Gender equality in healthcare access during international health crises: a systematic review
Verónica Osorio Calderón
During the last Public Health Emergencies of International Concern like Zika or Ebola outbreaks, women were more affected in terms of morbidity and mortality rates. The care giving role of women exposes them to infection and does not allow them to look for healthcare, as well as keeping them from participating in policymaking. Consequently, rapid responses do not consider gender inequalities slowing the implementation of solution to meet women’s needs and perpetuating inequality in the society. As such, the recovery of a health system after a health crises is more difficult and gender inequalities are accentuated in the society. Considering the importance of this issue, my Master’s* thesis focused on analysing the rapid responses for health emergency crises through a systematic review of the policies and research available focusing on the last two major outbreaks: Ebola in West Africa in 2014, and Zika in the Americas in 2015.
At an international level, the guidelines analysed – OCHA Gender Toolkit and the Emergency Response Framework – highly recommend gender differentiation for rapid responses considering health needs and differences of women. They suggest not only to provide healthcare services focused to women, but also their participation on all levels of decision making. At a regional level, Strategic Rapid Responses also suggest the inclusion of women as a vulnerable group in all the stages of rapid response. However, at a local level, in both National Plans for Ebola and Zika, gender disaggregation is omitted and consider both men and women without any differentiation of needs. Moreover, women are considered only in their role as mothers. In relation to research about gender inequalities in healthcare access, no systematic review met the inclusion criteria. The lack of systematic reviews available remarks the need of tools for policy making for rapid responses.
In conclusion, there are three main results. First, there is a gap of research related to gender inequalities in health emergencies. It is necessary to count with primary research based on disaggregated data during health emergencies in order to consider women’s needs and inequalities. Second, the inclusion of gender inequalities on decision making was lost at local level, which is the most important stage of policymaking as social factors determine the rapid response. Cultural and social factors determine the role of women in the society, as such, it is essential to consider them when implementing policies. And third, health policies and guidelines did not use systematic reviews as source of information. Therefore, more efforts are needed to connect the world of academia and policymaking in order to improve effective and evidence-based policies during health emergencies.
As a recommendation, governments should implement a Risk Analysis of Health including gender inequalities to help failing or failed states facing a health emergency. Also, it is recommended to increase the elaboration of systematic reviews related to healthcare access and gender inequalities during health emergencies to use it as a tool of information in the elaboration of rapid responses.
*Chevening Scholar, MSc. (c) Social Policy and Social Research, IOE University College London. To obtain the full study, please contact Veronica at firstname.lastname@example.org