Does gender make you sick? Understanding and improving health from a comprehensive gender perspective.

Lead Research Organisation: University College London
Department Name: Institute for Global Health

Abstract

Everyone has the right to a chance of a long life in good health, no matter whether they are a man or a woman, rich or poor. However, globally men (in both rich and poor countries) experience a higher burden of disease and have lower life expectancy than women. Much of this difference is due to men's risk-taking behaviours: they drink more alcohol, smoke more tobacco and drive more dangerously than women do. Some of this is driven by gender - i.e. the social rules and norms that tell each and every one of us what is appropriate behavior for men and women in all societies.

Much of the current research on gender and health focuses mainly on women and girls and their health-related risks. We believe it is very important to understand and address the issues that globally place men more at risk of illness, disability and early death. This is important not only for the health of men, but also for women's health too - for example, there is increasing evidence that young women in many countries are now beginning to drink and smoke at similar rates to their male peers. There is also evidence that men's risk-taking impacts negatively on women's health and wellbeing.

We plan to establish and strengthen a network of researchers, practitioners and health advocates, who are engaged with studying and acting to improve the health of both men and women around the world through a better understanding of gender and health issues. Over a period of 3 years, researchers and campaigners in Asia, Africa, the Middle East, the Americas and Europe will come together to deliberate and identify solutions to improve the health of populations in different parts of the world. These ideas will be shared and debated with both policy makers and the communities of men and women whose health outcomes we are hoping to improve.

Seminars will be open to a wide variety of participants, and at least half the time the seminars will be web-based and hence available to all. We will communicate the outputs from the seminars through websites and social media, and hope that in doing so we can raise awareness that gender affects the behaviours, risks, and health of everyone, not just women and girls.

Planned Impact

This proposed activities will benefit a wide range of stakeholders - both as immediate and potential future beneficiaries. Immediate beneficiaries will include collaborators in the proposed new network of researchers, and advocates with an interest in gender, health and masculinities. In addition, participants in the seminars held in each country will benefit from the opportunity to discuss and share ideas about gender and health and identify common problems and solutions.

Additional beneficiaries from each seminar will include those who access the seminar series through the web. Seminars will either be held as webinars, in which case seminar participation is available to all web-users. In addition, we will upload seminar highlights (e.g. presentations, podcasts and vod-casts) post-hoc - again making the seminars available to all web-users. The webinars and all web-based activity will be administered through UCL.

Potential future beneficiaries of this seminar series will include those in decision-making positions who are concerned with priority-setting and resource allocation in health programmes nationally, regionally and globally. Seminar outputs will include policy briefs and research summaries, and these will be disseminated locally to key decision-makers identified through the networks of our proposed collaborators. It is hoped that these outputs will increase the capacity of health decision-makers to make evidence-informed decisions about how best to address issues of gender, health and masculinities. Where evidence is lacking, the network will use its linkages and communication skills to advocate for increased research funding and evidence-gathering.

The proposed new network and seminars will benefit other emerging processes in global health research and policy. For example, through our close links to multilateral institutions (such as WHO and UNFPA) we expect the seminars and their outputs to be of great benefit as they develop their future gender and health strategies.

This proposal has been developed with a range of inputs from both academic and civil society partners, and engagement with civil society will be crucial to ensuring that evidence-informed decisions around gender, health and masculinities are in place in the future. We expect the seminars will be of great interest to a wide variety of civil society organisations working in the fields of health, gender and development. The proposed outputs from the seminars will be useful as advocacy tools. In addition, we expect that future research proposals will be developed as collaborative activities between academic partners and civil society partners. These proposals will specifically include more junior members of staff from collaborating institutions in order to build future capacity in this area.

We will measure the impact of the seminar series through a variety of monitoring indicators, including, but not limited to:
1. Number of collaborative institutions and individuals who participate in the new network focused on gender and health
2. Rates of participation in seminars - both physical attendance, and participation in webinars
3. Sign-up rates to receive email invitations to web and other events hosted by the network
4. Number of times that web-based videos and presentations are viewed and downloaded after events
5. Number of collaborative research proposals submitted by network members
6. Participation of junior colleagues in the development of research proposals.

