Execution of an IR project with an intersectional gender lens

Reflexivity process by the implementation team

The composition of the implementation team and meaningful stakeholder/community engagement are both vital to inform your project design and implementation activities. Researchers should be self-aware of their own biases to avoid any social prejudices against the study participants. Thus, before implementing your project, use the questions in Table 11 to guide your research team to critically reflect on your own biases and power dynamics might impact the project activities.

Development of data collection tools with an intersectional gender lens

Collaborate with the research participants when designing the research tools for your study. It is important to include some research participants in your research team. This participatory approach will not only enhance the relevance and sensitivity of the questions in your study tools, but also minimize power imbalances in the research process, as well as the risk of perpetuating stigma and social injustice.²² Use gender frameworks as a basis for developing questions with an intersectional gender lens to explore how the different social variables under analysis intersect with the relevant gender domains to shape participants’ experiences with the IR intervention. Use the information from the intersectional gender analysis matrix to design the data collection tools.

Below are some tips for designing questions for data collection tools incorporating an intersectional gender lens:^73,74,75

• Ensure that the questions capture details of the different social variables (e.g. sex, gender identity, education level, ethnicity etc.) so data can be disaggregated as relevant to your study.
• Consider gender relations domains that are most relevant in the context of your study.
• While developing the data collection tools, consider the differences between the needs of women, men and non-binary people and how such differences vary in specific situations relevant for your study.
• Start questions by asking about one social variable first (i.e. avoid combining two variables in a single question). For example, do not ask: “How do you think your age or gender identity influence your decision to seek health care?” Rather, begin the question with: “How do you think that your gender identity influences your decision to seek health care?” The other intersecting social variables such as age, sex, ethnicity, sexual orientation, education etc. can be asked subsequently so all the variables – as adequate to your study – can be included.
• Questions must allow for intersectional gender interactions to be investigated. For example, how does being a woman and being a migrant affects one’s access to health care in a specific context?
• The data collection tools/methods must be sensitive to the participant’s identity. For example, be sensitive to the different social variables of the study participants’ and formulate questions paying extra attention to the wording of the questions, avoiding gender stereotypes, misconceptions or stigmatizing terms.
• Include some open questions about the participants’ experience with the intervention. (See: Developing gender-sensitive indicators)

Pre-testing of the data collection process

All study instruments (quantitative and qualitative) should be pre-tested to check the validity and reliability of data collection tools. Pre-testing allows the research team to check whether the research instructions and questions are clear, context-specific and that adequate time has been allowed to administer the questionnaire, etc. Ideally, pre- testing with individuals from the population of interest ensures that potential participants understand the questions and helps the research teams to design questions that are sensitive to the needs and experiences of participants.⁷⁶ If this is not feasible, pre-testing should be conducted from a comparable study population and environment.

Pre-testing the research methodology with participants, and using their feedback, can make the research design more robust. It assists identification of ideal data collection sites, time periods for data collection and any other related requirements that may have been overlooked during the planning phase, such as compensation of participants.⁷⁰ Since data management is critical to the success of the research, the research team should be available during discussions that follows the pre-test, in order to incorporate changes into the final design of the tool and facilitate the incorporation of appropriate checks into the data entry system. This stage includes designing the forms for recording measurements, developing programmes for data entry, management and analysis, as well as planning dummy tabulations to ensure the appropriate variables are collected.

The implementation of the overall research project involves both conducting and monitoring the proposed activities, as well as updating and revising the project plan according to emerging lessons and/or conditions. You should be aware that the planning and start-up phases of an IR project can take a considerable amount of time, especially when the project is intentional about ensuring gender inclusion aspects. You should take this into consideration while developing your project timeline. As mentioned, your implementation team should be interdisciplinary in nature with expertise in heath, gender and intersectionality research, and should be self-aware of their own biases. Use participatory approaches, methods and tools and be respectful and accountable to research participants and the community at large. (See: Project execution)

Consider the following tips to incorporate an intersectional gender lens when implementing your IR project:

• Ensure a robust study design that allows analysis of why and how relevant social variables intersect to influence implementation.
• Determine what intersecting social variables are most relevant to the implementation context and why.
• Conduct activities during times and spaces when respondents are likely to be available and free to interact with the project team.
• Use formats that are readily accessible to participants (e.g. meetings, surveys on paper, online, phone calls).
• Explore how the study participants with different social variables are impacted by the IR problem in question.
• Provide the research team with adequate capacities, expertise and resources on approaches to enable them to conduct intersectional gender analysis.

