Despite the importance of incorporating gender analysis into existing research programmes, it is not without its challenges. This brief outlines some of these challenges, along with ways in which Research in Gender and Ethics (RinGs): Building Stronger Health Systems has responded to them. RinGs is a cross research programme consortium (RPC) bringing together three health systems RPCs – Future Health Systems, ReBUILD, and RESYST – to better understand gendered dynamics in health systems and to galvanise gender analysis in health systems research.
Research shows that CHWs are effective in delivering health services in low- and middle-income countries. They can also improve equitable health care and extend access for populations who are difficult to reach. But data are often too patchy or project specific. Several assumptions are commonly made about CHWs including that they are less expensive than formal health care workers as a way of delivering key services. What is striking, however, is the lack of robust evidence on the cost-effectiveness of CHWs. In order to enhance understanding and inform policy dialogue on the role of CHWs in the health system, the…
The recent thematic series on close-to-community providers published in this journal brings together 14 papers from a variety of contexts and that use a range of research methods. The series clearly illustrates the renewed emphasis and excitement about the potential of close-to-community (CTC) providers in realising universal health coverage and supporting the sustainable development goals. This editorial discusses key themes that have emerged from this rich and varied set of papers and reflect on the implications for evidence-based programming. We are at a critical stage in the development of CTC programming and policy which requires the creation and communication of…
Gender—the socially constructed roles, behaviours, activities and attributes that a given society considers appropriate for males, females and other genders—affects how people live, work and relate to each other at all levels, including in relation to the health system. Health systems research (HSR) aims to inform more strategic, effective and equitable health systems interventions, programs and policies; and the inclusion of gender analysis into HSR is a core part of that endeavour. We outline what gender analysis is and how gender analysis can be incorporated into HSR content, process and outcomes . Starting with HSR content, i.e. the substantive focus of HSR,…
In the health sector we are facing a double challenge; there is a shortage of formal health workers and a concurrent push to scale up programmes to meet targets such as Universal Health Coverage and the Millennium Development Goals. Working with Community Health Workers (CHWs) is thought to be a potential solution. Ensuring that CHWs are properly supported is vital if they are to fulfill the critical role they can play in improving the health of communities. There are management challenges associated with CHW programmes, including attracting recruits, turnover and performance. A range of different health actors are involved in…
A new way to prevent HIV, known as pre-exposure prophylaxis (PrEP), can provide protection where condoms are not used. Integrating it into HIV and sexual health programming for various communities has become a focus of researchers and health and development agencies. However, PrEP raises important challenges in the context of female sex work. To protect sexual and reproductive health and avoid pregnancy, PrEP must be used with condoms but that may be difficult where clients perceive PrEP as an alternative. Frequent HIV testing and medicalisation of HIV prevention in low-income settings presents challenges for those who lack the rights and…
This brief examines the reform of health systems in post-conflict settings through a gender lens, using the World Health Organization’s health system building blocks as a framework. Research into the importance of reconstructing health systems after a crisis or war is relatively new, therefore literature discussing challenges and best practices related to gender equity is weak and the evidence base limited. Further study is clearly needed into the impact of strengthening the health system on gender equity.
This policy brief looks at the context of gender and health, and how they are affected by conflict. It also assesses whether humanitarian assistance in the immediate post- conflict period addresses the impact of conflict on health from a gender perspective. A second sister brief examines long-term reform of the health system through a gender lens, using the World Health Organization’s health system building blocks as a framework.
In this commentary, we discuss a photography competition, launched during the summer of 2014, to explore the everyday stories of how gender plays out within health systems around the world. While no submission fees were charged nor financial awards involved, the winning entries were exhibited at the Global Symposium on Health Systems Research in Cape Town, South Africa, in October 2014, with credits to the photographers involved. Anyone who had an experience of, or interest in, gender and health systems was invited to participate. Underlying the aims of the photo competition was a recognition of the importance of participation of…
Many countries in Sub-Saharan Africa have undergone a process of decentralising health system planning and management, shifting authority to varying degrees from central government to local districts. There are gaps in research on health worker performance at the district level. To strengthen the evidence base, PERFORM – a research consortium of three European and three African universities – has applied action research using a holistic “systems approach” to explore how improving management skills can enhance workforce performance at district level. The project aimed to boost the capacity of health managers in three districts in Ghana, Tanzania and Uganda to identify…