Publications

10 25 50
 
Description Our seminars (held in India, USA, South Africa) have been instrumental in opening a debate about men's involvement in health services previously mainly focused on women. We have had lively discussions about the impact of involving men in services to improve health outcomes for both men and women, particularly when addressing violence. While we have not yet reached consensus, there is a growing body of evidence that involving men in health programmes will result in better outcomes for the men themselves, as well as for their female partners.

Our seminars held in London, and involving partners from across the world (India, South Africa, USA, Mexico, UK) have been instrumental in moving the discourse forward among partners - particularly to see the interlinked relationship between the health needs of both men and women in relation to gender norms. As noted, our seminars led to a greater understanding/awareness that gender in global health affects everyone. This proved to be a strong catalyst for the development of Global Health 5050 which has now raised money from Wellcome Trust to develop and distribute a global report on the gender responsiveness of 150 global health organisations. We are looking at gender responsiveness both internally (e.g. promotion and protection of women's careers, and issues of gender parity in representation in the workforce), as well as how these organisations serve the needs of all people of all gender identities through their policies and programme delivery. This latter aspect builds directly from the findings of our seminars that gender is often narrowly conceptualised in global health organisations and the health needs of many people in the population (men, boys, women not of reproductive age) are often not being addressed.
Exploitation Route Our seminars have helped catalyse a discussion (among researchers, policy makers, practitioners, advocates, activists) focused on understanding that: (a) gender as a term does not apply only to women; (b) gender norms influence the health outcomes of both men and women; (c) gender is in the main missing as a key concept from policies and programmes aimed at improving health outcomes globally.
We have established a nascent network of all who came to our seminars, and plan to apply for further funding opportunities to take this work and these ideas forward. Our work on promoting accountability for gender equity in global health organisations (https://www.globalhealth5050.org/) will, we hope, be of interest to everyone who works in the field of global health and/or gender.
Sectors Communities and Social Services/Policy,Healthcare,Pharmaceuticals and Medical Biotechnology

URL https://www.globalhealth5050.org/
 
Description 2016: The results from our seminars (esp in India) have been used to foster further debate and discussion among policy makers in India - particularly in relation to men's own health needs as well as the need to involve men in health services for the sake of women's health. There has been positive feedback from senior policy makers in India on the need to have equitable services for men and women. 2017: The results of the seminars held in London (in February 2017) have been extremely positive and have led to the establishment of a global network of partners who work on issues of gender and health. This network (hosted by the new Centre for Gender and Global Health) at UCL includes researchers, practitioners, policy makers, advocates and activists. Future activities include: joint publications; joint seminar series; and applying together for further funding to run the network. In 2017 following the London seminars we established Global Health 5050, drawing upon some of the seminar speakers for membership of our Advisory Council. Global Health 5050 is a new initiative that seeks to hold 150 global health organisations accountable for the gender responsiveness of their policies and programmes. We are compiling a report which will be launched in 5 cities around the world in the first quarter of 2018. The initiative has gained a great deal of interest from both policy makers and policy influencers, and is the first comprehensive accountability mechanism for assessing gender equity and gender equality in global health organisations. Update Sept 2018: Global Health 50/50 was launched in March 2018 and our report has had a significant impact on the issue of gender equality in global health organisations. The editor of the Lancet called it a "landmark in the history of global health". Full details are available at our website: https://globalhealth5050.org/ and details of impact for advocacy and accountability are available here: https://globalhealth5050.org/updates/.
First Year Of Impact 2017
Sector Communities and Social Services/Policy,Healthcare,Pharmaceuticals and Medical Biotechnology
Impact Types Societal,Policy & public services

 
Description Development of tools for European Union to incorporate a gender lens in their health portfolio
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
URL https://www.youtube.com/watch?v=ly4lXY4Gai4&feature=youtu.be
 
