Gender disparities in refugee
contexts: Case studies using
health indicators
Khassoum Diallo
Senior Statistician
UNHCR
Global Forum on Gender Statistics, Manila 11-13 October, 2010
ESA/STAT/AC.219/20
SCOPE OF FORCED DISPLACEMENT

Forcibly displaced persons
represent a significant share of
the de facto population of many
countries
Share of displaced population vs total population, end
2009
Syria



Refugees and Asylum-seekers ~
16 million end-2009. Internally
Displaced People (27 million)
Daddab refugee camp (300,000
people): 4th city of Kenya does
not appear in any official
statistics or map of Kenya
In many countries, MDGs or
other international goals cannot
be achieved without addressing
the needs of populations affected
by conflicts and emergencies,
especially women and children
5%
Jordan
8%
Colombia
10%
Afghanistan
0%
12%
2%
4%
6%
8%
10%
12%
2
Demographic patterns



Increasing share of urban refugees
(close to 60% in 2009
Between 70-90% of refugees remain in
their region of origin
Age & sex distribution
Female
Category
Male
0-4yrs
5-11yrs
12-17yrs
18-59yrs 60yrs+
0-4yrs
5-11yrs 12-17yrs 18-59yrs
60yrs+
R+AS
5%
9%
7%
24%
2%
5%
10%
8%
27%
2%
IDPs
5%
9%
7%
26%
3%
5%
10%
7%
26%
3%
RET
9%
12%
7%
19%
2%
9%
13%
8%
19%
2%
RDP
11%
13%
6%
25%
1%
10%
10%
6%
17%
1%
3
Data Sources & methods






UNHCR’s Health Information System
The Standards and Indicators Programme
(over 100 countries, by location)
Participatory assessments (over 120
countries, at least once every year)
Routine registration and monitoring
system from Governments & other
partners
Mix of sources (surveys, censuses,
estimation methods etc.)
Data quality assessment and triangulation
4
Health Information System
Core health topics: Mortality, morbidity, RH, Nutrition, Access to
5
services
Relationships
Conflict
Displacement
Health
Gender related issues: Women, men, boys and girls impacted
differently
• Gender based violence (e.g. rape, domestic violence)
• Reproductive/including maternal health
• Access to health services
6
Analyses/ Presentation Methods



Gap and Trends analyses
Scorecards
Indices: Composite indices,
including the gender parity index
7
Illustration using selected indicators




Access to services
Women’s empowerment
Gender based violence
HIV Testing and Counseling
8
Access and use of health facilities
% of deliveries at health centers, 2009
Zambia
Yemen
Uganda
Thailand
Tanzania
Sudan
Rw anda
Nepal
Kenya
Ethiopia
Djibouti
Chad
Cameroon
Burundi
Bangladesh
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
9
Women’s participation in decision making
Percentage of camps w hich meet the standard of minimum 50% female members in food
distribution committees
Camp Indicator
Standard not met
Less than 45% involved in
distribution are w omen
Standard almost met
45-50% involved in
distribution are w omen
Standard Met
More than 50% involved in
distribution are w omen
10
VCT: Tested for HIV
VCT: Tested for HIV refugees > 18 years
female
male
100%
90%
80%
60%
50%
40%
30%
20%
10%
Ug
an
da
Rw
an
da
Bu
ru
nd
i
Dj
ibo
ut
i
Ye
m
en
bia
Za
m
Ke
ny
a
Su
da
n
Ch
ad
Ne
pa
l
Gu
in
ea
0%
Ta
nz
an
ia
% by sex
70%
11
Measuring performance in health
CRITERIA
INDICATOR - CAMP
No. of
camps
STANDARD
ALMOST MET
Yes
NOT MET
No
Does your office have a Standard Operating Procedure (SOP) for
SGBV?
% of Camps
%
%
%
Standa
Stan
Standar
rd
dard
d not
almost
Met
met
met
89
92%
75
88%
3%
9%
64
97%
2%
2%
90
23%
6%
71%
81
77%
1%
22%
Percentage of food beneficiaries entitled to food who received
food during latest food distribution
82
71%
23%
6%
<2,000
Average number of kilocalories available per person per day
84
48%
6%
46%
45-49%
<45%
Percentage of female members in food distribution committees
10,001-12,000
>12000
Min 50%
40-49%
<40%
Max 15%
15-20%
>20%
Min 90%
80-89%
<80%
100%
90-99%
<90%
100%
90-99%
<90%
Min 10%
7-10%
<7%
Min 10%
7-10%
<7%
100%
90-99%
<90%
Min 2,100
2,001-2,001
Min 50%
Max 10,000
No
Yes
Percentage of SGBV cases who received support (DP)
Percentage of SGBV cases <18 years old who received support
(DP)
Percentage of asylum-seekers / refugees who participated in
SGBV training
Percentage of UNHCR and partner staff who have completed
SGBV training
No. of persons per primary health care facility
Percentage of live births attended by skilled personnel (excl.
TBAs)
Percentage of newborn children with low birth weight (< 2500 gs)
(weighed within 72 hrs)
Measles vaccination coverage
Have stocks of condoms run out for more than a week?
8%
76
68%
4%
28%
138
52%
7%
41%
128
62%
2%
36%
122
97%
1%
2%
95
64%
17%
19%
90
69%
103
57%
9%
34%
31%
Min 20 L.
18-19 L
<18 L
Average quantity of water available per person per day (litres)
Max 80
81-100
>100
No. of persons per usable water tap
82
52%
12%
35%
Max 200
201-250
>250
No. of persons per usable well/hand pump
59
51%
7%
42%
100%
90-99%
<90%
Percentage of pop. living within 200 m from water point
98
55%
11%
34%
12
Gender Parity Index (GPI)
Gender parity index (GPI) 2009 (Ordered)
GPI Definition
Ratio of female to male values of a given indicator. A GPI of 1 indicates parity between sexes.
The gender parity index (GPI): ratio between the female and the male rates (F/M), where:
GPI below 1 means disparity in favor of boys/men
GPI = 1 means parity (the male and female indicators are equal)
GPI above 1 means disparity in favor of girls or
Indicator
Percentage of UNHCR and partner staff w ho have
completed SGBV training (RET)
Percentage of UNHCR and partner staff w ho have
completed SGBV training (CMP)
Percentage of SGBV cases w ho received support (URB)
Percentage of SGBV cases w ho received support (RET)
GPI
Female
Male
(Gender
Denominat Female
Female Denominat
Male
Male
Parity
or
Numerator Indicator
or
Numerator Indicator Index F/M)
678
400
59.0%
1,160
435
37.5%
1.57
2,981
799
26.8%
6,577
1,528
23.2%
1.15
2,190
1,733
79.1%
147
110
74.8%
1.06
682
542
79.5%
69
68
98.6%
0.81
13
In conclusion: Lessons learnt from
gender analyses




Gender disparities remain high for many
health-related indicators in a number of
refugee contexts
Difficult to analyze most of maternal
health indicators from a gender
perspective
Data collection and quality remain a
challenge
Post analysis phase: translation of
findings
14