Pascale Allotey and Michelle Remme discuss solutions and strategies to tackle gender equality

This year, 2020, marks the 25th anniversary of the Beijing Declaration and Platform for Action where 17,000 participants, 30,000 activists and 189 governments met in China to affirm that equality between women and men is a matter of human rights and a condition for social justice. 

The declaration acknowledged that while the status of women had advanced in some important respects, progress was uneven, inequalities persisted, obstacles remained, and these had serious consequences for the health and wellbeing of all. The call to action brought the peripheral ‘women’s agenda’ into the mainstream development agenda, and has been the foundation for a range of initiatives to promote women’s empowerment as a means to achieve equality. However, gender equality and how to achieve it has, in broad terms, resulted in three, often competing, agendas. 

First, the agenda to improve women’s health outcomes remains unfinished. This agenda holds as its central tenet, the transformation of gender power relations as fundamental to gender equality. Health outcomes for women who face sexual and other forms of violence cannot improve in societies that do not hold partners and other perpetrators to account. Women are unable to fulfil their potential or exercise their rights over their own bodies where policies deny access to sexual and reproductive health services. Women are unable to contribute to the development of scholarship, evidence, policies and practices that impact on their lives when societal norms perpetuate structures that exclude women from opportunities to engage. The empowerment of women is critical to this agenda in order to redistribute and balance power. 

The second agenda relates to men’s health outcomes. Harmful and restrictive gender norms around masculinity contribute to the underlying causes of poor health outcomes for men and boys, such as of high rates of suicide and high-risk behaviours.¹ The evidence for the poorer health outcomes is borne out through the global burden of disease studies. While the analysis draws on gender roles, the dynamic does not rely on the prevailing impact of patriarchy and gender power relations. However, targeted interventions focused on men’s health could reduce the overall burden of disease, with spillover benefits for the psychological and physical health of their female partners, family members, and society as a whole.²

A third agenda outlines the need to refocus the gender discourse to recognize the fallacies of heteronormativity and of gender as binary. The arguments for gender equality under this agenda highlight the intersectionality of gender power relations and the stigma and mistreatment often faced by LGBTQI communities. Addressing gender equality under this agenda would need to include the development of an evidence base to better understand  the range of health needs, as well as strategies to uphold rights and eliminate discrimination.  

These agendas have created arguments for competing vulnerabilities, competition for resources and have diluted efforts to advance gender equality. The dissonance relates to a fundamental difference in the expected outcome of equitable health policies and programmes. For the women’s rights and LGBTQI rights advocates, gender equality (and equity) is one of the outcomes of health programmes, and is on equal footing with health impact. Within a public health approach, which underpins many of the men’s health arguments, better health is the primary goal, and gender equality is instrumental in contributing to the improvement of health outcomes. In reality, however, there are significant opportunities for convergence. Gender equality should not be about competing ideologies. 

From a rights perspective, equality is not a zero-sum game – rights for one do not reduce the rights of another. Interventions to advance gender equality from the perspectives outlined above, all have the potential to improve ease of access to healthcare and resources. 

We need different agendas promoting the specific health needs of women, men and people with non-conforming gender identities. But we also have a common agenda, which is to promote policies, approaches and investments that aim to transform structural gender inequalities and power dynamics. 

We need to retain ‘proximate’ gender strategies that focus on women’s empowerment, redefining masculinity or promoting diversity to overcome barriers and drive health access. However, we also need to go beyond these strategies, and refocus our efforts to address the upstream gendered power inequalities together. Otherwise, a gender equality agenda from a men’s health perspective could focus on changing restrictive norms around masculinity, self-care and health-care seeking alone, and miss out on the opportunity to address the deeper power and privilege that underlies the perpetration of violence against women.

Achieving gender equality cannot be described with statistical data alone. Where inequality is rooted in the maldistribution of power and resources, the social justice perspective that underpins global health provides strong justification for interventions that have an explicit values agenda to right the wrongs in society.³

Pascale Allotey is the Director of the United Nations University’s International Institute for Global Health. 

Michelle Remme is a Research Fellow at the United Nations University’s International Institute for Global Health.

Competing Interests: None.

Acknowledgements: This opinion article draws on discussions from the group of ‘gender disruptors’ who met at a dialogue hosted by UNU-IIGH in April 2019.

 

1. Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G. The men’s health gap: men must be included in the global health equity agenda. Bull World Health Organ. 2014 Aug 1;92(8):618–20. 
2. Hawkes S, Buse K. Gender and global health: evidence, policy, and inconvenient truths. The Lancet. 2013 May;381(9879):1783–7.
3. Khosla R, Amin A, Allotey P, Barroso C, George A, Hardon A, et al. “Righting the wrongs”: addressing human rights and gender equality through research since Cairo. Sex Reprod Health Matters. 2019 Jan 1;27(1):329–32.

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