How to do (or not to do)… gender analysis in health systems research

Morgan, Rosemary; George, Asha; Ssali, Sarah; Hawkins, Kate; Molyneux, Sassy; Theobald, Sally

doi:10.1093/heapol/czw037

Cited by 196 publications

(267 citation statements)

References 34 publications

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“…Health systems reflect the social, political and economic contexts they operate in, including gendered social norms [27,28]. A gender analysis in health systems research involves asking questions about the gendered nature of research, programmes or policies and their impact [27,29].…”

Section: Gender Analysis and The Gender Division Of Labour In Healthcarementioning

confidence: 99%

Feminisation of the health workforce and wage conditions of health professions: an exploratory analysis

et al. 2019

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Background: The feminisation of the global health workforce presents a unique challenge for human resource policy and health sector reform which requires an explicit gender focus. Relatively little is known about changes in the gender composition of the health workforce and its impact on drivers of global health workforce dynamics such as wage conditions. In this article, we use a gender analysis to explore if the feminisation of the global health workforce leads to a deterioration of wage conditions in health. Methods: We performed an exploratory, time series analysis of gender disaggregated WageIndicator data. We explored global gender trends, wage gaps and wage conditions over time in selected health occupations. We analysed a sample of 25 countries over 9 years between 2006 and 2014, containing data from 970,894 individuals, with 79,633 participants working in health occupations (48,282 of which reported wage data). We reported by year, country income level and health occupation grouping. Results: The health workforce is feminising, particularly in lower-and upper-middle-income countries. This was associated with a wage gap for women of 26 to 36% less than men, which increased over time. In lower-and upper-middle-income countries, an increasing proportion of women in the health workforce was associated with an increasing gender wage gap and decreasing wage conditions. The gender wage gap was pronounced in both clinical and allied health professions and over lower-middle-, upper-middle-and high-income countries, although the largest gender wage gaps were seen in allied healthcare occupations in lower-middle-income countries. Conclusion: These results, if a true reflection of the global health workforce, have significant implications for health policy and planning and highlight tensions between current, purely economic, framing of health workforce dynamics and the need for more extensive gender analysis. They also highlight the value of a more nuanced approach to health workforce planning that is gender sensitive, specific to countries' levels of development, and considers specific health occupations.

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Section: Gender Analysis and The Gender Division Of Labour In Healthcarementioning

confidence: 99%

Feminisation of the health workforce and wage conditions of health professions: an exploratory analysis

et al. 2019

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“…Table 2 lists a series of questions for researchers to consider when designing their IRP research. Additional opportunities for integrating sex and gender in IRP as relates to models of health systems research have been reviewed in detail elsewhere [33]. …”

Section: Discussionmentioning

confidence: 99%

Why sex and gender matter in implementation research

Tannenbaum

Greaves

Graham

2016

BMC Med Res Methodol

257

243

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BackgroundThere has been a recent swell in activity by health research funding organizations and science journal editors to increase uptake of sex and gender considerations in study design, conduct and reporting in order to ensure that research results apply to everyone. However, examination of the implementation research literature reveals that attention to sex and gender has not yet infiltrated research methods in this field.DiscussionThe rationale for routinely considering sex and gender in implementation research is multifold. Sex and gender are important in decision-making, communication, stakeholder engagement and preferences for the uptake of interventions. Gender roles, gender identity, gender relations, and institutionalized gender influence the way in which an implementation strategy works, for whom, under what circumstances and why. There is emerging evidence that programme theories may operate differently within and across sexes, genders and other intersectional characteristics under various circumstances. Furthermore, without proper study, implementation strategies may inadvertently exploit or ignore, rather than transform thinking about sex and gender-related factors. Techniques are described for measuring and analyzing sex and gender in implementation research using both quantitative and qualitative methods.SummaryThe present paper describes the application of methods for integrating sex and gender in implementation research. Consistently asking critical questions about sex and gender will likely lead to the discovery of positive outcomes, as well as unintended consequences. The result has potential to strengthen both the practice and science of implementation, improve health outcomes and reduce gender inequities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12874-016-0247-7) contains supplementary material, which is available to authorized users.

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“…The majority of studies provide, at most, a cursory mention of gender and the implications these strong social norms have on SRH needs, access and care. Morgan et al (2016), looking specifically at health systems research, recommend incorporating gender analysis into the content, process and outcomes of research through ensuring gender-responsive research questions. The authors also recommend sex disaggregation of results, considering gendered social norms in data collection, using explicit gender analysis frameworks in data analysis and eliciting participant feedback directly.…”

Section: Gender Analysismentioning

confidence: 99%

Adolescent sexual and reproductive health: scoping the impact of programming in low- and middle-income countries

Rankin¹,

Heard²,

Diaz³

2017

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The International Initiative for Impact Evaluation (3ie) is an international grant-making nongovernmental organisation promoting evidence-informed development policies and programmes. We are the global leader in funding and producing high-quality evidence of what works, for whom, why and at what cost. We believe that better and policy-relevant evidence will help make development more effective and improve people's lives. 3ie scoping papers 3ie develops its thematic grant programmes in a particular development area or sector through an organised scoping process. This multifaceted exercise helps ensure that new windows address priorities for evidence production where evidence is limited and gaps have been identified. 3ie scopes the demand for evidence through consultation with potential users, including policymakers, programme managers, researchers and civil society. Scoping exercises usually include producing an evidence map of interventions and outcomes of included studies and reviews. This aids identification of where more or better evidence is needed and where evidence is sufficient for producing systematic reviews. Other scoping can include reviewing existing programming and funding. The results include priority questions for which there is demand for answers. Scoping papers consolidate this information into a justification for what a thematic grant programme will address. About this paper3ie conducted scoping work on adolescent sexual and reproductive health to assess evidence on the effectiveness of related programmes in low-and middle-income countries, and to identify priorities for funding new 3ie impact evaluations and systematic reviews in this area. An evidence gap map is reported in this paper, and is also available in the 3ie Evidence Gap Map Report series, Adolescent sexual and reproductive health: an evidence gap map. An interactive version of the map is available on the 3ie website. The William and Flora Hewlett Foundation provided funding for this scoping project.All of the content is the sole responsibility of the authors and does not represent the opinions of 3ie, its donors or its Board of Commissioners. Any errors and omissions are also the sole responsibility of the authors. Any comments or queries should be directed to the corresponding author, Kristen Rankin, at krankin@3ieimpact.org. AcknowledgementsWe are extremely grateful to James Jarvis-Thiébault, Nadine Pfeifer, Mark Englebert, Julie Perng and Ashley Holst for their research assistance. We could not have done this work without the support and leadership of Annette N Brown and further technical support and review comments from Beryl Leach. We appreciate Edoardo Masset's helpful review comments on the evidence gap map. 3ie developed the evidence gap map with guidance and input from an advisory group, who also reviewed this draft. We are very thankful to its members, listed below. Additionally, 3ie would like to thank the wide range of stakeholders who participated in consultative workshops and a roundtable. A complete list of particip...

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How to do (or not to do)… gender analysis in health systems research

Cited by 196 publications

References 34 publications

Feminisation of the health workforce and wage conditions of health professions: an exploratory analysis

Feminisation of the health workforce and wage conditions of health professions: an exploratory analysis

Why sex and gender matter in implementation research

Adolescent sexual and reproductive health: scoping the impact of programming in low- and middle-income countries

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