Gender equality and gender norms: framing the opportunities for health

Gupta, Geeta Rao; Oomman, Nandini; Grown, Caren; Conn, Kathryn L.; Hawkes, Sarah; Shawar, Yusra Ribhi; Shiffman, Jeremy; Buse, Kent; Mehra, Rekha; Bah, Chernor A; Heise, Lori; Greene, Michael B.; Weber, Ann M.; Heymann, Jody; Hay, Katherine; Raj, Anita; Henry, Sarah; Klugman, Jeni; Darmstadt, Gary L.

doi:10.1016/s0140-6736(19)30651-8

Cited by 194 publications

(168 citation statements)

References 71 publications

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“…Recognizing gender-specific aspects of disease acquisition, detection, treatment options, and response to treatment can help ensure that health policies are effective and equitable. As the historical legacy of gender-based inequality is deeply embedded in medical research and the health sector, action to prevent undue gender-specific disparities in health outcomes is an ethical imperative and mandated in the SDG [32].…”

Section: Resultsmentioning

confidence: 99%

Vivax malaria in pregnancy and lactation: a long way to health equity

Brummaier

Gilder

Gornsawun

et al. 2020

Malar J

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Background: The Sustainable Development Goals (SDG) call for increased gender equity and reduction in malariarelated mortality and morbidity. Plasmodium vivax infections in pregnancy are associated with maternal anaemia and increased adverse perinatal outcomes. Providing radical cure for women with 8-aminoquinolines (e.g., primaquine) is hindered by gender-specific complexities. Case presentation: A symptomatic episode of vivax malaria at 18 weeks of gestation in a primigravid woman was associated with maternal anaemia, a recurrent asymptomatic P. vivax episode, severe intra-uterine growth restriction with no other identifiable cause and induction to reduce the risk of stillbirth. At 5 months postpartum a qualitative glucose-6-phosphate dehydrogenase (G6PD) point-of-care test was normal and radical cure with primaquine was prescribed to the mother. A 33% fractional decrease in haematocrit on day 7 of primaquine led to further testing which showed intermediate phenotypic G6PD activity; the G6PD genotype could not be identified. Her infant daughter was well throughout maternal treatment and found to be heterozygous for Mahidol variant. Conclusion: Adverse effects of vivax malaria in pregnancy, ineligibility of radical cure for pregnant and postpartum women, and difficulties in diagnosing intermediate levels of G6PD activity multiplied morbidity in this woman. Steps towards meeting the SDG include prevention of malaria in pregnancy, reducing unnecessary exclusion of women from radical cure, and accessible quantitative G6PD screening in P. vivax-endemic settings.

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Section: Resultsmentioning

confidence: 99%

Vivax malaria in pregnancy and lactation: a long way to health equity

Brummaier

Gilder

Gornsawun

et al. 2020

Malar J

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“…The 2030 Agenda for Sustainable Development/Sustainable Development Goals (SDGs) represents a unique opportunity to promote human rights, equality, and well‐being for all . This bold, visionary global agenda aims to “leave no one behind” and “reach the furthest behind first,” with a view toward eliminating all forms of extreme human suffering.…”

Section: Leaving No One Behindmentioning

confidence: 99%

Leaving no one behind: Is the achievement of the Sustainable Development Goals possible without securing the dignity, rights, and well‐being of those who are “invisible”?

Anastasi

Asiamah

Lal

2020

Intl J Gynecology & Obste

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The persistence of obstetric fistula-a devastating childbirth injury occurring largely among poor, marginalized women and girls-constitutes a human rights violation and a public health crisis. The Sustainable Development Goals (SDGs) aim to "leave no one behind." Failing to eliminate fistula jeopardizes attainment of several of the SDGs.Member States of the United Nations adopted a UN Resolution on ending fistula in 2018, calling for an end to fistula within a decade. Building upon recommendations of the UN Secretary General's 2018 Report on Obstetric Fistula, the Resolution calls for significantly increased commitments and investments to end fistula. Crucial interventions for eliminating fistula include high-quality, equitable, accessible health systems; implementing costed national strategies for eliminating fistula; integrating fistula into national plans to achieve the SDGs; strengthening national fistula task forces; and significantly increased, sustained financial support. Fistula elimination necessitates protecting women's/girls' human rights and addressing social determinants that affect women's/girls' ability to "survive, thrive and transform," including social and economic inequities; gender-based violence; child marriage and early childbearing; and access to education. Enhanced awareness-raising and advocacy; improved research, data, monitoring and evaluation; holistic social reintegration and survivor empowerment; and community engagement are additional key strategies for realizing this ambitious goal.

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“…Many organisations involved in global health governance have adopted formal gender strategies that seek to mainstream gender in activities and programs, address inequalities, ensure gender-responsive health delivery, and strengthen responses for women, men, girls, boys and non-binary people. In practice, however, few prioritise the issue [1][2][3][4][5]. Institutions with considerable power to shape global responses to health problems therefore largely overlook gender inequality as a fundamental driver of health inequities and adverse health outcomes.…”

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confidence: 99%

Political challenges to prioritizing gender in global health organisations

Shawar

Shiffman

2020

Journal of Global Health

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Political challenges to prioritizing gender in global health organisations Background Many global health organisations have adopted formal strategies to integrate gender in their programming. In practice, few prioritise the issue. Institutions with considerable global power therefore largely overlook fundamental drivers of adverse health outcomes: gender inequality and harmful gender norms. We analyse the factors shaping attention to gender in organisations involved in global health governance. Methods Drawing on scholarship from the fields of organisational behavior and management, sociology, international relations and the policy process, we undertook a thematic analysis of peer-reviewed scholarship and organisational documents. We also conducted 20 semi-structured interviews over Skype with individuals working at the cross-section of gender and health. Results In seeking to reform the policies and practices of global health organisations, gender proponents confront patriarchal organisational cultures, hostile political environments and an issue that is difficult to address as it requires upsetting existing power structures. Proponents also face three linked challenges internal to their own networks. First, there is little cohesion among champions themselves, as they are fragmented into multiple networks. Second, proponents differ on the nature of the problem and solutions, including whether reducing gender inequality or addressing harmful gender norms is the primary goal, the role of men in gender initiatives, which health issues to prioritise, and even the value of proponent cohesion. Third, there are disagreements among proponents on how to convey the problem. Some advance an instrumental case, while others believe that it should be portrayed as a human rights issue and using any other argument undermines that fundamental justification. Conclusions Prospects for building more gender-responsive global health organisations will depend in part on the ability of proponents to address these disagreements and develop strategies for negotiating difficult organisational cultures and political environments.

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Gender equality and gender norms: framing the opportunities for health

Cited by 194 publications

References 71 publications

Vivax malaria in pregnancy and lactation: a long way to health equity

Vivax malaria in pregnancy and lactation: a long way to health equity

Leaving no one behind: Is the achievement of the Sustainable Development Goals possible without securing the dignity, rights, and well‐being of those who are “invisible”?

Political challenges to prioritizing gender in global health organisations

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