Gender—gender requires us to ensure that health policy, programmes, services and delivery models are responsive to the needs of women, men, girls and boys in all their diversity.
Gender refers to the socially constructed characteristics of women and men – such as norms, roles and relationships of and between groups of women and men. It varies from society to society and can be changed. While most people are born either male or female, they are taught appropriate norms and behaviours – including how they should interact with others of the same or opposite sex within households, communities and work places. When individuals or groups do not “fit” established gender norms they often face stigma, discriminatory practices or social exclusion – all of which adversely affect health. It is important to be sensitive to different identities that do not necessarily fit into binary male or female sex categories.
Gender norms, roles and relations influence people’s susceptibility to different health conditions and diseases and affect their enjoyment of good mental, physical health and wellbeing. They also have a bearing on people’s access to and uptake of health services and on the health outcomes they experience throughout the life-course.
WHO’s UN-SWAP Status
WHO has made great strides in meeting and exceeding requirements on performance indicators detailed in the United Nations System-wide Action Plan towards gender quality and the empowerment of women (UN-SWAP). In 2016, WHO significantly improved its UN-SWAP performance, with 80% of the Performance Indicators either “Meeting” or “Exceeding Requirements” compared to 60% in 2015 and 53% in 2014. Specifically, progress was made on three Performance Indicators, with a remarkable achievement of “Exceeds Requirements” for Indicator 1. Policy and Plan, and “Meets Requirements” for Indicator 8. Resource Tracking and 14. Knowledge Management.
In 2017, only three Performance Indicators remain where WHO’s performance should improve in order to “Meet Requirements”. These are: Indicators 9. Resource Allocation, 10. Gender Architecture and Parity, and 13. Capacity Development.
There are often misconceptions about terms related to gender. WHO has chosen to define them in this way:
Gender analysis identifies, assesses and informs actions to address inequality that come from: 1) different gender norms, roles and relations; 2) unequal power relations between and among groups of men and women, and 3) the interaction of contextual factors with gender such as sexual orientation, ethnicity, education or employment status.
Gender analysis in health
Examines how biological and sociocultural factors interact to influence health behaviour, outcomes and services. It also uncovers how gender inequality affects health and well-being.
Gender based division of labour
Refers to where, how and under what conditions women and men work (for or without pay) based on gender norms and roles.
Level 2 of the WHO Gender Responsive Assessment Scale: Ignores gender norms, roles and relations and very often reinforces gender-based discrimination. By ignoring differences in opportunities and resource allocation for women and men, such policies are often assumed to be “fair” as they claim to treat everyone the same.
Refers to equal chances or opportunities for groups of women and men to access and control social, economic and political resources, including protection under the law (such as health services, education and voting rights). It is also known as equality of opportunity – or formal equality. Gender equality is often used interchangeably with gender equity, but the two refer to different, complementary strategies that are needed to reduce gender-based health inequities.
Gender equality in health
Women and men have equal conditions to realize their full rights and potential to be healthy, contribute to health development and benefit from the results. Achieving gender equality will require specific measures designed to support groups of people with limited access to such goods and resources.
More than formal equality of opportunity, gender equity refers to the different needs, preferences and interests of women and men. This may mean that different treatment is needed to ensure equality of opportunity. This is often referred to as substantive equality (or equality of results) and requires considering the realities of women’s and men’s lives. Gender equity is often used interchangeably with gender equality, but the two refer to different, complementary strategies that are needed to reduce gender-based health inequities.
Gender equity in health
Refers to a process of being fair to women and men with the objective of reducing unjust and avoidable inequality between women and men in health status, access to health services and their contributions to the health workforce.
The process of assessing the implications for women and men of any planned action, including legislation, policies or programmes, in all areas and at all levels. It is a strategy for making women’s as well as men’s concerns and experiences an integral dimension of the design, implementation, monitoring and evaluation of policies and programmes in all political, economic and societal spheres so that women and men benefit equally and inequality is not perpetuated.
Refer to beliefs about women and men, boys and girls that are passed from generation to generation through the process of socialization. They change over time and differ in different cultures and populations. Gender norms lead to inequality if they reinforce: a) mistreatment of one group or sex over the other; b) differences in power and opportunities.
Refers to social relations between and among women and men that are based on gender norms and roles. Gender relations often create to hierarchies between and among groups of men and women that can lead to unequal power relations, disadvantaging one group over another.
A policy or programme that considers gender norms, roles and inequality with measures taken to actively reduce their harmful effects.
Refers to what males and females are expected to do (in the household, community and workplace) in a given society.
Level 3 of the WHO Gender Responsive Assessment Scale: Indicates gender awareness, although no remedial action is developed.
Level 4 of the WHO Gender Responsive Assessment Scale: Considers women’s and men’s specific needs and intentionally targets and benefits a specific group of women or men to achieve certain policy or programme goals or meet certain needs. Such policies often make it easier for women and men to fulfil duties that are ascribed to them based on their gender roles, but do not address underlying causes of gender differences.
Images, beliefs, attitudes or assumptions about certain groups of women and men. Stereotypes are usually negative and based on assumed gender norms, roles and relations.
Level 5 of the WHO Gender Responsive Assessment Scale: Addresses the causes of gender-based health inequities by including ways to transform harmful gender norms, roles and relations. The objective of such programmes is often to promote gender equality and foster progressive changes in power relationships between women and men.
Level 1 of the WHO Gender Responsive Assessment Scale: Perpetuates gender inequality by reinforcing unbalanced norms, roles and relations and often leads to one sex enjoying more rights or opportunities than the other.