Community Connections: A Look at EngenderHealth’s Work at the Intersections in India, Ethiopia, & Tanzania 

Woman smiling in a field

While many international development programs are built around siloed sectors that in turn create siloed programs, EngenderHealth does things differently. Across our work, EngenderHealth applies an intersectional, inclusive lens to ensure our programming is equitable and addresses the needs of marginalized and underserved communities. 

Meeting People Where They Are  

EngenderHealth’s intersectional approach prioritizes the holistic well-being of individuals across our global work. Join us in hearing from Anna Temba, Technical Director, Tanzania; Meskerem Setegne, Associate Project Director, Ethiopia; and, Dawood Alam, Associate Director, Social and Behavior Change Communication, India, on how our community-driven interventions exemplify the power of working at the intersections of health and development to better engage local communities, foster ownership and ensure sustainability of our programming. 

Meeting the diverse needs of all people in India 

Choral Mauladia poses near by her cart where she sells vegetables at a local market. Street vendors face a number of difficulties, including harrassment from local officials and displacement by urban development projects. Given these threats, Choral joined the Self Employed Women's Association (SEWA), a trade union that works to secure the rights of workers in the informal sector.

Indeed, EngenderHealth India’s work at the intersections has led to a unique and groundbreaking partnership focusing on gender mainstreaming in health and nutrition programs: the Mainstreaming Gender in Largescale Food Fortification Programs strengthens the work of reducing micronutrient malnutrition by addressing the gendered drivers of micronutrient deficiencies to achieve equity in nutrition. Alongside Global Alliance for Improved Nutrition (GAIN), PATH, World Food Programme (WFP) and other development partners, the program incorporates a framework of gender equality within nutrition programs including fortification to improve health outcomes, particularly for maternal, child and adolescent health.  

The program concentrates on gender social norms that affect awareness and accessibility of nutritious food for women and girls who bear a higher burden of micronutrient deficiencies. Meaningful involvement of women, girls, and communities in designing and implementing nutrition programs is among the recommendations, as well as capacity building of all stakeholders in applying a gender lens to programs. 

Insights from a gender analysis under the project identified the enablers that can be leveraged for gender integration in the supply-side intervention so that quality standards are informed by the needs and expectations of women and children who bear the highest burden of deficiencies. 

Rimjhim Jain, Senior Specialist–Gender Equality and Social Inclusion Lead, India, says “The focus is for nutrition programs to improve awareness, accessibility and acceptability among vulnerable groups, including women and girls.” 

The project advocates for strong policies on diversity and inclusion in the operational cycle of nutrition programs and social safety net schemes in states across the country encompassing production, distribution, promotion, uptake, and monitoring and evaluation–so that programs attain their full potential for impact, scale, and sustainability by considering the most vulnerable groups. For instance, using inclusive and gender-sensitive information, education, and communication material and communication strategies help to raise awareness of healthy nutrition and its acceptance tailored to marginalized groups.

Tools and resources like a self-paced digital training course on the linkages of gender in health and nutrition have been developed to strengthen institutional capacity to apply a gender lens to nutrition programs. A framework of gender indicators is being layered onto the existing results framework of nutrition programs to guide integration of accountability standards in the system.  

Reaching across sectors and changing gender norms in Ethiopia 

Four women sitting outside a building in Ethiopia

From working in humanitarian settings to integrating mental health and psychosocial support within our GBV response, to addressing water, sanitation, and hygiene issues in schools as an entry point for expanding knowledge and access to sexual and reproductive health care, EngenderHealth’s work in Ethiopia constantly reaches across the usually siloed boundaries of health and development sectors to collaborate and create lasting change. 

A recent example of EngenderHealth’s unique approach can be seen in the Reach, Expand, and Access Community Health (REACH) program that integrates SRHR, menstrual hygiene management (MGM), and water, sanitation and hygiene services (WASH) for women and young people.  

REACH is focused on: 

We know that gender norms directly affect SRHR, MHM, WASH, and nutrition outcomes and understand that is only by working in the intersections of these sectors that we can improve women’s and girls’ agency and decision-making powers, support access to resources and services (for instance, through the country’s health extension program), engage influential religious and community leaders to transform beliefs and perceptions related to gender norms, and facilitate awareness of and adherence to established women’s and girls’ rights. 

Everyone wins: Connecting HIV, Family Planning, and GBV services in Tanzania 

Three men sitting at a table and looking at documents in Tanzania

This trust can be seen across EngenderHealth’s programming. From integrating sexual and reproductive health information and services into nutrition programs, HIV/TB programs into economic empowerment, to our work around HIV and family planning (FP), EngenderHealth’s work in Tanzania is all about meeting people where they are. These intersections occur nationally through policy and guidelines changes all the way to local service delivery within communities.  

One key area of intersectional work is our USAID Afya Yangu – Northern project that is improving access to traditionally siloed HIV/TB services, connecting with FP services, and bringing GBV screening and care into HIV services.  

Through this program, EngenderHealth supports: 

We also empower communities to demand integrated services and to transform harmful gender norms. Our innovative approach to outreach includes community dialogues with men to identify opportunities to encourage and test for HIV and link to appropriate care. In fact, in 2023, through male support groups, our team reached nearly 40,000 men and supported the identification of 355 HIV positive men, ensuring they received the care and treatment they need.   

“Our work at the intersections in Tanzania ensures that everyone wins: we improve access to SRH services while contributing to HIV epidemic control–and, most importantly, clients are reached holistically and report more satisfaction with their health services.” – Anna Temba 

Working at the intersections creates lasting change 

When working at the intersections of health and development sectors, EngenderHealth has learned that it is critical to keep a few things in mind:  

SRHR outcomes are influenced by social determinants of health such as poverty, education, employment, and social norms and it is through partnering with other sectors to integrate interventions that address these underlying factors that we can create an enabling environment for SRHR. 

And it is important to remember the immense value of working in collaboration with local organizations and community leaders who have expertise and knowledge of specific contexts and populations. Engaging in meaningful partnerships ensures that interventions are culturally sensitive, contextually appropriate, and sustainable. 

One organization like EngenderHealth cannot be everything to everyone, but we can bring people, partners, and policies together to do a better job of reaching people with the services they need and want. Together, we can overturn the status quo and work together at the intersections to create a new reality of collaboration and connection within health and development. 

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