Description Request to present evidence on the relationship between gender and health to All Party Parliamentary Group on Malaria and NTDs
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
 
Description Global Health 50/50: Towards accountability for gender equality in global health
Amount £29,764 (GBP)
Funding ID 210398/Z/18/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 02/2017 
End 01/2018
 
Description Collaboration with Stanford University 
Organisation Stanford University
Country United States 
Sector Academic/University 
PI Contribution The Lancet has commissioned Stanford University to produce a series of 5 papers on gender and health. We have been contracted by Stanford to contribute to at least 2 of the papers, and will draw on our experiences of research on gender and health as well as conducting new data synthesis in this area.
Collaborator Contribution Stanford University will be leading on the coordination of 5 papers in a series on Gender and Global Health.
Impact Outputs from this multidisciplinary collaboration (public health specialists, medical specialists, health economists, international relations experts, mathematical modellers, social historians) will be 5 Lancet papers in 2017/8.
Start Year 2017
 
Description Global Health 50/50 
Organisation Global Health 50/50
Sector Charity/Non Profit 
PI Contribution We have established Global Health 5050 which is an initiative to hold 150 global health organisations to account for the gender responsiveness of their policies and programmes in global health. The advisory board for the initiative includes several key members of the seminar series that we have held in the past 3 years of ESRC funding.
Collaborator Contribution Our partners are serving on our advisory board and as advocates for the goals and objectives of Global Health 5050.
Impact We have established an advisory council for Global Health 5050 that contains policy makers and policy influencers at the highest levels in gender and global health. This work has been made possible by establishing networks and contacts through the seminar series, and establishing the UCL Centre for Gender and Global Health. The advisors include:Frances Baum, Chair, People's Health Movement Advisory Council Jan Beagle, Under-Secretary General for Management, United Nations James Chau, Special Contributor, CCTV International & WHO Goodwill Ambassador for Sustainable Development Goals and Health Helen Clark, former Prime Minister of New Zealand & Administrator, UNDP Jocalyn Clark, Executive Editor, The Lancet Gary Darmstadt, Professor and Associate Dean for Maternal and Child Health, Stanford University Roopa Dhatt, Executive Director and Co-Founder, Women in Global Health Cecilia García, Deputy Director of Public Policy, Human Rights Commission of Mexico City Bience Gawanas, former Commissioner for Social Affairs, African Union Commission Hind Khatib-Othman, Managing Director, GAVI Alliance Ilona Kickbusch, Director, Global Health Centre, Graduate Institute, Geneva Geeta Misra, Executive Director, CREA Ulrika Modeer, State Secretary for Development Cooperation, Sweden Sania Nishtar, Founder and President of Heartfile, Pakistan Levi Singh, Secretary-General, African Youth & Adolescent Network on Population & Development Sheila Tlou, former Minister of Health of Botswana & UNAIDS Regional Director Ravi Verma, Asia Regional Director, International Center for Research on Women
Start Year 2017
 
Description Sexual health of migrants and refugees 
Organisation Weill Cornell Medical College in Qatar
Department Chemistry
Country Qatar 
Sector Academic/University 
PI Contribution I am leading a proposal (to VW/Wellcome Trust) in collaboration with one of our partners on the ESRC grant to look at the sexual health of migrants/refugees in West Asia and Europe. This work will use a gender lens to determine health risks.
Collaborator Contribution Our partner (WCMC-Qatar) will conduct modelling of the empirical evidence for the impact of interventions.
Impact This research is fully funded by Wellcome Trust.
Start Year 2017
 
Description Establishing a website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact We established a website to highlight the work of Global Health 5050 https://www.globalhealth5050.org/ which is holding 150 global health organisations to account for the gender responsiveness of their policies and practices in global health.
Year(s) Of Engagement Activity 2017
URL https://www.globalhealth5050.org/
 
