of participants were women. The program is expected to lower economic and cultural barriers to women’s employment in urban poor districts, where more than 60 percent of female participants lacked the capacity to generate income prior to entering the program. Almost half of these women aspire to continue devoting time to child care and household activities, so their training has focused on typical self-employment occupations, such as baking, cooking, and cosmetics. Younger generations with aspira- tions for salaried employment have sought training primarily related to garment and other textile production and computer skills. A rigorous impact evaluation of PATI will take place in 2012 to test whether participants are effectively increasing their prospects for employment. Creating more engineering educational opportunities for women in India Through the Second Technical/Engineering Education Quality Improvement Project (TEQIP), the Bank is working with the government of India to strengthen higher and technical education vital to addressing current skill shortages in the country’s economy. The project is improving the quality of engineering schools and thus helping expand the pool of highly qualified engineers, including by targeting women. Specific interven- tions include promoting the capacity building of technical education policy planners and administrators and strengthening monitoring and evaluation mechanisms to improve the governance of institutions. The project’s Equity Action Plan helps ensure that students and teachers from tribal communities and other vulnerable groups, including girls, benefit equally from the project. Despite rising female enrollment in engineer- ing programs in India, increases are not occurring in all disciplines, and the “gender-friendliness� of many campuses needs to be improved. This means ensuring that all refurbishments financed by the project will follow infrastructure guidelines to improve the ability of campuses to serve both women and disabled students, as well as expanding access to training for female engineering faculty. Reducing risky behavior among girls in Malawi Between 2006 and 2010, the Bank increased the use of cash transfer (conditional and unconditional) schemes to address gender inequalities. This trend partly stemmed from evidence that conditional cash transfer programs increase the demand for girls’ schooling in poor countries and thus reduce gender disparities. In Malawi, one of the poorest countries in the world, a pilot experiment conducted in 2008 provided cash trans- fers to adolescent girls (aged 13–22) to encourage them to enroll in primary school and reduce their dropout rate in primary and secondary school. Their attendance was checked every month and payment for the following month was withheld for any student whose attendance rate was below 75 percent in the previous month. The two-year intervention led to a significant improvement in girls’ enrollment and attendance rates, as well as their grades. Importantly, the program also provided other benefits, such as, a 40 percent drop in the probability of girls getting married while in school, a 30 percent drop in the chances of them becoming pregnant while in school, and a 38 percent drop in the onset of their sexual activity—all after the first year of the program. The money made the girls less vulnerable to contracting HIV and other sexually transmit- ted infections; 18 months after the program began, HIV infections among girls in the program were 60 percent lower than those who were in the control group. Girls who received payments not only had less sex, but when they did, they tended to choose younger, safer partners because they no longer had the same incentive to seek gifts or cash from their sexual partners. The project in Malawi now serves as a model for initiatives that seek to improve the lives of adolescent girls and young women. Source: World Bank staff. 14 G e t t i n G to e q ua l rEducing Stigma rElatEd groups and the public can influence social norms and to Hiv/aidS in SoutH aSia attitudes. As a result of this initiative, India’s national AIDS program is moving forward with work to reduce Both women and men afflicted by HIV, AIDS, and other stigma in health care settings, and a global stigma action sexually transmitted diseases often suffer from stigma network has been formed to promote learning and ex- and discrimination in their communities, including by change on promising approaches. health providers and local policy makers. Stigma and discrimination amplify the marginalization of vulnera- Among the winning projects that tackled gender-based ble groups at highest risk for HIV: female and male sex stigma was Ashodaya Samithi in Mysore, India, a net- workers, men having sex with men, transgender persons, work of sex workers, many of whom are living with and drug users, especially female drug users. Increased HIV. The project activities included offering advocacy marginalization drives these at-risk populations further and employment services, sensitizing health personnel, away from the reach of health services and other social assisting female and male sex workers at health facili- services. To tackle this issue, in 2008 the Bank organized ties to access services, and improving access to alterna- a South Asia Regional Development Marketplace that tive economic opportunities. Partnering with the po- awarded small grants to