The problem of gender inequality in health care
Social policy aimed at creating conditions for development based on use and development of human potential, is intended to include a gender component into all areas of public life: politics, economics and culture. And while gender inequality and discrimination are particularly important. Unfortunately, gender inequality in health is one of the most acute social problems, that need to be addressed below.
First, it is necessary to define such important notions:
- Gender equity means honesty and fairness in the distribution of benefits, power, resources and responsibilities between women and men. This concept recognizes that women and men have different needs, power and access to resources and that these differences should be identified and treated in a way that it helped to overcome the imbalances and disparities between the sexes. (UNICEF 2008)
- Gender Equality means there is no discrimination by sex in terms of opportunities, allocation of resources or benefits, and access to services and care. (UNICEF 2008)
In the health care both of these phenomenon are important. Inequalities in health between women and men reflect biological factors, which remain unchanged, and socially constructed gender differences, which can have an impact. Therefore, the aim of health policy often is to achieve gender equity, rather than gender equality. For example, the policy should not be sent for compulsory equalization of mortality and morbidity between men and women, as some of the differences reflect the purely biological aspects related to health. (WHO 2008)
Thus, all citizens regardless of their gender are interested in the development of healthcare system and services, but because of the biological characteristics associated with reproductive function, women use health services more intensively. For women in particular are important health services associated with reproductive function (the right to motherhood, unwanted pregnancy, the possibility of obtaining high-quality and timely medical assistance in case of pregnancy and childbirth, etc.), which involve the provision of appropriate health services, their accessibility, acceptability and quality. (Payne 2006)
Speaking about gender issues it is important that women are not only consumers but also producers of medical services. According to official statistics, women in health care present about 80% of employees. (Hausman L. 2007) Thus, for the principle of equality of citizens’ rights to receive medical care and quality health services, it is necessary to know what are the gender health issues and what are the known methods of solving them.
Gender differences in health care (in the quality of health care to meet the needs of women and men) are well known: there is a difference between men and women in life expectancy, risk of mortality and morbidity in behaviors regarding their own health and use of health services. (Payne 2006) At the same time, according to numerous research evidence to demonstrate the importance of a number of different social determinants of health, which interact with gender inequality in its various forms, so that their impact on health can be enhanced even more. Nevertheless, gender-sensitive health policies are not discussed and investigated directly. In determining the needs of women and men in health care continues to dominate an approach based on gender-specific needs for health care services. It’s no secret that for women and girls these needs are mainly associated with reproduction and treatment of diseases of reproductive system. (Payne 2006)
In health systems in the world there are different ways to acknowledge the existence of gender inequalities and gender injustices. In different countries to achieve gender equality are used different strategies, which can be divided into four categories: legal and regulatory approaches, organizational approaches and informational approaches.( Bertakis 2000)
With regard to the policy issue, there are two key elements in the need to include gender among the highest priorities in the activities of the health systems. The first element is lack of attention to gender issues (injustice) in public policy in general, and, that it is extremely important, in health care policy in particular. Second element is that many health systems generally can not cope with the estimation of the diverse needs for health care services that are available for both men and women.
If in the health care system will not be taken concrete measures to overcome all forms of injustice, it can cause a number of consequences, including premature death and ill health among people exposed to injustice, and increased burden on the health-care system. Thus, gender inequlity involves a number of consequences. The most important of them is a gap between women and men mortality and morbidity. As a result, the gap has had a substantial cost to health systems and society in general, especially social and economic costs associated with excessive premature mortality in men and excessive morbidity. (WHO 2011)
Every government has responsibility for the development of the health policy, which takes into account all the needs of the population, including gender issues. And it’s very important that the state confirmed its responsibility for social justice in health care and social equality, stressed the importance of social equality (including gender) in health and medical services. The importance of a gender approach to health policy and strategy has been stressed at the international level within the UN. Nevertheless, each State must develop its own policies in health, taking into account gender issues. (WHO 2011)
Next it is necessary to discuss what the health care priorities to fix health inequities within Hong Kong that should be over the coming decade.
Health care Policy approaches, aimed to fix health inequities in Hong Kong
The adoption of a gender strategy as a state policy requires to solve complex social problems in Hong Kong. One of the main purposes of gender-related social policy is the protection of public health and, above all, increase the health and reproductive health of women and men. On how to responsibly and promptly responds state and civil society on the dynamics of change in gender relations, preventing the emergence and spread of negative tendencies and promoting the development of gender solidarity, directly dependent the quality and standard of living of the population of Hong Kong, political and social stability.
In the basis of a health policy can be put one of the three approaches:
- Regulatory approaches include laws aimed at combating discrimination, human rights and the protection of patient rights, and laws requiring authorities in the public sector to take measures against manifestations of gender inequality. (WHO 2009)
- The organizational approaches include the incorporation of gender issues among the highest priorities; development of budgets, taking into account specific gender needs (so-called “gender budgeting”), setting targets for outcomes for health and use of gender tools to facilitate the assessment of evidence concerning gender differences. With these approaches is used a variety of tools to identify and demonstrate gender equality issues present in making decisions on fiscal issues in the development and implementation of policies and policy outcomes. (WHO 2009)
- The informational approach focuses on the need to have accurate and complete information, which is the basis for effective strategic management of health care. These approaches include the use of health indicators that are gender sensitive and gender equality indices. (WHO 2009)
There are some approaches, which must be developed and applied: the inclusion of gender issues among the highest priority (the so-called “gender mainstreaming” or integrated approach to equality between women and men), development of budgets from a gender-specific needs (so-called “gender budgeting”).
1) The inclusion of gender issues among the highest priorities. The inclusion of gender issues among the highest priorities is directed to provide a policy addressing gender issues, bearing in mind the systemic approach in which each level is entered politics of gender analysis and assessment of the impact of interventions on men and women. (WHO 2009)
2) Development of budgets with consideration of gender-specific needs. Development of budgets from a gender-specific needs, or gender budgeting means an analysis of the various stages of the budget process from the standpoint of the gender issue and is often seen in the context of human rights and legislative changes. (WHO 2009) But only development of budgets is not enough to achieve gender equality: it should be part of a broader strategy aimed at the inclusion of gender issues among priority in all policy areas, for example, together with an estimation of the impact of interventions on men and women.
With all of the above approach assumes the same conditions necessary to achieve gender equality and implement the changes, and can help to fix gender inequities in health care in Hong Kong.
Bertakis K et al. (2000). Gender differences in the utilization of health care services. Journal of Family Practice, 49:147–152.
Hausman L. et al. (2007). The global gender gap report 2007. Geneva, World Economic Forum. Retrieved from: http://www.weforum.org/en/initiatives/gcp/Gender%
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Payne S. (2006). The health of men and women. Cambridge, Polity.
Wizeman TM, Pardue ML. (2001). Exploring the biological contributions to health: does sex matter? Washington DC, National Academy Press
WHO (2009). “How can gender equity be addressed through health systems?”. Retrieved from: http://www.euro.who.int
WHO (2011). Human rights and gender equality in health sector strategies. Retrieved from: http://www.ohchr.org/
UNICEF (May 12, 2008). “Gender equality”. UNICEF. Retrieved from: http://www.unicef.org/gender/