Female health workers in Senegal not only juggle full-time jobs during the day and work a “second shift” when the get home at night, but they are often deployed to health posts far from home. This can exacerbate interpersonal and family conflict, including with their spouses. It can also create delays and bottlenecks in the services they provide to their clients.

The Senegal Ministry of Health and Social Affairs (MSAS) recognized the need to be more responsive to these and other issues of gender inequality, as well as to forms of workplace violence and discrimination, in its foundational Plan to Institutionalize Gender in the MSAS and Reinforce Gender Integration Capacity, developed in 2015.

This strategic planning document aims to integrate gender equality in human resources management in the health sector, such as promoting decent work and a culture of gender equality; challenging stereotypes; supporting female health workers to integrate professional work and family life; and countering gender-based violence, discrimination and sexual harassment in health professional workplaces, starting with a sectoral code of conduct.

Rights, entitlements, opportunities, and access are not equally distributed throughout society.

To implement this plan, Senegal’s MSAS Gender Cell worked with IntraHealth International’s Neema project last month to convene 38 gender focal points from its regions, the MSAS Human Resources and Research units, and the Ministry of Women, Family, and Childhood. They gathered during July 30 – August 2 to discuss Senegal’s relevant policies, gender discrimination and inequality in the health sector, and the transformative principles and practices of substantive gender equality.

They also discussed the challenges and opportunities for addressing gender discrimination and inequality in Senegal’s health sector, and then voted on priority challenges to tackle in developing a gender-transformative human resource management policy. The first was to develop a roadmap to designing the sectoral code of conduct.

Transformative policies promote the relative position of women, girls, and marginalized groups and attempt to transform the underlying social structures, policies, and broadly held social norms that perpetuate gender inequality.  

Operationally, this involves using substantive equality principles, special measures, and enabling conditions to:

• End impunity for perpetrators of sexual harassment and other forms of discrimination.
• Introduce, make use of, or further legal protections against gender discrimination.
• Transform family, school, and/or work arrangements so that women are not penalized or disadvantaged for caregiving.
• Challenge and change common discriminatory gender beliefs or norms.
• Change the imbalance of power or otherwise level the playing field.

Substantive equality is central to any conception of gender-transformative workforce policy because it recognizes that rights, entitlements, opportunities, and access are not equally distributed throughout society, and that there is a need to counter the effects of past (or present) systemic structural discrimination by temporary special measures that sometimes treat people differently in order to achieve equal outcomes.

Special measures, enshrined in human rights treaties such as the Convention to Eliminate All Forms of Discrimination Against Women, seek to neutralize and redress preferences held by other more privileged groups that are often already embedded in social and work institutions.

Effective temporary special measures such as affirmative action aim to end historic discrimination. They place women or other marginalized groups in a situation of comparative advantage for a limited period, in higher numbers than would otherwise occur, with the aim of achieving substantive equality in the long term.

And temporary special measures can also include or be supplemented by:

• Measures that actively involve or build the capacity of workers and managers to understand new equality measures and initiatives, to raise awareness about gender bias and stereotyping, or to claim rights and opportunities. For example, workers’ rights education.
• Governance mechanisms and complaints procedures that address any allegations of bias or discrimination and create disincentives against future discrimination. For example, organizational sexual harassment policies.
• Enabling conditions, which are institutional arrangements or policies that support work-family integration or otherwise enable disadvantaged groups to access opportunities and achieve substantive gender equality in the workplace. For example, on-worksite child care.

The first three days of the MSAS meeting provided the foundation for developing a gender-transformative code of conduct (rollout planned for the spring of 2019). A key activity will be field research on workplace sexual harassment and other forms of gender discrimination in seven regions. The group will also convene a taskforce, advocate to policy stakeholders to assure support for adoption, design, development, implementation, and follow up of the code of conduct.  

We need to take a courageous and innovative position.

“The challenges of developing and implementing a code of conduct against discrimination in the context of health work in Senegal are great, but we can overcome them," says Dr. Maimouna N’doye, Neema’s technical advisor for gender and youth. “We need to take a courageous and innovative position. Senegal ratified the Convention to Eliminate All Forms of Discrimination Against Women, whose preamble states that ‘the role of women in procreation must not be a cause of discrimination’. There is no better kickoff to fight discrimination in the workplace!”

This Senegal code of conduct intervention is part of a new initiative to extend gender transformative workforce policy and practice in francophone West Africa, where the IntraHealth-led Mali Human Resources for Health Strengthening Activity is preparing a gender analysis on behalf of Mali’s Human Resources Directorate, whose results will be disseminated and used to inform gender-transformative human resources policies and action plans in the health sector.

This activity is part of the US Agency for International Development-funded Neema project, led by IntraHealth International. IntraHealth works on gender equality and gender-based violence prevention efforts in collaboration with the Ministry of Women, Family, and Gender; the Ministry of Health; the Ministry of National Education; and UNWomen in 7 regions in Senegal (Kolda, Sédhiou, Saint Louis, Matam, Tambacounda, Kédougou, and Diourbel).