Table 4 Measuring Progress Against Gender Equitable Health System Attributes
Attributes of Gender Equitable Health System | Manifestation in Mozambique | Manifestation in Timor Leste | Manifestation in Sierra Leone | Manifestation in Northern Uganda |
|---|---|---|---|---|
Provision: Health services addressing most urgent health care needs of men and women across life span in an appropriate manner. | While the delivery of health services has improved, adolescent girls and women lacked access to reproductive health care services. Concerns regarding respectful delivery. | Health service provision had improved dramatically, yet problematic health indicators for women and adolescent girls, particularly in rural areas. | Free health care initiative has prioritized care for women and children, although Ebola significantly weakened health system. | Health service delivery improved since war, yet significant shortfalls in service provision particularly for reproductive needs of women and girls. Concerns regarding respectful delivery. |
Access: Ensure men and women across the life span are able to access and utilize services unimpeded by financial, social, geographic barriers. | Significant financial, geographic and cultural barriers existed for both men and women, while women faced the added burden of lack of autonomy over their health care decisions. | Barriers for health access existed, particularly geographic barriers. | Free health care initiative officially removed financial barriers, but research indicates that people still needed to pay out of pocket fees to secure care. Geographic barriers still exist as well as gender norms undermining women’s ability to make decisions. | Significant financial, geographic and cultural barriers to access, which were shaped by, gender norms. |
Relevant, sex-disaggregated health information that informs policy. | Not consistently available. | Efforts to implement health information system with sex-disaggregated information underway. | Not consistently available, but planning is underway | Not consistently available. |
Equitable opportunities for male and female health professionals working within the health system. | No strategy developed or implemented to promote gender equity in the human resources of the health system. | No strategy developed or implemented to promote gender equity in the human resources of the health system. | No strategy developed or implemented to promote gender equity in the human resources of the health system. | No strategy developed or implemented to promote gender equity in the human resources of the health system. |
Equitable health outcomes among men and women and across age groups | HIV/AIDS rates 3–4 times higher among adolescent girls than boys; maternal health mortality among highest in the world. | Reproductive health outcomes for girls and women still problematic. | Double challenge from conflict and Ebola, health indicators significantly worsened, MMR particularly challenging. | Outcomes among women and adolescent girls remained problematic. |