Targeting Gender-Related Barriers to Health as UN Focuses on Gender Equality

Last week the 66th session of the United Nations (UN) Commission on the Status of Women wrapped up discussions on achieving gender equality and empowerment of all women particularly in the context of climate change and the ever-changing work world. Gender inequality in many areas  contributes to poor health and well-being for not only  women but for all people.

The COVID-19 pandemic has highlighted inequalities linked to gender, challenging progress toward gender equality (equal outcomes for women, men, and gender-diverse people) and setting back efforts to close the gender gap by an estimated 36 years, according to the World Economic Forum’s 2021 Global Gender Gap.

While a focus on gender is inherent in some global health efforts such as family planning and maternal health, all efforts to improve health and well-being can benefit from using a gender lens to illuminate key issues and opportunities.

Below are ways that some Task Force  programs apply a gender lens to address inequalities.

Our Children Without Worms (CWW) program focuses on controlling and eliminating soil-transmitted helminth (STH) infections, commonly known as intestinal worms, in school-age children, women of reproductive age and adolescent girls.

Intestinal worms seriously affect pregnant women and women of reproductive age because the conditions caused by worms leaves women at higher risk of maternal and infant mortality and iron-deficiency anemia. This past year CWW partnered with the World Health Organization (WHO) to raise awareness about the importance of regular deworming of adolescent girls and women of reproductive age. The policy brief provides policy-makers and program managers with the best practices for supporting women at risk of intestinal worms such as the safety of pregnant and lactating women taking deworming treatments.

Another Task Force program, the Focus Area for Compassion and Ethics (FACE), promotes  awareness that some women in particular are systematically excluded from receiving certain public health interventions.

For example, pregnant and breastfeeding women are rarely included in mass vaccination efforts with newly developed vaccines to control epidemics like those that protect against COVID-19 or Ebola. The desire to protect these women from potential risks often overrides data that show these vaccines are not only unlikely to cause harm but that the disease itself is more severe for women who are pregnant and their babies than for their non-pregnant peers. Likewise, pregnant and breastfeeding women are often left out of community-wide “mass drug administrations” that treat and prevent neglected tropical diseases, due to concerns about theoretical side effects.

“A gender lens allows us to more clearly see important gaps in access to public health interventions and highlights important ethical issues related to gender, such as diminished respect and autonomy,” said Dr. Ashley Graham, FACE’s Director of Research and Operations.

FACE plans to expand research related to the exclusion of pregnant and breastfeeding women from epidemic vaccination efforts to more closely examine practices in the control of neglected tropical diseases. 

A third Task Force program, the Health Campaign Effectiveness (HCE) Coalition, is supporting implementation research on the integration of health campaigns and transition of interventions delivered in a campaign to the primary health care system in 24 countries. Through case studies and implementation research, HCE has learned that health campaign planners need to better understand viewpoints, opportunities and barriers to implementation with a gender lens.

For example, in Nepal the Coalition’s partner HEAL worked closely with the Ministry of Health on a pilot project in Rainas municipality to partially integrate lymphatic filariasis and vitamin A campaigns. The program leaders learned the importance of including women and children at all levels of planning health campaigns through dialogue with different ministries and at the district and community level. In addition, there is a need to understand short-and long-term migration patterns that affect the taking of lymphatic filariasis medicine that may vary by gender. 

Similarly, the HCE Coalition supports the Bruyere Research Institute on studies in Indonesia and Ghana to identify patterns of non-participation in health campaigns for diseases such as neglected tropical diseases, malaria and vaccine preventable diseases including COVID-19. Among other factors, researchers are investigating gender-based barriers and enablers to access health campaigns and services. Additionally, they are looking at how variable access to health interventions based on gender affects participation in the workforce, as well as family and community life. 

“Millions of women need to be continuously protected from neglected infectious diseases and vaccine preventable diseases in order to participate more fully in communities and economies for gender equality to be achieved,” said Dr. Eva Bazant, Senior Implementation Research Director of the HCE Coalition.

As the recent UN meeting highlighted, in order to improve access to health for all, gender equality must be a key area of focus.

Header photo: Women in a community near Saidpur, Bangladesh participate in a water, sanitation, and hygiene forum to prevent the spread of intestinal worms and schistosomiasis. Photo courtesy of Maruf for Children Without Worms.

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