Research for stronger health systems during and after crisis

Are health systems interventions gender blind? Examining health system reconstruction in conflict affected states

Valerie Percival, Esther Dusabe-Richards, Haja Wurie, Justine Namakula, Sarah Ssali and Sally Theobald

Globalization and Health 2018 14:90 https://doi.org/10.1186/s12992-018-0401-6

This paper is an output of ReBUILD's work on gender in post conflict health systems - and is part of the Building Back Better e-resource.

Countries recovering from conflict and fragility often engage in wide-ranging institutional reforms to address inequities, including within the health system. But whilst current global health policy prioritizes improving the health of women and girls, research and policy do not sufficiently explore how health system interventions contribute to the broader goal of gender equity. 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. The analysis shows that across all these settings, health interventions did not adequately reflect on how gender norms are replicated by the health system, nor 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. Key attributes of gender equitable health systems are proposed to guide further research and policy.

The paper concludes that 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. And given the 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.

You can read the full paper here.

An accompanying blog by Val Percival – Health systems and gender: what do we need to know and why does it matter? – has been published in the BMC ‘On Health’ blog site.