Gender and health systems

Gender, the socially and culturally constructed roles and relationships between women and men, shape the ways in which health systems are planned, delivered, and experienced by users.

Male biases in service provision have resulted in health services which are not necessarily designed to address the full range of health needs and rights of women. Health status is currently being defined more broadly than in the past by international bodies such as the World Health Organisation, to include issues previously overlooked - most notably, the physical and psychological injuries caused by gender-based violence, and harmful traditional practices such as female genital mutilation. Increased participation of women as health service providers and planners increases the likelihood that services meet women’s needs and rights. To promote accountability and service responsiveness there is also need to create opportunities for health "users" – different groups of women and men to feed into the planning and delivery of health services.

The health system itself is a gendered structure. For example from a human resources perspective, gender can affect who is employed, at what level of an institutional hierarchy, their work experiences, their chances of experiencing gender based violence, their degree of job satisfaction, and their chances of promotion. These are important equity issues in themselves and also influence the quality and appropriateness of services provided for women and men.

This section of the health system resource guide provides examples and tools to mainstream gender in the delivery of health system delivery. This requires action at multiple levels: defining health services in ways that meet women’s and men’s multiple health needs; addressing gender imbalances in human resources for health and integrating gender concerns in different health financing strategies and global health initiatives, such as the Global Fund, Sector Wide Approaches, donor harmonisation approaches and multi-sectoral approaches.