Gender and health: a technical paper

Studies on health differences between men and women tend to emphasise biological factors as determinant. Instead, this technical paper, written by the Gender and Women’s Health Department at the World Health Organisation (WHO), explores the implications of the shift to a 'gender and development' (GAD) approach for the analysis of health and health care issues. It argues that a gender approach in health can consider the roles that social and cultural factors as well as power relations between women and men play in promoting, protecting and impeding health.

Existing development policies that focus on women continue to define them as passive victims who need special treatment. New research is now focusing instead on gender relations. After a definition of the term ‘gender’ to refer to the socially defined characteristics that different cultures assign to those individuals defined as either female or male, the paper explores the impact of gender inequalities on the health of women and men. The second part of the paper examines a number of factors that need to be considered in order for health policies to address the inequalities between women in men in relation to their health.

The paper argues that patterns of health and illness show differences between the sexes. The paper found that:

• Men and women are at risk of ill-health from tropical diseases, HIV and violence in different ways. Overall, women are most disadvantaged as they have less access to a range of resources and less capacity to realise their potential for health.
• Different gender roles lead to divisions of labour and lower status for women. Moreover, the 'double burden' of productive and reproductive activities can have negative consequences for women.
• Medical research is a gendered activity. Thus, problems that cause considerable distress for women such as incontinence and osteoporosis have received little medical research attention.
• Normal processes of pregnancy and childbearing have been turned into medical events with control taken away from women themselves.
• Medical knowledge is usually presented as superior and gives women no opportunities to make decisions about their own bodies.

A gender-focused approach to health and health care needs to be translated into concrete strategies for identifying and addressing the health needs of both women and men, including the planning of services. Implications to this end include:

• measuring women's health through routinely collected health statistics that are disaggregated by sex
• creating institutions with responsibility for ensuring that the health needs of women are adequately represented on the medical research agenda. This includes the use of a balanced research approach that includes both qualitative and quantitative research methodologies
• identifying gender concerns in the policy environment by means of initial? gender analyses
• taking into account gender inequalities before financing, resource allocation and other health sector reform decisions are taken
• including more women in the design, implementation and evaluation of health policies and programmes.