Gender disparities in clinical practice: are there any solutions? Scoping review of interventions to overcome or reduce
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(2020) 19:166
REVIEW
Open Access
Gender disparities in clinical practice: are there any solutions? Scoping review of interventions to overcome or reduce gender bias in clinical practice Lorena Alcalde-Rubio1, Ildefonso Hernández-Aguado1,2, Lucy Anne Parker1,2, Eduardo Bueno-Vergara1 and Elisa Chilet-Rosell1,2* Introduction Gender, understood as “social relationships between males and females in terms of their roles, behaviours, activities, attributes and opportunities, and which are based on different levels of power”, [1] is one of the main social determinants of health [2]. The damage caused to population health by gender inequality across the globe is immense and justifies comprehensive actions addressing gender equity in health at all levels [3]. In the words of Hawkes and Buse, “Now is the time to take the call from Alma Ata in its literal sense—“Health is for All” not only for some. Embedding of gender in global health provides one promising route to attainment of the longstanding, but long-languishing, human right—the right to health” [4]. The root causes of gender inequality encompass all societal spheres and a multisectoral approach is required [5]. In fact, it has been shown that actions across multiple sectors in low and middleincome countries can improve a variety of health and development outcomes [6]. Therefore, there is no doubt that gender mainstreaming should pervade all policies. The UN Economic and Social Council embraced this approach in 1997 as “assessing the implications for women and men of any planned action, including legislation, policies, or programmes … so that women and men benefit equally, and inequality is not perpetuated” [7]. * Correspondence: [email protected] 1 Department of Public Health, History of Science and Gynaecology, School of Medicine, University Miguel Hernández, Crta Nacional, N-332, s/n, 03550 Sant Joan d’Alacant, Spain 2 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
On global level, the impact of gender inequality on health was later included in the UN’s the Millennium Development Goals, and remains significant in the Sustainable Development Goals [8]. In the health domain, there has been a substantial interest in gender issues in the last two decades. Vlassof and García Montero explained why gender is key to understanding all dimensions of health including healthcare, health seeking behaviour and health status. Consequently, they proposed transformation in all areas of the health sector in order to integrate gender perspective [9]. This integral change should encompass actions on policy, research, training and programmes including interventions at the individual level. We have witnessed an appreciable increase in the consideration of gender in health plans [5, 10] and particularly in those focused on women’s reproductive health [11, 12]. However, more than 20 years of research from high-income, middle income and low-income countries shows that gender inequalities remain embedded in health systems [13, 14]. Within health care systems, unconscious g
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