Governments are putting women and girls at greater risk of the health and socio-economic impacts posed by the coronavirus pandemic, two global studies released Wednesday show, calling on leaders to prioritise gender equity in their response to the health crisis.
Two studies, one from a global research partnership led by the Global Health 50/50 Project in London and another by the Center for Global Development (CGD) in Washington, were released Wednesday to coincide with World Health Day that highlight major failings by national governments to consider sex or gender in their Covid-19 policies.
Many women have shouldered a heftier burden taking on more unpaid work such as carer responsibilities, while an overwhelming number occupy frontline healthcare roles and other jobs classed as "essential" like teaching, cleaning and domestic services, as well as consumer-facing jobs that potentially increase their risk of exposure to the virus.
“What we’ve got is a blanket disregard for inequity in these policy responses,” Professor Sarah Hawkes, co-director of the Global Health 50/50 Project, said of the way governments have managed the pandemic in respect of gender.
The Sex, Gender and Covid-19 Health Policy Portal, a global study collaboration between the Global Health 50/50 Project, the African Population and Health Research Center, and the International Centre for Research on Women in India, tracked 192 countries and reviewed the websites of ministries of health from 76 countries as part of their latest research into gender and Covid-19. They examined government health policies based on six key areas according to World Health Organization (WHO) pandemic response recommendations: vaccination, public health messaging, clinical management, protection of healthcare workers, disease surveillance and maintenance of essential health services. They found that 91 percent of Covid-19 health policies made no reference to gender.
This is despite the WHO repeatedly urging governments to ensure their Covid-19 health policies are gender-responsive. Only four countries – Canada, Bangladesh, South Sudan and India – passed muster, reporting policies for three out the six key areas. Scandinavian and northern European countries, which are known for considering gender across policy areas and were expected to do well, ranked relatively poorly.
Professor Hawkes says that, historically, health and medical systems have been gender-blind, but the pandemic has exacerbated inequities. Viewing the pandemic’s effect on gender could lead to a far better understanding of attitudes towards vaccination and to more effective public messaging on Covid-19.
“If you just have a policy that says everybody must get vaccinated but don’t take into consideration why women might have hesitation around vaccination, you’re going to see that reflected in data that, for example, women of a certain age are likely to be under-vaccinated,” Professor Hawkes said.
“If you put a vaccine out that has not been tested on pregnant women it’s not surprising to see these women might be hesitant about vaccination.”
Women and girls in lower-income countries have borne the brunt of the Covid-19 crisis, according to new research from the Center for Global Development. The CGD has analysed more than 400 global studies released since the pandemic began.
Unlike past crises where men’s employment was typically at risk, early evidence on the pandemic has shown an inordinate impact on women’s employment, working hours and wages relative to those of men. More women than men lost their jobs and businesses run by women were forced to shutter at higher rates.
Overall, the CGD data has shown that women have different experiences of the pandemic. Aside from the higher rates of domestic violence, which have been well-documented, more women have dealt with deteriorating mental health – higher rates of depression, anxiety, stress and fear – than men. And in some countries, access to sexual and reproductive health has declined.
“What was anecdotal is now increasingly backed up by rigorous data and evidence: Women have been disproportionately hurt by the Covid-19 pandemic – whether it’s the operation of their businesses, their earnings, or their own safety and security,” said Megan O’Donnell, who leads the Center for Global Development’s Covid-19 Gender and Development Initiative.
The CGD, like the GH 50/50 Project, also evaluated how well national governments had performed in response to the pandemic and found that, to date, less than 20 percent of economic relief and recovery policies were designed to address women’s needs.
The role of sex
As with past pandemics, there is evidence that the effects of Covid-19 have been exacerbated by social attitudes to gender but there is also the role of biological sex to consider and how biological differences have led to different health outcomes. Professor Hawkes said there are clear differences in male and female immune system responses to viruses that may explain higher ICU admissions for men than women generally but that in certain countries social attitudes to gender, and not biological sex, may account for the discrepancy.
“Patterns of who seeks health care are very gendered, and then when you’re inside the health system how you get treated depends on whether you’re a man or a woman,” Professor Hawkes said.
She cites data showing that the rate of ICU admission for men is double that of women in some countries.
“Some of that is possibly down to gender in countries where you have to pay for admission to an ICU,” she said. “Is it that families just don’t pay for women to be admitted to ICU? We just don’t know; the studies haven’t been done.”
Regardless of the reasons behind these differences, ignoring gender and sex could have huge implications for pandemic planning, recovery and ongoing vaccination programmes.
According to UN estimates, an additional 47 million women and girls will fall into extreme poverty due to the global health crisis and poverty rates will not return to pre-pandemic levels until 2030.
To try to resolve some of the gender inequities, CGD researchers have made a number of recommendations including cash transfers; labour programmes to reduce and redistribute the unpaid care work women do; improving data collection; and monitoring the everyday realities of women and girls to tailor Covid-19 strategies and recovery measures. Last but not least, the CGD calls for more women to take on leadership and decision-making roles.
Researchers from both the CGD and GH 50/50 Project agree that the onus is on governments to do more to reverse “gender blindness”.
“Gender gaps will not disappear with the distribution of vaccines,” said the CGD’s lead researcher, Megan O’Donnell. “Covid-19 has exacerbated long-standing gender inequalities, and – if governments don’t act – could have far-reaching negative impacts on women’s health and economic standing for decades.”