community groups and net- lice to ensure protection of the rights of sex workers works to fund innovative approaches to reducing stigma. was an important element of Ashadoya’s success. The The results were summarized in the report “Tackling project was able to show an increase in the number of HIV-Related Stigma and Discrimination in South Asia�. reported incidents of discrimination from 0 to 157, The initiative reached nearly 100,000 people through with 75 percent of incidents resulting in a solution sat- community innovations and training. Strategic partner- isfactory to the aggrieved party. The Ashodaya Samithi ships such as unlikely alliances between female sex work- has established a regional training site to build capacity ers and the police led to new insights on how to reduce of other networks of marginalized groups, including stigma. The initiative demonstrated that strategies that gender-based minority groups. A similar project, foster interaction between gender-based minority Swathi Mahila Sangha in Karnataka, India, was man- aged by female sex workers, of whom many were HIV positive. This project increased media exposure and built capacity through awareness and advocacy campaigns. For- mative research showed a change in inter- nalized stigma and a doubling of female sex workers who regularly sought health care from 30 to 60 percent over an 18-month period. uSing HouSEHold incEntivES to acHiEvE gEndEr Equality Decisions about the use of health or educa- tion services are made within the house- hold. Traditional gender roles within the family influence these decisions and medi- ate the impact that governments and mar- kets can have on achieving gender equality. For example, women often face constraints to participating in the labor market, which may influence how their families perceive Photo: Shehab Uddin/Drik/Majority World Promoting Gender equality through Human Development 15 the returns to girls’ education and skills training. In some countries, sons from poor families may face greater pressure than their sisters to leave school at an early age in order to earn income, in part because of social restrictions against girls work- ing outside the home. Mandates such as compulsory school atten- dance or child immunization pro- grams alone do not guarantee com- pliance. For this reason, a range of incentives to influence household choices and behaviors are necessary. Due to poverty and social norms, public investments in social services that reduce or even eliminate the cost of accessing education and health services may be insufficient to close gender gaps in human de- velopment—gender-targeted efforts may be required (box 5). Cash trans- Photo: B Legeller, UN fers to households have proven to be a particularly effective tool, for ex- ample, incentivizing families to seek health care and aftermath of various adverse financial and weather nutrition for their children and send them to school, shocks. The program provides cash to chronically reducing dropout rates, and encouraging out-of-school poor households with children up to age 14, provided boys and girls to resume their studies. Evidence points that they complete certain activities, such as sending to the need for these programs to be designed with an their children to school and ensuring expectant moth- understanding of household dynamics and power rela- ers and infants receive checkups. As of 2011, two mil- tions to ensure that they do not indirectly worsen de- lion poor households benefit from the program, and velopment outcomes for either girls or boys. In addi- over 90 percent of the cash recipients are women. A tion, community-level education efforts targeting qualitative review of the program conducted in 2010 women and caregivers with information about the im- found that it has made an important contribution to portance of proper investments in health, nutrition, empowering the women participants, particularly fe- and education can help ensure that gains in human de- male parent leaders. The program enabled these women velopment are sustainable. to negotiate with their husbands to redistribute their household chores and, in some cases, obtain their EmpowEring motHErS and lifting spouses’ help with household work. The study also girlS out of povErty found that mothers have become increasingly aware of the need for proper maternal health services, are de- in tHE pHilippinES manding better health services for their children, and The Bank-supported Pantawide Pamilyang Program in have become more involved in their children’s school the Philippines aims to break the intergenerational cycle work. A comprehensive and rigorous quantitative im- of poverty by promoting greater investments in human pact evaluation is currently underway which will pro- capital on the part of poor families. The program was vide further evidence on how this program impacts piloted in 2007 and later scaled up nationwide in the gender equality. 