Sex and Gender in Research on Healthcare Workers in Conflict Settings: A Scoping Review

Habib, Rima R.; Halwani, Dana A.; Mikati, Diana; Hneiny, Layal

doi:10.3390/ijerph17124331

Cited by 10 publications

(9 citation statements)

References 86 publications

(185 reference statements)

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“…This supports findings from other settings, for example, Afghanistan and Somalia, which described health worker shortages, preferences for women health workers, gender inequalities, multiple employments and donor dependence amid ongoing insecurity 37–39. Many challenges women health workers encountered were similar for men, but impacts often affected women disproportionately 40–44. Women described complexities and challenges in how conflict influenced professional and social gender norms, including increased but more precarious work opportunities, harassment and violence.…”

Section: Discussionsupporting

confidence: 79%

“…[37][38][39] Many challenges women health workers encountered were similar for men, but impacts often affected women disproportionately. [40][41][42][43][44] Women described complexities and challenges in how conflict influenced professional and social gender norms, including increased but more precarious work opportunities, harassment and violence. Differential treatment by managers, often based on INGO policies, increased work stress and precarity.…”

Section: Discussionmentioning

confidence: 99%

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’We are trying to live in a normal way, but nothing is normal about us anymore…’: a qualitative study of women’s lived experiences of healthcare in opposition-controlled areas of Syria

et al. 2022

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IntroductionThe Syrian conflict, which has included mass killings, displacement, infrastructure destruction and illegal targeting of health facilities and staff mainly by the Syrian government and allies, is in its 10th year. This study explored the lived experiences of women within healthcare, both as health workers and service users, in Syrian opposition-controlled areas (OCAs).MethodsWe chose a qualitative study design, with 20 in-depth interviews conducted remotely over WhatsApp and Messenger with purposively sampled Syrian women (ie, 15 health workers, 5 service users). We analysed data using interpretative phenomenological analysis.ResultsAnxiety, fear and horror affected women’s everyday work and wellness. Excess workload and insecurity were major challenges for women health workers, who also had household and caring responsibilities. Coping mechanisms included: (1) normalising death; (2) acceptance of God’s will; and (3) focusing on controllable issues such as health services provision while accepting the reality of insecurity and death. Conflict contributed to changing social norms and expectations, and women became key actors in healthcare provision, though this did not translate directly into greater decision-making authority. Structural biases (eg, lack of maternity leave) and gender-based violence (eg, increased harassment and child marriage) inordinately affected women.ConclusionThis is a first effort to amplify women’s voices in health policy and systems research on the Syrian conflict. Women have become key healthcare providers in OCAs but remain under-represented in decision making. While the conflict-related social transformation, increasing the role of—and demand for—women health workers could be viewed positively for women’s empowerment, the reality is complex and long-term implications are unclear.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

’We are trying to live in a normal way, but nothing is normal about us anymore…’: a qualitative study of women’s lived experiences of healthcare in opposition-controlled areas of Syria

et al. 2022

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“…However, regulatory reforms and frameworks tend not to sufficiently address gender concerns. Armed conflicts have distinct burdens on men and women in the health workforce; studying these differences within health systems and their relation to job type, task distribution, exposures, and health outcomes in men and women is essential [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

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

2021

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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.

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“…Although males represented a smaller portion of the workforce than females, they had a higher rate of injuries related to intentional violence than their female colleagues. Although the reasons for this are unclear, research by Habib et al 17 found that males report higher exposures to physical violence and abuse, whereas females report more verbal abuse. A higher exposure to physical violence may partially explain higher injury rates.…”

Section: Discussionmentioning

confidence: 99%

Workplace violence against healthcare workers using nationally representative estimates of emergency department data, 2015–2017

Carey

Hendricks

2023

American J Industrial Med

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Introduction: Workers in the healthcare industry are at increased risk for workplace violence. The goal of this analysis is to determine the rate of injuries healthcare workers incurred as a result of intentional violence by patients in the workplace.Methods: Injuries linked to workplace violence that were treated in US emergency departments from 2015 to 2017 were identified using data from the National Electronic Injury Surveillance System-Occupational Supplement (NEISS-Work). All estimates and 95% confidence intervals were calculated using SAS ® 9.4 Proc Survey to incorporate the stratified sample design of NEISS-Work.Results: Approximately 1.14 million injuries to workers in the healthcare industry were treated in US hospital emergency departments between 2015 and 2017.Intentional injuries by another person accounted for 15% of these healthcare-related injuries. The results also showed that male healthcare workers' rate of injuries was 2.3 times higher than their female counterparts despite composing a smaller proportion of the workforce. Injury rates were highest among the less-than-25 age group, and decreased as healthcare workers' age increased.Conclusions: Workplace violence is a serious problem in today's healthcare settings that affects both employees and patient care. Although violence in the healthcare industry has been researched for decades, there has been an increase in violent incidents in this industrial sector. The disparity in injury rates by sex and age are areas of concern. Further research in these areas is necessary to understand the root causes of these incidents and inform violence prevention strategies.

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Sex and Gender in Research on Healthcare Workers in Conflict Settings: A Scoping Review

Cited by 10 publications

References 86 publications

’We are trying to live in a normal way, but nothing is normal about us anymore…’: a qualitative study of women’s lived experiences of healthcare in opposition-controlled areas of Syria

’We are trying to live in a normal way, but nothing is normal about us anymore…’: a qualitative study of women’s lived experiences of healthcare in opposition-controlled areas of Syria

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

Workplace violence against healthcare workers using nationally representative estimates of emergency department data, 2015–2017

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