- This module is intended for use in pre-service and in-service training of health professionals.
- This publication will also be of use to health policymakers and program managers as a reference document, or in conjunction with in-service training.
Despite the documented impacts of poverty and gender on noncommunicable diseases (NCDs), health professionals, program managers, and policymakers are not always adequately prepared to address these dimensions of health in their work. This report provides evidence on the nexus of poverty, gender, and NCDs and concrete recommendations for gender-responsive NCD prevention and management efforts.
In many cases, health investments disproportionately benefit the non-poor. As a result, poor households and communities might have less access to effective services for NCD prevention and control than might other households. This is of particular concern because the risk factors for NCDs increasingly are concentrated in low-income communities. Furthermore, evidence suggests that men and women experience the risk factors for, and the consequences of, NCDs differently. This calls for a gender-sensitive approach to the prevention and control of NCDs.
Gender norms shape men’s and women’s roles, activities, and behaviours that determine their exposure to the risk factors for NCDs – such as tobacco use, exposure to unclean cooking fuels, and occupation-related risks.
Although women tend to live longer than men, they become sick and disabled more often. Overall, men and women are generally afflicted by the same NCDs (with the exception of certain types of cancer); however, the rates, trends, and specific types of disease differ and are often context specific. Intra-group differences are often hidden by global or national statistics.
Gender and other social norms shape the health-seeking behaviour of men and women, as well as their access to prevention and treatment for NCDs. However, data is often not adequately disaggregated to allow for intersectional gender analysis, such as examining the effects of women’s constrained mobility, access to and control over resources, and decision-making in different contexts.
In some contexts, health service providers are often unaware of, and inconsiderate towards, women’s health needs and barriers to accessing care, which may negatively impact future care-seeking behaviour.
Because women and girls are traditionally responsible for care and domestic work and tend to be economically dependent on a male head of household, the illness or death of a family member may increase their burden of care and have devastating social and economic effects, particularly for widows.
The steps include 1) collecting and analysing surveillance data disaggregated by gender, age, and other indicators of social exclusion to identify the differential burden of risk factors. This evidence should form the basis for coalition-building and advocacy efforts for increased resources for prevention and control; 2) developing evidenced-based national and sub-national policies for NCDs explicitly focused on gender equity; and 3) identifying gender-equitable means of implementing NCD policies.
At the service level, health systems can benefit from shifting away from acute care to prevention and management of risk. Evidence-based guidelines should be tailored to fit local contexts, and routinely assessed and revised. Investments should be made to improve the capacity of the health workforce and clinical information systems to capture and respond to the needs of men and women from marginalised populations.
At the program level, the report identifies four areas for improvement: 1) addressing geographical barriers by investing in primary health care facilities, NGOs and private providers, and community-based approaches; 2) addressing economic barriers, particularly for poor women, through, for example, community-based health insurance schemes; 3) addressing informational and sociocultural constraints through, for example, culturally appropriate messaging targeting women with lower levels of literacy and/or restricted access to media; and
4) collecting and analysing data disaggregated by gender and other indicators of disadvantage, and conducting qualitative research.