16 G e t t i n G to e q ua l Box 5 Changing incentives for gender equality Keeping boys in school in the Caribbean Many poor households in both the Caribbean and Central America are unable to invest in secondary schooling for their children due to cash constraints and other factors, resulting in school dropouts. Particularly among boys, limited opportunity for gainful employment contributes to their engagement in crime and violence and an impoverished adulthood. Conditional cash transfers can be designed to address this problem by properly identifying the constraints to secondary schooling and responding with the right incentives to keep boys in school. In 2008, the Bank’s Jamaica Social Protection Project was set up to improve the design of the government’s PATH program, which aims to offset the higher oppor- tunity cost of boys staying in school. The PATH program provides greater benefits to boys than girls for school attendance, which rise incremen- tally for every additional year of secondary school completed, and a bonus for graduating from high school and moving on to tertiary education or training. Preliminary results and qualitative analysis indicate that the project has already helped increase the school attendance of secondary school-age boys and thus close the gender gap. Getting more girls into school in Cambodia Most Cambodian children attend school, but low completion rates remain an issue, especially in rural areas and among girls. Among rural girls, only 78 percent of 15-19 year-olds complete grade 1 and only 17 percent complete grade 7. In 2005, the Bank launched the Cambodia Education Sector Support Project (CESSP) to address constraints in supply, demand, quality and efficiency, with a special focus on poor and underserved communities. The project has promoted gender equality in a number of ways. First, the project encouraged girls’ school enrollment and atten- dance by expanding schools in poor areas to shorten travel distances and promote community oversight; improving school sanitation facilities, with separate facilities for girls; and providing a clean and safe physical environment. Second, the project is also using teacher training as an avenue to challenge gender stereotypes, leading to greater awareness-raising about the importance of equal access for boys and girls to educa- tion and other opportunities. Third, by expanding the government’s effort to provide scholarships to students from disadvantaged backgrounds, with a disproportionate number of scholarships targeted to girls. The project funded scholarships of $60 and $45 to students ready to make the transition from primary to secondary school, provided that students enrolled in school, maintained a passing grade, and were absent without “good reason� fewer than 10 days in a year. The program resulted in more than a 20 percentage point increase in enrollment and attendance in participating schools for both girls and boys 18 months after they first joined the program, and 4 years later were found to also have increased the transition rates to upper secondary school, especially among girls. Creating opportunities through early childhood development programs in Mozambique Regardless of income, women worldwide bear a disproportionate share of the responsibility for child care, which often limits their ability to pur- sue educational or economic opportunities. Access to subsidized, quality child care is positively associated with increases in the number of hours women work, particularly in formal sector jobs, suggesting that better access to child care affords women greater flexibility and income-earning opportunities. In collaboration with the Government of Mozambique and Save the Children, the Bank conducted an impact evaluation of innova- tive, community-driven early childhood development (ECD) centers in the rural Gaza province, where 42 percent of children who do not receive ECD services are stunted and 50 percent are at risk in terms of cognitive functioning. These delays have significant implications for children’s readiness to learn and, therefore, their future success. The ECD program enrolls poor and vulnerable children aged 3–5 in high-quality, low-cost ECD services that build the foundation for lifelong learning. The program promotes cognitive stimulation and language skills, as well as good health, nutrition, and hygiene practices at home, which mostly benefit women. After 2 years, girls who participated in the programs were signifi- cantly more likely to be enrolled in primary school at the right age than girls who did not participate. Participants also scored significantly better on measures of cognitive, fine motor, and socioemotional development, and were better prepared to learn. The gender equality impacts extend even further, as big brothers and sisters were more likely to be enrolled in school, and both fathers and mothers were more likely to be engaged in income-generating activities, presumably because the preschool program frees up several hours of each day previously spent in child rearing. Improving the nutrition of women and children in Tajikistan Tajikistan has much higher rates of stunting than countries in the same region and at the same income level. Recent data show the rate of stunt- ing is relatively high—29 percent among children aged 6 months to 5 years. The high stunting rate means that infants and young children suffer from chronic undernutrition, which severely, and often irreversibly, impairs their physical and cognitive development—and adversely affects the country’s productivity and growth. The risk of malnutrition further escalated when the 2008 food price shock reduced the purchasing power of Tajik families, with more than one-third of households classified as food insecure. In 2009, the situation worsened again when the global financial crisis resulted in a one-third decline in workers’ remittances, as