How can data help health systems research #PressForProgress for women?
This blog post is part of a wider HSG blog series to celebrate Internation Women's Day 2018. In this series, HSG members provide their perspectives on why gender should be a critical component of UHC, and what we can do about it.
By Erlyn Rachelle Macarayan, member of the HSG Translating Evidence into Action Thematic Working Group
This is a re-posted blog. Original post found on Health Systems Global's News & Commentary
Many superheroes of today are women who became leaders in their own fields - 48 women have won Nobel Prizes and many more are leading major breakthroughs in science, while the rest have soared to become the world’s most powerful leaders. International Women’s Day is a reminder of these successes, but we are also reminded with their hashtag - #pressforprogress - of how much further we have to go on the path to gender equality.
An important step to move this agenda forward is to understand where the gender disparities are – to do this, we need to quantify it. Sex-disaggregated data will not only ensure that policies and interventions can best be targeted to those who are in most need of care, but it also gives concrete evidence to the additional spillover effects that empowering women and girls has on their families, the economy, as well as across the globe.
If sex-disaggregated became the norm, health systems research would be better positioned to understand and address the challenges facing women (and men). From leadership to crisis response to interventions, here are three examples that highlight some of these challenges:
1. Women in decision-making roles for healthcare systems.
There are many contentious issues in healthcare such as abortion, contraceptives, and child marriage. It is critical to examine gender differences in decision-making on these policies, by asking:
Will having more women leaders in health systems, especially in legislatures, lead to changes in policies and interventions to address these issues?
Will policies be more gender-specific if more women are in power?
Will training more women to become leaders translate to substantial decreases in maternal and child mortality, improved maternity leaves and lesser pay gap, improved supports for breastfeeding?
We need much more specific data to explore these questions further. So far, what we know is that: “women hold only 26 percent of hospital CEO positions and 21 percent of executive positions at Fortune 500 health care companies even though they make up 78 percent of the health care work force.” The data should not only be on the number of women leaders in healthcare, but also on how such numbers have translated into action. These data will be useful both in making the contributions of women to healthcare more visible and in strengthening evidence for investing in training more women leaders.
2. Women and health systems in fragile and conflict-affected states
Data on refugees is scarce, making it even tougher to get adequate data on how many women and their children suffer from the atrocities of war and conflict. In 2015, UNHCR reported sex-disaggregated data for only 46% of refugees. We need to know:
How many pregnant women had to traverse miles, if not countries, just to deliver their babies and access quality care?
What are the experiences of women fleeing from their countries while taking their children with them?
There have been many reported cases of rape in human trafficking. Data to examine the magnitude of these issues, as well as peoples’ experiences, are not only needed for health systems in war-torn areas, but also for countries that are on the verge of collapse given their rising socioeconomic inequalities. Such information would be useful in identifying interventions that can be more responsive to women’s needs and can best mitigate the harmful effects of these issues not only on their lives, but on their families as well.
3. Establishing gender-specific interventions. Communicating health research requires translation of how such evidence can be used to inform targeted interventions, but without disaggregated data that is not possible. Lack of awareness of how heart attacks present differently in men and women are becoming more apparent. Women experience more non-chest pain symptoms during a heart attack, like palpitations, back pain or indigestion, but they and their providers dismiss these as other non-heart-related things, like anxiety, leading to delayed care. Much more specific breakdown allows health systems researchers to understand important differences in healthcare needs, their utilization of care, and perhaps less understood - the access to and quality of treatment each group receives, including how they respond to policies or interventions.
Gender equality is, on its own, a separate agenda, but it is also an issue that should be comprehensively dealt with across all sectors. There should no longer be a debate that development without gender equality can never be sustainable. For us to know whether we have made sufficient progress in this agenda, we cannot be blinded by aggregate measures that fail to capture the unique and distinct experiences of different groups. Existing data sources should include gender-related indicators that can help us understand better what works and what more needs to be done. The Data2X of the UN is a start, but we all need to do so much more if we are to #pressforprogress for women.
Erlyn would like to thank Vivienne Benson, Nasreen Jessani, Daniela Rodriguez, and Leah Murphy for all the revisions made and citations added to this article.