Description International conference on male involvement in sexual and reproductive health, Mumbai 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact This was an international conference on male engagement in sexual and reproductive health programmes, held in Mumbai, India, in Feb 2016. The PI, Dr Sarah Hawkes, was invited to give a keynote speech in the opening panel, based on her previous participation in the ESRC-cofunded meeting on male engagement in addressing gender-based violence, held in New Delhi in August 2015. The Mumbai meeting included representatives from the Government of India, WHO and other international organisations.
Year(s) Of Engagement Activity 2016
URL http://www.nirrh.res.in/icrh2016/
 
Description Invited to chair WHO expert meeting on gender in research into Neglected Tropical Diseases 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The WHO/TDR research programme held a meeting in November 2018 on adopting a gender lens for future research activities. I was invited to be the chair of the entire meeting.
Year(s) Of Engagement Activity 2018
 
Description Invited to participate in a panel at Women Leaders in Global Health conference, London, November 2018. Talk focused on our new initiative Global Health 50/50. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact At the London Conference "Women Leaders in Global Health", Global Health 50/50 (GH5050) was invited to a panel organisd to reflect on the work and outputs of Global Health 50/50 itself. As co-founder and co-director of GH5050, this gave us an opportunity to reach a wide global audience of policy makers, funders, practitioners and students to talk about gender equality in global health careers.
Year(s) Of Engagement Activity 2018
URL https://www.wlghconference.org/
 
Description Seminar gender equality and violence, New Delhi, India 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact In August 2015, approximately 60 representatives from Indian government offices, academic institutions (including UCL), philanthropy and civil society came together to discuss, debate and deliberate the question of how to address gender based violence (GBV). The discussion focused on solutions: what is known about how to prevent and respond to GBV including the strategic engagement of men and boys, and how can these lessons be applied at scale in the Indian context? More broadly, what lessons can be leveraged as world leaders convene to adopt the world's next set of development goals, known as the 2030 Agenda?
Year(s) Of Engagement Activity 2015
URL http://www.icrw.org/publications/transformation-2030
 
Description Seminar on disaster, risk reduction, resilience and gender and health 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact We held a seminar on gender and disaster to explore the relationship between gender norms, behaviours, roles, and outcomes in disaster. Seminar participants were drawn from across the globe and through extensive use of social media we reached a wide audience.
Gender, specifically gender inequality, plays a major role in vulnerability to disasters and their impacts (in the short and long-term). Societal constructs, which marginalise certain groups, establish these vulnerabilities that both create and exacerbate disasters. When looking at disasters through the 'gender lens' it is vital to remember that the subject of gender in crises is not limited only to women (although gender inequality significantly disadvantages women, in general and throughout the disaster cycle, therefore the launch largely focussed upon women), nor can gender be restricted to two binary categories of 'male' or 'female', instead numerous gender identities exist. Similarly, we must understand the complex intersections between gender oppression and other forms of oppression, such as racism or ableism, and how these contribute to unique experiences of discrimination that create exposure or vulnerability to disaster.

The seminar participants recognised that post-disaster efforts must be cross-sectoral and collaborative. Academics and practitioners need to work in partnership to fill data gaps, particularly in collecting further disaggregated data, and then use findings to shape the way that we work. Likewise, government and private sector involvement are crucial to engaging a wider audience and beginning to influence social constructs, policy and legislation. In isolation, the ability of each sector to make positive change is limited.
Year(s) Of Engagement Activity 2017
URL http://www.rescueglobal.org/news/view/launch-of-the-university-college-london-centre-for-gender-and-...
 