migrant workers from Tajikistan lost construction jobs in Russia. To miti- gate the risk of malnutrition, the Bank launched the Community and Basic Health Project to provide food packages and micronutrient supple- ments to approximately 50,000 vulnerable pregnant and breastfeeding women, infants, and children under age 5. To ensure that these benefits are not reversed, an additional grant from the Bank’s Japanese Social Development Fund provides ongoing support to community-based nutri- tion programs and the provision of nutritional supplements to women and children in the most food-insecure region of the country. As of mid- 2011, the project had trained 1,000 primary healthcare workers and 300 community volunteers to deliver education on breastfeeding, good nutrition, and care of sick children to 1,000 pregnant women, and micronutrient supplements and vitamins had been delivered to approxi- mately 44,000 women and children. Over the long term, this program aims to mitigate and address the impact of poor nutrition on childhood physical and cognitive development and improve the health-seeking behaviors of mothers and caregivers. Source: World Bank staff. Promoting Gender equality through Human Development 17 gEtting to Equal The evidence is clear: gender inequality undermines But there is much more work to do. Many critical gen- human productivity and welfare, as well as develop- der gaps persist at country and global levels—in mater- ment and growth overall. The WDR 2012 rightly points nal mortality, school enrollment and learning at all lev- out that because gender inequality is often grounded in els, earnings and productivity, and voice and agency in the rules and social norms that are embedded in house- households and society—particularly among disadvan- holds, markets, and institutions, effective policies and taged populations. While most gender gaps focus on investments in education, health, social protection, and girls and women, in some areas boys and men, who are labor must acknowledge, and work through, these same critical to advancing gender equality, are more disad- channels. vantaged and require special targeting. The Bank will continue to use and improve all of the tools at its dis- The examples highlighted in this note are a sampling posal to expand and strengthen investments in quality of the hundreds of Bank-supported activities around human development programs that address these gen- the globe that have contributed to gender equality der disparities and create equal opportunity. through investments in human development. The Bank’s global strategies and country programs in health, In addition to targeted financing, timely and reliable education, social protection, and labor all share the aim data across countries on gender-specific indicators of reducing the array of economic, social, and political are necessary to monitor progress and identify trouble disparities between men and women and across all pop- spots. More and better impact assessments of policies ulation groups. and programs on gender equality and evidence-based research can lead to gender-focused country dialogue Impressive gains in women’s rights and investments and investments. More active knowledge exchange in education and health services in many countries among countries regarding the barriers to gender equal- have made the world a more equal place for men and ity and effective solutions can enrich global debate and women. Life expectancies, educational access, and strengthen future policy making. In order to accomplish educational attainment for both men and women have these goals, the Bank recognizes the importance of increased, reducing many gender gaps. More women working in partnership with the international commu- are participating in the labor market as paid work nity to promote innovation and learning on human de- opportunities have expanded, giving women greater velopment and gender equality. 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The Unmet Need for Contraception.� Human Development Network, World Bank, Washington, DC. http://siteresources.worldbank.org/INTPHAAG/Resources/UnmetNeedforContraceptionAAG040610.pdf. ———. 2010e. “The World Bank’s Reproductive Health Action Plan 2010–2015.� World Bank, Washington, DC. ———. 2011a. “Implementing the Bank’s Gender Mainstreaming Strategy: FY09–FY10; Annual Monitoring Report.� World Bank, Washington, DC. ———. 2011b. “Maternal Death Audits as a Tool for Reducing Maternal Mortality.� Human Development Network, World Bank, Washington, DC. http://siteresources.worldbank.org/INTPRH/Resources/376374-1278599377733/ MaternalDeathAuditMarch22011.pdf. ———. 2011d.�The World Bank Group Education Sector Strategy 2020: Learning for All; Investing in People’s Knowledge and Skills to Promote Development.� World Bank, Washington, DC. World Bank and State Planning Organization of the Republic of Turkey. 2009. “Female Labor Force Participation in Turkey: Trends, Determinants, and Policy Framework.� Report No. 48508-TR. World Bank, Washington, DC. http://siteresources.worldbank.org/TURKEYEXTN/Resources/361711-1268839345767/Female_LFP-en.pdf. For more information on the Bank’s work on gender equality and human development, please visit: World Bank Results: www.worldbank.org/results Education: www.worldbank.org/education Health, Nutrition, and Population: www.worldbank.org/health Social Protection and Labor: www.worldbank.org/sp