Gender blind? An analysis of global public-private partnerships for health
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RESEARCH
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Gender blind? An analysis of global publicprivate partnerships for health Sarah Hawkes1* , Kent Buse2 and Anuj Kapilashrami3
Abstract Background: The Global Public Private Partnerships for Health (GPPPH) constitute an increasingly central part of the global health architecture and carry both financial and normative power. Gender is an important determinant of health status, influencing differences in exposure to health determinants, health behaviours, and the response of the health system. We identified 18 GPPPH - defined as global institutions with a formal governance mechanism which includes both public and private for-profit sector actors – and conducted a gender analysis of each. Results: Gender was poorly mainstreamed through the institutional functioning of the partnerships. Half of these partnerships had no mention of gender in their overall institutional strategy and only three partnerships had a specific gender strategy. Fifteen governing bodies had more men than women – up to a ratio of 5:1. Very few partnerships reported sex-disaggregated data in their annual reports or coverage/impact results. The majority of partnerships focused their work on maternal and child health and infectious and communicable diseases – none addressed non-communicable diseases (NCDs) directly, despite the strong role that gender plays in determining risk for the major NCD burdens. Conclusions: We propose two areas of action in response to these findings. First, GPPPH need to become serious in how they “do” gender; it needs to be mainstreamed through the regular activities, deliverables and systems of accountability. Second, the entire global health community needs to pay greater attention to tackling the major burden of NCDs, including addressing the gendered nature of risk. Given the inherent conflicts of interest in tackling the determinants of many NCDs, it is debatable whether the emergent GPPPH model will be an appropriate one for addressing NCDs. Keywords: Global public private partnerships for health, Gender, Mainstreaming, Non-communicable diseases
Background Gender is an important determinant of health status – influencing, at a minimum, rates of risk-exposure to common drivers of ill-health, health-care seeking patterns, and the nature of the health system’s response to illness. It is with the latter that we are concerned in this paper. We focus on global public-private partnerships for health (GPPPH) since they are an important component of the global health architecture, are seen as having significantly increased the resources available for global health [1–4], and are promoted by some as offering critical opportunities to improve “efficiency, equity, value * Correspondence: [email protected] 1 Institute for Global Health, University College London, 30, Guilford Street, London WC1N 1EH, UK Full list of author information is available at the end of the article
for money, and outcomes in global public health” [5]. Moreover, the public-private partnership approach has been encouraged as a mech
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