This primer explores how health researchers, policy analysts, program and service managers, decision-makers, and academics can effectively apply an intersectional perspective to their work. It provides an overview of intersectionality; a comparison of intersectionality to other approaches; a rationale for the use of an intersectional approach in gender and women’s health research; step-by-step guidance for integrating intersectionality into research and policymaking; and case studies on violence against women, cardiovascular disease, and HIV/AIDS.
The key assumptions of intersectionality are a) the pursuit of social justice as the main objective; b) the conceptualisation of identity and social categories as multi-dimensional, dynamic, historically grounded, socially constructed, and linked to the macrostructural level; and c) power as central to analysis, as it has a critical role in creating and perpetuating the personal and social structures of discrimination and oppression in the context of a given issue.
Engage research subjects to gain insight into their subjective experiences and self-identified needs, and collaboratively generate research questions. Review literature to determine the extent to which a) different axes of diversity are relevant; b) the relevant axes of diversity are incorporated in the analyses; and c) a more diverse sample would have yielded different findings. Centre power in the analysis, address social categories simultaneously, include a heterogeneous study sample, and be flexible.
For quantitative methods: examine statistical intersections and use an approach that explores differences among and between individuals of varying backgrounds. For qualitative methods: study individuals’ unique social locations and experiences with power and privilege. For mixed methods: situate the qualitative results within the general framework of society provided by the quantitative analysis to better understand how social barriers may prevent equal participation.
Key stakeholder groups include research participants, social justice communities, policymakers and service providers, and other researchers.
Identify if the problem is experienced differently by various social groups; undertake a situational analysis; identify what categories of experience are prevalent; and determine whether a current policy addresses certain disadvantages but creates discrimination for others.
Consider the impacts on marginalised groups and propose options that address the specific consequences of oppression.
Ensure implementers are compliant by maintaining the inclusion of affected key stakeholders throughout the process.
Compare results with the baseline to assess whether policy objectives have been achieved.
1) Analyse broad dimensions and specific operations of the policy field to identify inequalities; involve stakeholders in collecting evidence and identifying inequalities; and collate, synthesise, and thematise findings, 2) Vision with the available evidence collected. ‘Vision’ changes required at all levels of implementation, 3) Road test with the collated visioning and design consultations. Run ‘scenarios’ for each vision and identify what services need to be in place, and engage stakeholders to ensure these will have intended benefits, and 4) Use monitoring and evaluation to refine advice. Set equality and Human Rights indicators and outcomes; identify inspectorates and provide inspection criteria; set strategy for ongoing data collection; and use feedback from consultations to refine advice cross-strand.
