Inclusion (& Exclusion): The Basics

People working in development are finding that two questions are increasingly important. These are: who is included? And, who is left out?

Included in what? Left out of what?

Problem analysis: We are faced all the time with problems and we need to understand them. In this process of analysing, have we included all the main actors in the problem?

EXAMPLE: After civil and regional wars, all kinds of activities are carried out to disarm and reintegrate the male soldiers. As the problem is analysed and the interventions developed, women tend to be invisible. But women were victims during the fighting. They may also have been part of the problem, as soldiers (2% of troops in Liberia) or by encouraging husbands to bring back loot. See “Disarming, demobilising and reintegrating (DDR)” below.

EXAMPLE: For too long, the analysis of the issue of HIV/AIDS has focused on women because women are accessible through health facilities such as clinics. In “Working with Men, responding to AIDS, Gender, Sexuality and HIV” below, husbands and boyfriends are put back into the issue.

Developing a good project cycle: We plan, implement and monitor projects that might help the problem. But who are “we”? Have we included all the main actors who are involved? Or are there groups that are invisible, groups that are left outside the door?

EXAMPLE: The Ministry of Health in an African country decided it needed a ten-year Family Planning Plan. Each of the thirteen departments of the Ministry had a male doctor at its head, providing sufficient people for a working group. There were competent female nurses in each department but it was easier to leave them out. So the Family Planning Plan was written and published without the involvement of a single woman – and it was not very good.

Are beneficiaries included as partners?

EXAMPLE: An NGO working with the elderly was set up by good-hearted university graduates. They started a project with no consultation or Needs Assessment. Beneficiaries were seen as passive accepters of a service, not as partners. So young, middle-class, mainly men decided on the needs of elderly, rural, mainly women.

Do your services exclude or include?

Are your Services accessible to all or discouraging to most?

Women and Health: There are major issues around the ways that women cannot get access to services, especially Reproductive Health services. Click here for a publication by WHO on the subject (300kb pdf)

Involving men: The rights and roles of women and men are part of one big picture. Efforts to bring women into the mainstream of development now emphasize partnership between women and men – for example in the field of Reproductive Health and AIDS. The result is this collection of case studies:

"Working with Men, responding to AIDS, Gender, Sexuality and HIV” by Garry Robson, published by the International HIV/AIDS Alliance(68pp pdf). Click on the title and you will go to the AIDS Alliance web site; write "Working with Men HIV"into the Search slot.

“Across the world, people working on HIV/AIDS now recognise the importance of developing their work with men in order to have a real impact on the epidemic. There is a growing interest in identifying strategies that will be effective in reaching out to different groups of men and enabling them to change their attitudes and behaviour”
Garry Robson

What other issues need an understanding of both gender and inclusion?

Women & Disability: A link that will take you to a list of articles on Women and Disability is here. An article well worth reading is “Equity to Women with Disabilities in India”, by Indumathi Rao. She points out that women with disabilities are doubly excluded – because they are women and because they are not fully able.

Young people and Adolescents: According to the WHO publication “Adolescent Friendly Health Services” (789kb pdf), adolescents face a world of opportunities and dangers. They are at risk from many things and may find it difficult to get help from services designed for older people in settled relationships.

The author of the WHO document "HIV/AIDS & Adolescents" sees young people both as highly vulnerable and as the group that can learn to protect itself:

“In order for adolescents to take the risks that are important for their development and avoid those that will do them irreparable harm, their rights to health and development need to be fulfilled. This includes their rights to information and skills, a range of services, a safe and supportive environment, and opportunities to participate.

Frequently, this is not the case. HIV/AIDS flourishes where human rights are not protected. Adolescents are vulnerable because they often do not know how serious the problem of HIV/AIDS is, how it is caused or what they can do to protect themselves. Frequently they also do not have access to services that take their specific needs into consideration.

Some young people are particularly vulnerable. In countries where the predominant mode of transmission is by heterosexual sex, girls are often more vulnerable than boys, for both biological and social reasons.”
In the section that looks at what needs to be done, the document notes the importance (among other things) of:
• Involving young people in the development and implementation of programmes;
• Using HIV/AIDS as an entry point for moving a broader adolescent health and development agenda – many other problems are linked to HIV/AIDS in terms of cause and effect, for example alcohol, drugs and violence, as are protective factors.


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Maeve Moynihan
Human Rights & Inclusion Editor

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