INTRODUCTION
The gendered dimensions of health systems
The guide defines what a gender-equitable health system would look like and describes the gendered dimensions of the six building blocks of the health system – namely health service delivery, governance, medical products and technology, health systems financing, human resources, and health information systems.
What is a gender equitable system?
A gender equitable system: provides equitable opportunities for men, women, and gender minorities working within the health system; produces relevant sex-disaggregated health information that shapes policy; ensures men, women, and people of other genders, across the lifespan, are able to access and utilise services unimpeded by financial, social, and geographic barriers; and addresses their most urgent needs in an appropriate manner.
To work towards a more equitable health system that serves everyone, and meets health goals, policy makers should consider gender at all levels of the health system, and in all activities. Integrating gender into policy analysis is an issue of rights and social justice. Gender inequity always intersects with other areas of inequity such as those related to class, race, income, ethnicity, age, disability, migrant/settled status, and sexuality.
KEY TAKEAWAYS
Health service delivery
Assess health service delivery and health facilities, and engage community-based stakeholders in doing so, to understand how gender and other social norms influence access to quality care; expand awareness of and demand for gender-equitable health care beyond maternal care; and encourage service providers to engage men, such as spouses, in woman-centred care.
Human resources for health
Collect gender-disaggregated data at all levels; eliminate discrimination in hiring practices; strategically work towards a gender balance in the workforce all levels and promote women’s advancement; provide safe workplaces, including mechanisms to address violence and harassment; ensure equal pay for equal work; provide equal opportunities for participation in capacity building and professional development activities; provide paid parental leave, childcare, and spaces and flexible times for breastfeeding; and train all staff to provide gender-sensitive care and understand how gender and other social norms intersect to influence people’s experiences.
Governance
Ensure Ministries of Health collaborate with their counterparts responsible for gender equity in policy development; ensure health systems oversight, regulation, design, accountability, and policy frameworks are gender-transformative (i.e., address the root causes of gender-based health inequalities and transform harmful gender roles, norms, and relations); ensure a gender balance at all levels of governance structures; create a culture of gender sensitivity and integrate gender into all decision-making, including gender-responsive budgeting; and meaningfully engage communities regarding gender, rights, accountability, and health to inform policy and practice.
Health information systems
Train staff and integrate gender metrics into standard operating procedures; develop gender-sensitive indicators and data collection methods; collect and analyse data disaggregated by sex and other social stratifiers at all levels of the health system, including data on the social impacts of health interventions and related to human resources for health; and commission qualitative research to better understand health inequities.
Medical products and technologies
Commission studies to explore the differential impacts of medical products; ensure essential medicines lists reflect the gendered health needs of men, women, and gender minorities and that medicines for gender-specific care are available; and engage with diverse members of the community to assess the efficiency of procurement and supply systems and the gendered impacts of technology (on health, time, resources, empowerment, etc.).
Health financing
Integrate gender analysis into all health financing research and policy development processes, including Universal Health Coverage; ensure financial protection packages include sexual and reproductive health services; conduct a gender audit of essential health packages to ensure gender equity; and introduce financing mechanisms that reduce direct and indirect costs for those with least financial access.
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Suggested citation: Kate Hawkins, Sally Theobald, Sassy Molyneux, Richard Mangwi Ayiasi, Sreytouch Vong, Helen Elsey, Sarah Ssali, Kui Muraya, Racheal Apolot, Chinyere Mbachu, Matthew Greenall, David Musoke, Valerie Percival, Rosemary Morgan, Chandani Kharel, Tumaini Nyamhanga, Surekha Garimella, Rachel Tolhurst, Penelope Phillips-Howard and Josyula K. Lakshmi. Adopting a gender lens in health systems policy: A guide for policy makers : UNU Global Health, 2026.
