Gender Mainstreaming in Priority Health Programs: The Case of the Diabetes Mellitus Prevention and Control Program in Mexico

This project on gender-sensitive mainstreaming of diabetes mellitus prevention and control in health care was designed to address gender differences in approach to communication with men and women and awareness among health personnel of gender as an aspect of health communication in Mexico. It was selected in 2008 by the Gender, Ethnicity and Health Office of the Pan American Health Organization (PAHO) from entries in their contest “Best practices that incorporate a gender equality perspective in health”.

The National Center for Gender Equity and Reproductive Health (CNEGySR) and the Mexican Secretariat of Health studied public health campaigning based on statistics showing diabetes as a leading cause of disease and death, as well as the illness requiring the most cost-intensive treatment. In 2005, the national Diabetes Prevention and Control Program, with the support of some pharmaceutical laboratories, designed a gender-neutral campaign called México está tomando medidas (“Mexico is taking measures”) to alert people to the impact of excess weight and obesity as risk factors in developing diabetes, high blood pressure, and ischemic heart disease. Included in the campaign was a DVD distributed to those seeking health services for these problems. The DVD included a 30-minute exercise routine that people can do at any time of the day. They also received a paper tape measure to take waistline measurements. Waistline reduction was selected as the campaign focus due to the relevance of excess weight and obesity as risk factors. Based on a gender-sensitive evaluation of this campaign, CNEGySR then produced printed and audiovisual health self-care support materials designed for men and women as separate groups.

The National Center of Epidemiology Surveillance and Disease Control (CENAVECE) and CNEGySR carried out a qualitative evaluation of gender-sensitive materials to compare them with non-sensitive materials in order to document benefits and contributions resulting from the existence of materials specifically for men or women. In 2006, questionnaires were administered to male and female users. Three guides were developed to support comparison of patient records. Interviews were held with the individuals responsible for Education and Quality of Care in each hospital included in the evaluation, in addition to discussion groups with medical and nursing personnel. Based on requests, distribution of gender-differentiated materials was increased in 2007. A qualitative evaluation of acceptance and communication efficacy of these materials was conducted in May 2008. Among the findings were the following: women were more likely to exercise at home with a DVD, rather than in public settings; the motivational tone of the brochures was found to encourage self-care; and the tape measures were seen as a threat by both genders and was frequently not opened.

The experience reinforced the strategy, as stated here, that joint work with the authorities responsible for health programmes is fundamental for the incorporation of the gender equality perspective in health. Support for integrating a gender sensitive approach into the design of the health data system developed to document the care process in Mutual Support Groups (MSGs) focused on diabetes was requested by the Diabetes Prevention and Control Program.