The values and norms that guide the functioning of health systems are gendered this has implications for equity and outcomes. Understanding these dynamics and acting on gendered inequities is central to HPSR.

Why is this an important issue?

Health systems are comprised of what has been described as hardware, or the building blocks, and software. While many are familiar with the building blocks – service delivery, financing, governance, human resources, medicines and commodities and information systems – the software is equally important. The software of the system includes relationships, power, trust, values and norms.

Health systems are a product of their environment they are shaped by dominant notions of gender and in turn can reproduce or reinvent these power relations. HPSR seeks to strengthen the coverage, quality, efficiency and equity of health systems, this includes gender equity.

The field of HPSR - as with other academic disciplines – has historically discriminated against women. This is an issue of inequity and affects the quality of research produced.

Alliance track record

The Alliance recognizes the need for gender sensitive research and decision making related to HPSR. In 2018 the Alliance convened a group of gender and health systems experts at a workshop on the HPSR research agenda and gender and intersectionality. To ensure that policies and programmes address gender-based social inequities, they must be informed by evidence on gender and its intersections with other social stratifications (such as race, ethnicity, caste etc.). The objectives of the meeting were to inform broader thinking on the HPSR agenda and guide future funding.

Issue in practice

The Alliance supports a programme of work on gender and intersectionality for HPSR in the South East Asia Region. The Ramalingaswami Centre for Social Determinants of Health in India is a lead regional mentor institute. They manage a research fellowship programme for participants from the region, especially from fragile and conflict-affected settings. Fellows participate in a mix of in-person and online courses, which serve as the basis for a global online resource on gender and intersectionality.

Our commitment to promoting women leaders in HPSR is demonstrated in all our projects – which require at least 50% of team members are women – and through specific initiatives, such as publication mentorship.

The Alliance disaggregates its own data by gender, tracking metrics such as lead authorship of peer review publications. We are committed to collecting, and reporting, on further data that takes into account gender and other forms of historic advantage and disadvantage.

We have launched mentorship programmes specifically targeted at women and are supporting new areas of research that employ a gender and intersectionality lens in health systems strengthening.