Description Seminar on gender-based violence, UCL 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact We organised a panel on gender-based violence (GBV) and invited speakers from across the UK as well as South Africa to share experiences, ideas and research plans for the "next generation" of research on GBV. The opening session of the panel was webstreamed, and questions were invited from a global audience through the use of social media. The event was attended by approx 100 people in the room itself, and many more people who joined us through social and webstreaming media.
The event garnered a lively and wide-ranging discussion, particularly on the question of whether and how to capture emotional and psychological GBV in surveys.
The seminar reached a wide audience through the use of social media and live webstreaming, and questions were invited from around the world by using social media platforms.
Year(s) Of Engagement Activity 2017
URL http://ighgc.org/events/centre-launch-panellists
 
Description Seminar on institutional responses to Gender and Health 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact This seminar brought together policymaker, practitioners, researchers, advocates and activists to discuss the institutional responses to gender within global health institutions.
Leaders from the worlds of both the UN and NGOs recognized that challenging the gender status quo requires vision, leadership and accountability. Jan Beagle (UNAIDS), Maryse Simonet (EU) and Geeta Misra (CREA) all called for partnership across institutions and movements. These views were reflected in the contributions from academics on the seminar panel too. The panels recognized the need to embrace the non-linear and complex nature of human relationships, power, and the construction of gender and health, and proposed an intersectional approach to understanding gender and health. Such an approach may help synthesize this complexity across policy, research, and programs.

The complexity of the relationship between gender and global health institutions was addressed from the perspectives both of outward-facing activities as well as the action for gender equity/equality within institutions themselves.

In the tradition of feminism and other social advocacy movements, panelists embraced the notion of being 'a thorn in the side' of their institutions, organizations and communities in order to continually challenge gender norms and go beyond the status quo.

The seminar reached a wide audience through the use of social media and live webstreaming - and questions were invited from around the world with the use of social media platforms.
Year(s) Of Engagement Activity 2017
URL http://ighgc.org/events/launch-day
 
Description Seminar on masculinities and health 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact We held a seminar on masculinities and health as part of a UCL event focused on Gender and Global Health. The seminar brought together researchers, activists, advocates, policy makers, practitioners from around the world and provided an opportunity for interdisciplinary reflections on understanding the relationship between masculinity and health. Panellists focused on challenging the concept of hegemonic masculinity and how it relates to both men's and women's wellbeing.

Plans for future collaborative activities include establishing a network of researchers interested in masculinities and health, and hosting a further seminar series on this topic.

The seminar reached a wide audience through the use of social media and live webstreaming - and questions were invited from around the world with the use of social media platforms.
Year(s) Of Engagement Activity 2017
URL http://ighgc.org/events/launch-day
 
Description Seminar on masculinities and men's health, New York 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This workshop was a simultaneous webinar and physical panel discussion, held as part of the 'International Conference on Masculinities and Masculinities: Engaging Men and Boys for Gender Equality'. The title of the event was 'Global men's health: opportunities, barriers and benefits for everyone.' The aim of the seminar was to discuss, debate and contribute to progress within the area of men's health.
Year(s) Of Engagement Activity 2015
 
Description Seminar on men and antiretroviral therapies/HIV, Cape Town, South Africa 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This seminar was a simultaneous webinar and physical panel discussion, held as part of the 'Association for the Social Sciences and Humanities in HIV' (ASSHH) conference, at the Stellenbosch Institute for Advanced Study (STIAS) conference centre in Stellenbosch, South Africa. The aim of the seminar was to discuss, debate and contribute to progress within the area of men's engagement with ART/HIV services.
The seminar had both short-term and longer-term impacts. In the short term, the outcomes included: increased networking between international academic research organisations; promoting the voices of civil society as participants in the seminar; and engagement with decision-makers. The overall impact on beneficiaries: positive feedback has been received from participants, who expressed that they found the panel/webinar useful, informative and thought provoking.
In the longer term we are pursuing collaborative research proposals and joint publishing opportunities across the UK and South African groups involved, as well as planning for increased engagement with decision-makers.
Year(s) Of Engagement Activity 2015
 
Description Speaker at launch of Lancet special issue on Women in Medicine, Science and Global Health 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Lancet special issue on Women in Science, Medicine and Global Health is a ground-breaking publication highlighting the systemic under-representation of women in these professions. I was asked to present the summing up speech for the day's launch, having also contributed a commentary for the special issue.
Year(s) Of Engagement Activity 2018
URL https://www.elsevier.com/connect/the-lancet-targets-the-gender-gap-in-science-medicine-and-global-he...