Project monitoring

The main objective of monitoring is to assess whether the project implementation is aligned with the IR project objectives and plan. (See: Planning and conducting IR)

IR teams should conduct monitoring continuously, with the aim of improving project implementation processes. Use your baseline indicators to monitor both the process as well as the progress of the project activities. Seek feedback and adjust accordingly. Assess indicators for different groups of people in each project area, for example:

• Obtain feedback from team members and project participants on whether the project is meeting their needs and request their suggestions for improvement.
• If all project stakeholders are unable to participate, ascertain the reasons why not. For example, in certain contexts, women may not have been able to participate because they needed permission from their spouses.
• Adjust your research plan as necessary to enable you to achieve the IR project objectives.

Dissemination and uptake of research findings

Communication must be an ongoing and continuous component of the overall IR project process from initial planning stages, throughout implementation and during the final evaluation. Involving stakeholders in the development process early enhances ownership of the project, drives engagement in the process and promotes the ultimate uptake of the research findings and conclusions. Transparency, openness and engagement among IR team members, and with broader project stakeholders and participants are vital elements. Implementation research is different from other forms of research because the IR study can be adjusted according to the bottlenecks identified during the phases of the IR cycle. As new knowledge and data are being generated from your study, it is important to share them with stakeholders and key end-users during interactive collaborative sessions. This integrated knowledge translation approach will not only help researchers become more active and context-aware but also creates a much higher likelihood of the research findings being acknowledged, augmented and used by stakeholders and end-users. End-of-study knowledge translation activities are typically conducted at the end of the research and are focused on translating knowledge into more conventional information products and disseminating those to generally broader audiences, and over a longer period. The information should be accessible, simple to comprehend and clear, and communicated widely in an effective way through use of appropriate language, formats and technologies. Focus on the needs of the target audience, including the scientific community, nongovernmental organizations, policy-makers, technical staff and service providers, participants, and beneficiaries of the study. During dissemination consider the following points from an intersectional gender lens:

1. All forms of communication must avoid the reinforcement of gender stereotypes as well as harmful gender norms, roles and relations.
2. Present findings that are relevant to the study participants and, in doing so, highlight how the intersection of social variables influence an individual’s experience at the household, community and health system levels.
3. Report disaggregated results, ensuring participants’ confidentiality and anonymity.
4. Use inclusive, bias-free language, that is sensitive to the local geographical setting and cultural context.
5. Images and the type of media used to communicate health messages can and should be used to challenge gender-based stereotypes that may harm health. Avoid use of images depicting stereotypes or fostering stigma.
6. Highlight varying individual experiences in relation to gender power dynamics and at the different levels of the health system, household, community and institutional levels.
7. During the policy-making process, information should be presented to ensure decision-makers understand how the information impacts various populations, and how they are linked to inequalities in health outcomes. For example, highlight differences between vulnerable and non-vulnerable populations, and how information affects their access to health interventions, and how results differ in their health outcomes. (See: Gender considerations within the dissemination and reporting of infectious disease research, See: IR-related communications and advocacy)

Evaluation and closure of a research project

At project closure, your project team should reflect upon and discuss successes, failures and lessons learned and re-plan accordingly. (See: Planning and conducting IR)

Some contemplative questions on the lessons learned include the following:

• Was the time allocated to complete the various IR project activities sufficient/adequate?
• Did the project achieve desired, anticipated and/or unexpected outcomes?
• What difference did the project make for the participants and their communities?
• Did the project change or reinforce any gender-specific outcomes/attributes?
• What could be designed differently in a future IR project to enhance the inclusion of an intersectional gender lens ?