How can gender equity be addressed through health systems?

Gender differences in health and in how well health systems and health care services meet the needs of women and men are well known: in Europe, there are variations in terms of life expectancy, the risk of mortality and morbidity, health behaviours and in the use of health care services. There is also increasing research evidence demonstrating the importance of a number of different social determinants of health, and these interact with gender inequalities in ways that can magnify the impact on health.

Additionally, there has also been an increasing recognition that health policy may exacerbate gender inequalities when it fails to address the needs of either men or women, and that health systems must address gender equity. This forms part of good stewardship, as well as meeting the needs of the populations served. Gender equity objectives have also been identified in position statements from WHO, the United Nations and the European Union (EU). For the purposes of this policy brief, the ‘policy problem’ is the way in which health systems might address gender equity in order to reduce the health gap between men and women and to improve efficiency. This document identifies some of the main approaches used to address gender equity in health systems, elaborating on three examples in order to suggest how these methods might be developed in the context of health policies across Europe.

The underlying causes of the gender gap in health which might be addressed by health systems and health care services include differences between women and men in their use of preventive health care, their health behaviours and in their access to health care and treatment – all of which affect health outcomes for women and men. It is difficult to calculate the exact proportion of the gender gap that can be attributed to gender inequality in the planning and delivery of health services. However, the consequences of not addressing gender are likely to include persistent excess mortality among men, underuse, and inefficient use, of health resources, poor user satisfaction and, for some countries, perhaps, a widening gender gap in health.

Approaches to gender equality and gender equity

Health systems in Europe vary in their recognition of gender inequalities and gender inequities. A range of strategies have been used in various countries to address gender equity. These might be categorized as regulatory approaches, organizational approaches and informational approaches. It is important to note that these approaches might need to be combined to address gender equity goals effectively.