Global Health as Gender Equality
May 2021

By Bejanchong Foretia, MPH; Program Analyst AMCHP: Women’s and Infant Health Team, Global Health Workgroup

Setting the Stage for Gender Equity: The Beijing Platform for Action

In Beijing 1995, a unanimous vote was taken to adopt the Beijing Platform for Action (BPfA). This landmark achievement of the Fourth World Conference on Women was built to ensure that every woman and girl child could realize and actualize her full freedom, rights, and potential. It was, and still is, the most progressive blueprint for advancing women’s rights around the world. This framework helps us understand what global health could mean for women and girls. The BPfA considers 12 areas covering critical areas of concern:

  • ​Women and the environment
  • The girl child
  • Women and poverty
  • Human rights of women
  • Institutional mechanisms for the advancement of women
  • Women and the media
  • ​Women in power and decision-making
  • Women and the economy
  • Violence against women
  • Education and training of women
  • Women and health
  • Women and armed conflict

The BPfA was met with great enthusiasm as countries promised to advance gender equality to meet a universal goal of peace, sustainability, and elimination of poverty. The years following the adoption of BPfA would bring major agendas and resolutions to support those goals, with the intent of reminding the world of the commitments made in Beijing. The point driven home is there is no “world peace” if half the population remain oppressed and are made vulnerable by virtue of their sex and/or gender and by how society interacts with them. As a critical part of the ideal world, global health must be all inclusive and reach those who have always been excluded from power.

Gender Equity as Global Health 

To me, global health means: Security for women and girls by way of gender equality in all things, areas, and concerns to ensure health, well-being, and empowerment. Without this understanding, global health initiatives and projects become blind to the power hierarchies in any society that place women and girls, especially those in the minority, in vulnerable positions. While I focus on global health, it is important to recognize that domestic U.S. health policies are included in this framing. When we analyze power structures in our own health systems, we begin to ask critical questions such as:

  • “Who is in charge of women’s healthcare?”
  • “How is women’s health controlled?”
  • “What (if any) policies exist to protect women’s health?”

In a system where there is inequal access to not just health, but also to housing and education, questioning where the power lies is critical in determining how to provide access to these services to everyone.

In my courses at George Washington University Elliot School of International Affairs, I studied global gender policy hoping to incorporate gender studies into women’s health programs both domestically and internationally. I realized that the subject of gender as it relates to the health of women and girls, was still relatively new and often failed to achieve true transformative outcomes of gender empowerment. There are many reasons as to why: poor financial investment; lack of gender training for staff; lack of community voice and leadership; poor understanding of contextual gender norms; and even exploitative practices. These mistakes would bring severe consequences for the well-being of women and girls.

For example, as we enter Year 2 of the COVID-19 pandemic, the lack of emergency preparedness infrastructure in place for gender-based violence of women and girls became apparent. Emergency preparedness plans across states and countries failed to account for those who were required to stay indoors with an abuser and offered very little assistance to get them to safe houses or provide private ways of reporting abuse. Here, a global health emergency meant women and girls would be affected in a unique and severe way, but the lack of gender policy inclusion into emergency preparedness plans meant the COVID-19 pandemic would be underscored by what the UN calls a “shadow pandemic” of domestic and gender-based violence. Again, it is important to ask, who were the decision-makers; moreover, were issues of gender considered important to include and implement in an emergency? It is important to consider gender equality as a specific and significant aspect of global health because the health care of women and girls is often the first to be attacked and stripped in times of crisis. In this way, global health becomes an extension of human rights and ensures that everyone has full access to healthcare and the right to security. This notion was recognized at the Fourth World Conference on Women when BPfA was adopted. Twenty-five years later, we still have work to do in keeping the promises of this Conference as well as the many agendas and resolutions that we as members of the world conference agreed to. The UN Human Development Index 2020 rated the United States 17th in the world in gender-based disadvantage (what is called the Gender Inequality Index). This ranking reflects the need for even a powerful Global North country to incorporate gender equality into policy and programs for the benefit of all people.

But as we face new challenges such as climate change and racial equality, global health – and therefore gender equality – take on new meaning. We must think about the policing of Black and Brown bodies and its severe effects on maternal health. We must think about climate change that causes mass migration and displacement in which women and girls face trafficking, food insecurity, and violence. And while I speak of women and girls specifically, we must also recognize these issues as they affect men and boys, as well as gender and sexual minorities, differently. The idea is to rid ourselves of power imbalances that oppress certain groups in different contexts. Fortunately, there are many advocates who do invest in gender transformative solutions to global health problems.

What Can Be Done?

The challenges of the previous year have made the need for advocacy, leadership, and diversity a critical step in addressing these issues that intersect with issues of gender equality. This does not mean that future health programs should simply “add women” to become comprehensive and sensitive to gender needs. Gender equality must be mainstreamed into all aspects of planning, designing, implementing, budgeting, and evaluating health programs. Gender equality programming requires attention and responsiveness to the power dynamics in any context. It also requires a knowledge of intersectionality and the complexities of societal impacts on different groups. Many advocacy groups do this work: Promundo, seeks to engage men and boys in leading the charge to advocate for gender equality and preventing violence; Tostan International works to empower communities to lead their own development projects. Those of us working in the realm of Title V can learn from these examples to consistently and effectively center gender equality to reach our goals.

Consider these action items in your organizations to get started on mainstreaming gender:

  • Start writing gender analysis for your new projects—This means considering context, history, statistics, power dynamics, and gender norms for your population.
  • Learn about intersectionality—Think about how your program will affect multiple different groups and identities.
  • Invest in gender—Consider additional expenses to cover gender-related costs in your program budgets.
  • Ask about power—Where does power lie in your own organization? In the community? What is the relationship between your organization, the community, and government leaders?
  • Learn from one another! Peer learning is essential to expand our understanding of gender equality and how that shapes global health. Start looking for global examples of leaders and groups that center equality.

We, as MCH professionals, need to prioritize the rights of women and girls as essential to the life course of health and well-being. In doing so, we help to fulfill the promises of the BPfA while amplifying the voices, experiences, and rights of women and girls around the world.