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Are health systems interventions gender blind? examining health system reconstruction in conflict affected states
BACKGROUND: Global health policy prioritizes improving the health of women and girls, as evident in the Sustainable Development Goals (SDGs), multiple women’s health initiatives, and the billions of dollars spent by international donors and national governments to improve health service delivery in...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116483/ https://www.ncbi.nlm.nih.gov/pubmed/30157887 http://dx.doi.org/10.1186/s12992-018-0401-6 |
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author | Percival, Valerie Dusabe-Richards, Esther Wurie, Haja Namakula, Justine Ssali, Sarah Theobald, Sally |
author_facet | Percival, Valerie Dusabe-Richards, Esther Wurie, Haja Namakula, Justine Ssali, Sarah Theobald, Sally |
author_sort | Percival, Valerie |
collection | PubMed |
description | BACKGROUND: Global health policy prioritizes improving the health of women and girls, as evident in the Sustainable Development Goals (SDGs), multiple women’s health initiatives, and the billions of dollars spent by international donors and national governments to improve health service delivery in low-income countries. Countries recovering from fragility and conflict often engage in wide-ranging institutional reforms, including within the health system, to address inequities. Research and policy do not sufficiently explore how health system interventions contribute to the broader goal of gender equity. METHODS: This paper utilizes a framework synthesis approach to examine if and how rebuilding health systems affected gender equity in the post-conflict contexts of Mozambique, Timor Leste, Sierra Leone, and Northern Uganda. To undertake this analysis, we utilized the WHO health systems building blocks to establish benchmarks of gender equity. We then identified and evaluated a broad range of available evidence on these building blocks within these four contexts. We reviewed the evidence to assess if and how health interventions during the post-conflict reconstruction period met these gender equity benchmarks. FINDINGS: Our analysis shows that the four countries did not meet gender equitable benchmarks in their health systems. Across all four contexts, health interventions did not adequately reflect on how gender norms are replicated by the health system, and conversely, how the health system can transform these gender norms and promote gender equity. Gender inequity undermined the ability of health systems to effectively improve health outcomes for women and girls. From our findings, we suggest the key attributes of gender equitable health systems to guide further research and policy. CONCLUSION: The use of gender equitable benchmarks provides important insights into how health system interventions in the post-conflict period neglected the role of the health system in addressing or perpetuating gender inequities. Given the frequent contact made by individuals with health services, and the important role of the health system within societies, this gender blind nature of health system engagement missed an important opportunity to contribute to more equitable and peaceful societies. |
format | Online Article Text |
id | pubmed-6116483 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-61164832018-10-02 Are health systems interventions gender blind? examining health system reconstruction in conflict affected states Percival, Valerie Dusabe-Richards, Esther Wurie, Haja Namakula, Justine Ssali, Sarah Theobald, Sally Global Health Review BACKGROUND: Global health policy prioritizes improving the health of women and girls, as evident in the Sustainable Development Goals (SDGs), multiple women’s health initiatives, and the billions of dollars spent by international donors and national governments to improve health service delivery in low-income countries. Countries recovering from fragility and conflict often engage in wide-ranging institutional reforms, including within the health system, to address inequities. Research and policy do not sufficiently explore how health system interventions contribute to the broader goal of gender equity. METHODS: This paper utilizes a framework synthesis approach to examine if and how rebuilding health systems affected gender equity in the post-conflict contexts of Mozambique, Timor Leste, Sierra Leone, and Northern Uganda. To undertake this analysis, we utilized the WHO health systems building blocks to establish benchmarks of gender equity. We then identified and evaluated a broad range of available evidence on these building blocks within these four contexts. We reviewed the evidence to assess if and how health interventions during the post-conflict reconstruction period met these gender equity benchmarks. FINDINGS: Our analysis shows that the four countries did not meet gender equitable benchmarks in their health systems. Across all four contexts, health interventions did not adequately reflect on how gender norms are replicated by the health system, and conversely, how the health system can transform these gender norms and promote gender equity. Gender inequity undermined the ability of health systems to effectively improve health outcomes for women and girls. From our findings, we suggest the key attributes of gender equitable health systems to guide further research and policy. CONCLUSION: The use of gender equitable benchmarks provides important insights into how health system interventions in the post-conflict period neglected the role of the health system in addressing or perpetuating gender inequities. Given the frequent contact made by individuals with health services, and the important role of the health system within societies, this gender blind nature of health system engagement missed an important opportunity to contribute to more equitable and peaceful societies. BioMed Central 2018-08-30 /pmc/articles/PMC6116483/ /pubmed/30157887 http://dx.doi.org/10.1186/s12992-018-0401-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review Percival, Valerie Dusabe-Richards, Esther Wurie, Haja Namakula, Justine Ssali, Sarah Theobald, Sally Are health systems interventions gender blind? examining health system reconstruction in conflict affected states |
title | Are health systems interventions gender blind? examining health system reconstruction in conflict affected states |
title_full | Are health systems interventions gender blind? examining health system reconstruction in conflict affected states |
title_fullStr | Are health systems interventions gender blind? examining health system reconstruction in conflict affected states |
title_full_unstemmed | Are health systems interventions gender blind? examining health system reconstruction in conflict affected states |
title_short | Are health systems interventions gender blind? examining health system reconstruction in conflict affected states |
title_sort | are health systems interventions gender blind? examining health system reconstruction in conflict affected states |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116483/ https://www.ncbi.nlm.nih.gov/pubmed/30157887 http://dx.doi.org/10.1186/s12992-018-0401-6 |
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