This report suggests that the international trends towards a more efficient, effective and equitable health care sector, may affect men and women differently, given their different positions as users and producers of health care.
The report assesses the impact of four key health care reforms on gender equity in health:
Decentralisation: The HEN notes that the different needs of men and women should be taken into account as there is the risk that decentralisation may inadvertently support more conservative reproductive health agenda, in particular towards adolescents.
Financing: The report concludes that taxes and social insurance schemes appear to provide the most equitable basis for health financing. Inequities may well be increased by schemes such as private insurance, especially amongst women who generally have fewer financial resources.
Privatisation can lead to increased emphasis on reducing costs and maximising efficiency, thus having an important impact on gender equity in terms of access to health care and financial protection for the sick. Again, women will be more greatly affected as they are over-represented among both patients and personnel.
Some Priority setting methodologies such as disability-adjusted life-years (DALYs) as they seriously underestimate women’s burden of disease. For instance, sexually transmitted infections (STIs) or injuries caused by domestic violence are underestimated and under-reported. DALYs also tend to ignore social and cultural factors that determine disability. The HEN notes that most countries have stopped using the DALY methodology as a planning tool in recent years, due to limitations.
EPHA related article: Quantifying the gender gap
