Exploring the role of gender and women in the political economy of health in armed conflict: a narrative review

Abstract

Background The ripple effects of protracted armed conflicts include: significant gender-specific barriers to accessing essential services such as health, education, water and sanitation and broader macroeconomic challenges such as increased poverty rates, higher debt burdens, and deteriorating employment prospects. These factors influence the wider social and political determinants of health for women and a gendered analysis of the political economy of health in conflict may support strengthening health systems during conflict. This will in turn lead to equality and equity across not only health, but broader sectors and systems, that contribute to sustainable peace building. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on women and gender in the political economy of health in conflict. Results The existing literature that contributes to the emerging area on the political economy of health in conflict has overlooked gender and specifically the role of women as a critical component. Gender analysis is incorporated into existing post-conflict health systems research, but this does not extend to countries actively affected by armed conflict and humanitarian crises. The analysis also tends to ignore the socially constructed patriarchal systems, power relations and gender norms that often lead to vastly different health system needs, experiences and health outcomes. Conclusions Detailed case studies on the gendered political economy of health in countries impacted by complex protracted conflict will support efforts to improve health equity and understanding of gender relations that support health systems strengthening.

Strengthening health systems and peacebuilding through women’s leadership: a qualitative study

“…In most settings, we found women face systematic and structural barriers to participating in and advancing leadership positions in the health system, similar to the wider literature on women's leadership in health systems [54]. Advancing women's leadership in conflict settings is exacerbated by security issues and systems wide patriarchal attitudes emboldened by the presence of conflict [47,55,56]. Lack of political will to enhance women's leadership in health, alongside the policies adopted by de facto authorities in some contexts, contributed to reversing the privileges that women have recently achieved regarding access to leadership positions.…”

A missing piece in the Health for Peace agenda: gender diverse leadership and governance

“… 36 Our recent study shows that women’s inclusion in the political economy of health in conflict has greater dividends for sustainable peace and more equitable social economic recovery in the post-conflict period. 37 Yet, the conflict literature features very limited discussions on the important role of gender equity and equality within a broader health systems emphasis; its focus to date has been predominantly in very few post-conflict settings.…”

Gender and leadership in conflict settings

“…Women Leaders in Health and Conflict Initiative research found limited evidence on the role and impact of women’s leadership at the nexus of health and conflict. 4 , 5 A move is required from often anecdotal discussion to the development of rigorous and authoritative evidence. Advocating for women’s rights can be complemented by evidencing the impact of women’s leadership on humanitarian action such as minimizing risk and better decision-making.…”

“…7 The approach to women’s leadership must be inclusive, institutionalized and focused on intersectionality. 5 …”