Disrupting gender norms in health systems: making the case for change

Gender Equality, Norms, and Health Steering Committee

Research output: Contribution to journalReview article

Abstract

Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health. In this Series paper, we explore how to address all three through recognition and then with disruptive solutions. We used intersectional feminist theory to guide our systematic reviews, qualitative case studies based on lived experiences, and quantitative analyses based on cross-sectional and evaluation research. We found that health systems reinforce patients' traditional gender roles and neglect gender inequalities in health, health system models and clinic-based programmes are rarely gender responsive, and women have less authority as health workers than men and are often devalued and abused. With regard to potential for disruption, we found that gender equality policies are associated with greater representation of female physicians, which in turn is associated with better health outcomes, but that gender parity is insufficient to achieve gender equality. We found that institutional support and respect of nurses improves quality of care, and that women's empowerment collectives can increase health-care access and provider responsiveness. We see promise from social movements in supporting women's reproductive rights and policies. Our findings suggest we must view gender as a fundamental factor that predetermines and shapes health systems and outcomes. Without addressing the role of restrictive gender norms and gender inequalities within and outside health systems, we will not reach our collective ambitions of universal health coverage and the Sustainable Development Goals. We propose action to systematically identify and address restrictive gender norms and gender inequalities in health systems.

Original languageEnglish (US)
Pages (from-to)2535-2549
Number of pages15
JournalThe Lancet
Volume393
Issue number10190
DOIs
StatePublished - Jun 22 2019

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Health
Universal Coverage
Men's Health
Reproductive Rights
Women's Rights
Quality of Health Care
Conservation of Natural Resources
Parity
Health Personnel
Nurses
Physicians

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gender Equality, Norms, and Health Steering Committee (2019). Disrupting gender norms in health systems: making the case for change. The Lancet, 393(10190), 2535-2549. https://doi.org/10.1016/S0140-6736(19)30648-8

Disrupting gender norms in health systems : making the case for change. / Gender Equality, Norms, and Health Steering Committee.

In: The Lancet, Vol. 393, No. 10190, 22.06.2019, p. 2535-2549.

Research output: Contribution to journalReview article

Gender Equality, Norms, and Health Steering Committee 2019, 'Disrupting gender norms in health systems: making the case for change', The Lancet, vol. 393, no. 10190, pp. 2535-2549. https://doi.org/10.1016/S0140-6736(19)30648-8
Gender Equality, Norms, and Health Steering Committee. Disrupting gender norms in health systems: making the case for change. The Lancet. 2019 Jun 22;393(10190):2535-2549. https://doi.org/10.1016/S0140-6736(19)30648-8
Gender Equality, Norms, and Health Steering Committee. / Disrupting gender norms in health systems : making the case for change. In: The Lancet. 2019 ; Vol. 393, No. 10190. pp. 2535-2549.
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abstract = "Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health. In this Series paper, we explore how to address all three through recognition and then with disruptive solutions. We used intersectional feminist theory to guide our systematic reviews, qualitative case studies based on lived experiences, and quantitative analyses based on cross-sectional and evaluation research. We found that health systems reinforce patients' traditional gender roles and neglect gender inequalities in health, health system models and clinic-based programmes are rarely gender responsive, and women have less authority as health workers than men and are often devalued and abused. With regard to potential for disruption, we found that gender equality policies are associated with greater representation of female physicians, which in turn is associated with better health outcomes, but that gender parity is insufficient to achieve gender equality. We found that institutional support and respect of nurses improves quality of care, and that women's empowerment collectives can increase health-care access and provider responsiveness. We see promise from social movements in supporting women's reproductive rights and policies. Our findings suggest we must view gender as a fundamental factor that predetermines and shapes health systems and outcomes. Without addressing the role of restrictive gender norms and gender inequalities within and outside health systems, we will not reach our collective ambitions of universal health coverage and the Sustainable Development Goals. We propose action to systematically identify and address restrictive gender norms and gender inequalities in health systems.",
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