Gender Mainstreaming in Policy Making: An Overlooked Approach in Healthcare and Pharma?

17 Jan 2012 Farah Ramadan

While we all recognise the biological differences between women and men, healthcare hasn't always been viewed through a gender lens. This is changing in more advanced markets like the UK, the Nordics, and Canada, which have started to mainstream gender in their healthcare policy-making procedures, but it is often non-existent in developing or under-developed countries where the health gap hits most.

So What Is Gender Mainstreaming in Healthcare?
Gender mainstreaming refers to the process of evaluating the impact and implications on both women and men of any / all levels of policy-making from planning and implementation, to monitoring and evaluation.

Mortality and morbidity data show a discrepancy between women and men's health status and a difference in healthcare utilization and access, preventative healthcare use, and health seeking behaviours. For example, women's life expectancy is higher than men's; however, women live longer in disability. To give another example, men access primary care and utilize preventive care less than women.

Some of the differences are attributed to the different biological functions of females and males. Other undermined reasons are linked to the social roles and the impact of social determinants of health (such as labour, education, economic status and culture) on women and men. Failing to respond to the latter factors leads to gender inequities in healthcare, a concept that policy makers are increasingly wary about, and keen to eliminate.

While there is no clear evidence that directly links engendered healthcare systems to improved healthcare outcomes, research shows that healthcare systems responsive to gender inequities scored better service delivery and increased patients' satisfaction.

Gender mainstreaming efforts vary between countries and healthcare systems. Devising a gender policy depends on the baseline that the country's healthcare is at. Pre-requisites are necessary for successful gender mainstreaming to take effect. Top-down and bottom-up efforts are equally crucial to achieve gender sensitivity.

Pharma's Changing Gender Focus
In the pharmaceutical arena, the sector stood accused for many years of prioritising research into "male" diseases, and that areas such as contraception focused only on women, not men. However, over the last ten years or so, dramatic advances have been made in many areas of female health, notably cervical and breast cancer, and several pharmaceutical companies now have whole divisions devoted towards female health.

Nevertheless, in some parts of the world and in less developed societies, women face additional barriers to access of pharmaceuticals. The discrepancy stems from cultural norms, for example son preferences are still widely apparent in East Asian societies like India. Little has been done from the pharma's side to tackle gender inequities in medicine access.

A Growing Need
There is a growing need in healthcare to study the relationship between gender differences and the interaction between women and men, and healthcare systems. Assessing the impact on gender is especially important amid healthcare reform and when designing a healthcare intervention or prevention program.

In general, more advanced markets are beginning to acknowledge the importance of gender in healthcare. Squeezed public investments in healthcare will continue to go in a more gender-responsive direction looking for systems efficiency gains and personalized healthcare. Implications on pharmaceuticals' R&D and reimbursement decisions go hand in hand.


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