Gender dynamics in digital health: overcoming blind spots and biases to seize opportunities and responsibilities for transformative health systems

INTRODUCTION

This commentary highlights key gender dynamics in digital health, including blind spots and biases, as well as transformative opportunities and responsibilities. It draws upon literature and lessons learned from the International Development Research Centre’s ‘Strengthening Equity through Applied Research Capacity building in eHealth’ (SEARCH), which includes seven research projects in Bangladesh, Burkina Faso, Ethiopia, Kenya, Lebanon, Peru and Vietnam

Digital health “gendered blind spots” and biases

Girls and women are often targeted as key beneficiaries of programmes; however, they may continue to be missed if interventions do not account for the gendered social relations that govern access to digital technologies. Despite gendered blind spots and biases, digital health has the potential to positively impact gender relations.

Gender-blind interventions do more harm

When digital health interventions are gender-blind, they may potentially place key intended populations further risk at risk. For example, digital health programmes may threaten familial relationships if the messaging empowers practices in conflict with prevailing social norms.

Marginalised voices are not always heard

Third, women, girls, and other marginalised gender identities are often targeted as homogenous groups and not given opportunities to actively engage in and shape projects to better fit their needs.

Gender inequalities operate in health systems at multiple levels and must be addressed at individual, community, program and policy levels if digital health is to achieve its full potential. - Isabel Diaz-Reviriego

KEY TAKEAWAYS 

1. Gender-blind interventions can do more harm

   When digital health interventions are gender-blind, they may potentially place key intended populations further risk at risk. For example, digital health programmes may threaten familial relationships if the messaging empowers practices in conflict with prevailing social norms.

2. Understand gender inequality and power relations

   A critical first step in developing digital health solutions that support gender equality is to understand existing gender inequalities and power relations. Consulting and engaging marginalised women – as well as men, leaders, decision-makers, and gatekeepers – is vital to ensuring that interventions address their needs and do not further harm them.

3. Apply an intersectional gender lens

   Addressing gender inequality through digital health also requires exploring how gender intersects with other social stratifiers to influence experiences of marginalisation. Women, girls, and other marginalised gender identities are often targeted as homogenous groups and not given opportunities to actively engage in and shape projects to better fit their needs.

4. Ensure support is provided at every level

   Providing sustained support over time, across all health system stakeholders and levels, is necessary to ensure that transformative change is not limited to one subset of actors in the health system. Incremental learning and reflection are also required in order to nurture acceptance and respond to unanticipated reactions.

Given that digital health solutions are spread across diverse health system interfaces and levels, there is no one size prescriptive formula or checklist. Incremental learning and reflection is required to nurture ownership and respond to unanticipated reactions, particularly when shifting power relations underpinning gender inequality. - Mary Thompson-Hall

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