Comparative evaluation of indicators for gender equity and health

Abstract

Objectives: This paper reports on a comparative evaluation of indicators that are in use, or proposed for use, by leading international organizations to assess their adequacy for the purpose of monitoring key issues related to gender, equity and health.Methods: A comprehensive health information framework was developed on a generic framework by the ISO (2001) to use for the analysis of gender equity within mainstream health systems. A sample of 1 095 indicators used by key international organizations were mapped to this framework and assessed for technical quality and gender sensitivity. Results:The evaluation found defi ciencies in the indicators currently in use, from the viewpoint of both technical quality and underlying conceptual bases, as well as in their coverage of the framework, and especially in relation to health system performance.Conclusions: Routine administrative reporting offered large numbers of indicators but these did not allow for monitoring of gender equity and health. The paper concludes that there is merit in developing a core set of leading indicators that can be used for comparisons across peer countries and communities.Performance measurement has become a common feature of health organizations at national and international levels, and the importance of developing and using appropriate indicators has been of concern to the series of international meetings organized by the WHO Kobe Centre (WKC) on women and health and welfare systems. The fi rst of these meetings resulted in the Awaji Declaration (WKC 2000) which outlined principles for reforming the health and welfare system by shifting focus from health care policy to healthy public policy; from access to services to access to health; from institutions to integrated services delivery; from provider-driven care to client and community-centred care; and from narrow indicators of morbidity and effi ciency to broader indicators of equity and well-being. The Canberra Communiqué (WKC 2001) outlined a range of strategies to effect reform, including building women's leadership and capacity in data collection and analysis for action. It called for public health and health services data to be disaggregated by sex, and for collection design and analysis to 'identify gender differences in experiences, impacts, causes and responses to health needs' (WKC 2001). The Kobe Action Plan, (WKC 2002) operationalised the Communiqué and identifi ed the comparative evaluation of indicators of gender equity, gender equality and health used by international agencies as an immediate priority. The work described here is part of this project. Box 1 Defi nitionsGender -the cultural, social, temporal and political constructions of men and women, girls and boys.Gender indicators -measure the status of women against some 'normative' standard or reference group (e. g. men) and should be able to measure changes in women's status and roles over time.Equity -the equally fair treatment of women and men, including recognition that women and men have different needs, prefere...

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