The Fourth World Conference on Women, Beijing, 1995, embraced gender mainstreaming as a viable strategy to tackle the multifaceted drivers of gender inequality. In-line with this the Government of Ethiopia adopted mainstreaming approaches in the different sectoral ministries, internal processes, programs and projects, supported by the Ethiopia’s National Policy on Women (“Women’s Policy”), formulated in 1993, and formulation of a Gender Directorate in 2008, under the Federal Ministry of Health (FMOH). However, in terms of pursuing and implementing gender mainstreaming, many countries, including Ethiopia faced challenges due to lack of conceptual clarity and technical tools on how to mainstream gender, monitor, and evaluate progress. Despite efforts made by the Ethiopian health sector to set-up an institutional structure and allocate staff and budget for gender mainstreaming, the process was not based on clear direction and agreed terms with each of the internal departments and processes with in the Ministry. 
To address these challenges Pathfinder International Ethiopia, in close partnership with the Ethiopia FMOH, initiated technical and advocacy efforts to support development of FMOH gender mainstreaming strategy and policies and ensure they are understood and operationalized. Pathfinder International Ethiopia developed a Gender Mainstreaming Training Manual and trained health managers and providers on conducting gender analysis and mainstreaming gender at all levels. Pathfinder actively advocated with the MOH’s Women and Youth Affairs Directorate to develop a standard national guideline for gender mainstreaming. 
As a result of this advocacy, policy, and training support the MOH initiated a technical working group to articulate the gender related gaps and opportunities across the six building blocks of the health system. Gender issues were identified in each block, required interventions were designed, a monitoring and evaluation framework was established in collaboration with key stakeholders leading the health system and service delivery. Specific checklists were developed identifying roles and responsibilities of each unit to increase accountability in closing gender gaps. This process finally yielded the development of the Ethiopian Health Sector Gender Mainstreaming Manual, which set the bar for gender integration work high and laid an example for other sectors to do the same.

Setting the Bar: Gender Mainstreaming in the Ethiopian Health Sector