Gender is a key determinant of power, which in turn influences how health rights are realized and how health risks are experienced in Nepal. For example, risk of early childbearing, suffering violence, smoking tobacco, drinking alcohol or occupational exposure to harmful environments are all, in part, influenced by gender and power within relationships, families, communities and wider society. Gender further influences whether or not people seek health services, and the quality and effectiveness of care they receive.
Gender also impacts career pathways, including in the health sector. The health system itself is gendered, with career stability, career progression and equality of opportunity all experienced differently according to the gender of the person in the workforce.
In recognition of the importance and benefits of gender equality, the Government of Nepal has recently passed several laws and protections to promote gender equality, including the New Constitution of Nepal (2015). These laws make important provisions for women’s equality, including the right to equal lineage, equal property rights, and the right to safe motherhood. Such laws however are only slowly being translated into more equal outcomes for women and men – the country continues to be ranked low on the Gender Inequality Index, at 110 out of 160 countries.
The Gender and Health 50/50 Nepal report marks the first time that the Global Health 50/50 (GH5050) methods have been applied to a national context. Over the last five years, the GH5050 annual reports have sparked pivotal conversations for organizations working in health and ignited positive organizational change.
While reviewing the activities of global organizations provides important insights into the system, we cannot extrapolate from the global situation to understand what is happening at the country level. In Nepal, there is no evidence to date that documents how global bodies and national non-governmental organizations operating in the country are addressing gender equality in their workplaces and programs. The Center for Research on Environment Health and Population Activities has collaborated with Global Health 50/50 to fill this gap in evidence.
This report aims to generate evidence, policy recommendations and action on gender equality and women’s empowerment in the health sector in Nepal. The findings are intended to inform and incite advocacy for organizational policies and programs that are gender-responsive and development partners that are supportive of gender equality efforts in the country.
The report reviews the extent to which health organizations in Nepal take action to promote gender equality across four domains: commitment; evidence-informed policy content; equitable outcomes in power; and gender-responsive programming.
We assessed a sample of 77 organizations working in gender and health, including 47 global and 30 national organizations. An additional analysis was also conducted for two ministries and three government departments/divisions. Read more about our methods here.
1. Public commitments to gender equality are scarce: Less than half of national NGOs have publicly committed to gender equality. Making a public commitment to gender equality is the starting point for addressing gender inequities in the workplace and in health outcomes. A substantial proportion of organizations in this sample still need to put gender on the agenda as a first step towards gender-responsive programming.
2. Workplace policies to promote gender equality and diversity and inclusion are almost absent from the public domain. Of the 30 national NGOs, only two had a workplace gender equality policy that was publicly available. Workplace policies for gender equality, diversity and inclusion are key tools to promote and support better workplaces while also facilitating career progression for women and other under-represented groups.
3. Male leadership dominates: One third (10/30) of national NGOs were led by women. Gender parity and diversity in the leadership of organizations active in health will support positive change in workplace policies and health outcomes, as well as acting as a catalyst for broader diversity in the organization.
4. Many health programs of organizations in the sample are gender-responsive but nearly one in three Nepal NGOs have gender-blind programs. Gender-transformative programming is central to improving inequities in health outcomes.
Our findings indicate that there is substantial room for improvement on these variables for both global organizations and national NGOs. We present evidence for policy-makers and other key stakeholders to accelerate progress on gender equality in the health sector in Nepal.
Visit the Gender & Health Index to review the scorecard of each organization included in the 2022 Report.
Read about our Methods for data collection and validation here.