Feminist, rights-based solutions to address NCDs: Strengthening the evidence base on sex differences and gender inequities.

Towards a global call-to-action to close the gender health gap

At the 67th session of the Commission on the Status of Women (CSW 67) in March 2023, global leaders, researchers, and advocates highlighted the disproportionate burden of NCD and associated risk factors and persistent gaps faced by women and girls in accessing NCD-related information, prevention, timely diagnosis, services, and support.

In response, civil society raised a call to action, setting out four priority actions for Member States to achieve progress towards the Sustainable Development Agenda 2030 and improve health services and outcomes for women and girls.

The call-to-action outlines feminist solutions to addressing NCDs along four strategic areas:

1. Scale up grassroots innovations creating equitable solutions for NCD prevention and control;
2. Integrate NCD services, including digital health solutions, into primary health care;
3. Support the full, meaningful, and active participation of women and girls in health-related decisions, including health planning, programming, and monitoring, and
4. Strengthen the evidence base on sex differences and gender inequities.

This article is the final feature in a four-part series discussing key aspects and concrete examples of feminist, rights-based solutions to address NCDs outlined in the call to action.

Strengthen the evidence base on sex differences and gender inequities

Building a better understanding of sex and gender differences also requires understanding the intersecting disadvantages in the broader determinants of health, contextual barriers to accessing services, and availability pathways leading to quality care Crucially, this requires more and better quality evidence, as data must be disaggregated by sex and gender, at time of collection, during analysis, and when sharing evidence with decision-makers.

To this end, more research dedicated to closing evidence gaps in sex- and gender-related differences in addressing the burden, causes and management of NCDs is needed, and must be better supported through capacity building and funding.

EQUALS is a global network of over 100 partners including the International Telecommunication Union, GSMA, the International Trade Centre, the United Nations University and UN Women. The EQUALS Research Coalition focuses on generating knowledge about the existence, causes and remedies for gender tech inequalities, and on motivating key stakeholders to collect and share gender-relevant and disaggregated data.

A recent report from the EQUALS Research Coalition highlights gender gaps across different facets of digital technologies and provides an analysis of sex-disaggregated ICT data in Africa. One alarming example is that only 11% of African countries collect and share sex-disaggregated data on ICT skills among their populations.

Similarly to the EQUALS example, our understanding of the disparities in disease between sexes and genders is limited, leading to suboptimal diagnosis, decision-making and treatment. Funding mechanisms and government agencies have a pivotal role to play in addressing this issue by implementing guidelines on insisting on sex and gender-specific evidence throughout research and implementation processes. Funding policies should require researchers to prioritize the inclusion of sex and gender considerations in data collection, analysis, and reporting of biomedical research.

This shift towards more granular and gendered data collection and analysis will greatly benefit women and gender minorities who are currently underrepresented in research.

Background: Feminist, rights-based innovations, and solutions to address NCDs

The landscape of women’s health has transformed over recent decades. Improved maternal and neonatal health programs, demographic changes, urbanization and shifts in global dietary and behavioral habits mean that NCDs are now the leading causes of death among women and girls globally. Two out of three women die from an NCD  – including cancer, diabetes, cardiovascular diseases, chronic respiratory diseases and mental health conditions– accounting for 19 million deaths every year, a majority of which occur in low- and middle-income countries.

Gender is a major social and structural driver of inequity in health, which is both linked to and exacerbated by NCDs and their associated risk factors. In many countries, women face limited access to timely, safe, and quality health services and information. Similarly, they are often more exposed to NCDs and their risk factors due to persistent social, gender and economic inequalities. Globally, health conditions that affect women more than men garner less funding.

The right of women, girls, and gender minorities to participate in decisions concerning their health and wellbeing and access affordable, quality healthcare at every stage of their lives is a cornerstone of health equity. A feminist approach to addressing NCDs can reduce discrimination and support gender-equitable health and development commitments. To close the gender health gap, developing and supporting grassroot innovations and collaborations that harness new technology, context-relevant research and implementation on the ground offer promising initiatives to reduce premature deaths from NCDs that are worth supporting and scaling.

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