Tackling gender equity in health policy in Europe: a partnership

Eurohealth OBSERVER Eurohealth incorporating Euro Observer — Vol.18 | No.2 | 2012 16 TACKLING GENDER EQUITY IN HEALTH POLICY IN EUROPE: A PARTNERSHIP By: Isabel Yordi Aguirre Summary: Gender equity recognises that women and men have different needs and opportunities that impact on their health status, their access to services and their contributions to the health workforce. The underlying causes of the gender inequities that can be addressed by health systems and health care services include differences between men and women in their use of preventive health care, their health behaviours and in their access to health care and treatment. The World Health Organization aims to reduce these inequities by integrating gender into all of its health policies and programmes and by enhancing the capacity of its Member States to formulate and implement gender responsive health policies and strategies. Keywords: Gender Equity, Health Policies, Gender Mainstreaming, World Health Organization Isabel Yordi is Technical Officer on gender and health at the Policy and Cross Cutting Programmes Unit, World Health Organization Regional Office for Europe, Copenhagen, Denmark. Email: iyo@euro.who.int There is undeniable evidence showing that the gender roles and norms we adopt as we develop from childhood to adulthood, and the unequal access to power and resources between men and women, strongly impact on our health. It is also clear that the health sector can make a difference and needs to act when this impact is negative, unfair and avoidable for either women or men. The World Health Organization (WHO) has recognised this responsibility with the adoption of the Strategy to integrate gender analysis in the work of WHO  1 and the WHO Resolution 60.25. 2 The resolution calls for the WHO Secretariat and its Member States to integrate gender into health policies and programmes. The WHO Regional Office for Europe took this Resolution seriously and in 2010 gender became a cross cutting priority, together with equity and human rights. This is the result of many years of work and of a strong partnership with a committed, supportive and visionary partner who also became a good friend: Concepción (Concha) Colomer Revuelta, Director of the Women’s Health Observatory of the Spanish Ministry of Health, Social Affairs and Equality. Concha Colomer, to whom this issue of Eurohealth is dedicated, played a key role in supporting WHO to move forward gender mainstreaming in the health sector at a time when many Member States were going through a phase of “gender fatigue”. This was the unfortunate result of mainstreaming policies that did not have the required financial and human resources, systematic approach or political commitment. Some policies that were developed were not based on strong Eurohealth OBSERVER Eurohealth incorporating Euro Observer — Vol.18 | No.2 | 2012 17 evidence due to a lack of sex disaggregated data and gender analysis, or insufficient resources, capacity or mechanisms for their implementation. ‘‘ gender became a cross cutting priorityIn spite of being a region with the highest levels of gender equality among its 53 Member States, there are also serious differences between women and men in mortality, morbidity, healthy life years and use and access to health services and resources. These differences are the result of a combination of biological and social factors. In the new WHO health policy for Europe, Health 2020 policy framework and strategy, 3 * gender equity is a core value and refers to fairness and justice in the distribution of benefits, power, resources and responsibilities between women and men to allow them to attain their full health potential. Gender equity recognises that women and men have different needs and opportunities that impact on their health status, their access to services and their contributions to the health workforce. It acknowledges that these differences should be identified and addressed in a manner that rectifies the imbalance between the sexes. It is also important to highlight that when we look at gender inequities, we recognise that men and women are not homogenous groups so their health and their experience of health systems are also determined by the interaction between gender inequities and other social determinants of health such as poverty, employment, education and ethnicity. The underlying causes of the gender inequities that can be addressed by health systems and health care services include differences between men and women 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 * To be presented for ratification at the WHO Regional Committee in September 2012. men. The potential consequences of not addressing gender include persistent excess mortality among men, under use and inefficient use of health resources, poor user satisfaction and for some countries, perhaps a widening gap in health between men and women. 4 WHO aims at reducing these inequities by enhancing the capacity of its Member States to formulate and implement gender responsive health policies and strategies. Our work follows four strategic directions: integrating gender into WHO’s management, promoting the use of sex disaggregated data and gender analysis, establishing accountability mechanisms and building capacity. ‘‘ interaction between gender inequities and other social determinants of health The partnership with Concha Colomer and the Women’s Health Observatory has been crucial to implementing some of these strategic directions. The support and collaboration of the Observatory to develop the gender tool that accompanies the Child and Adolescent Health Strategy (see Cogoy and Tamburlini in this issue), the input of Concha Colomer into regional priorities such as the Tallinn Charter  5 and the development of Health 2020, her leading role in promoting the use of sex disaggregated data and gender indicators, and the experience of mainstreaming gender through the main health strategies in Spain–all these are initiatives that WHO treasures as best practices that have influenced our technical assistance to our Member States. One important aim of our years of working together was to create a regional platform that will serve to exchange experience and best practices, strengthen the capacity in the region and put gender equity in health onto the health agenda. Developing a strong network of focal points is the next step. For this, we miss Concha, both personally and professionally, but we hope that we can continue to build on her valuable legacy – what she believed in and was passionate about – improving gender equity for all. References 1 World Health Organization. WHO Strategy to integrate gender analysis and actions in the work of WHO. Geneva: World Health Organization, 2007. Available at: http://whqlibdoc.who.int/ publications/2009/9789241597708_eng_Text.pdf 2 World Health Organization. WHO Resolution 60.25. Geneva: World Health Organization, 2007. Available at: http://whqlibdoc.who.int/hq/2008/ WHO_FCH_GWH_08.1_eng.pdf 3 World Health Organization Regional Office for Europe. [Draft] Health 2020 policy framework and strategy. Copenhagen: World Health Organization, 2012. Available at: http://www.euro. who.int/__data/assets/pdf_file/0007/147724/ wd09E_Health2020_111332.pdf 4 Payne S. How can gender equity be addressed through health systems? Policy Brief 12. Copenhagen: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, 2009. Available at: http://www.euro.who. int/__data/assets/pdf_file/0006/64941/E92846.pdf 5 WHO Regional Office for Europe. The Tallinn Charter: Health Systems for Health and Wealth. Tallinn: World Health Organization, 2008. Available at: http://www.euro.who.int/document/e91438.pdf