Our group emphasises the following:
- Care crisis: Gender inequalities in the division of household labour persist worldwide. These gaps are exacerbated during periods of crisis. Women in particular become or remain primary carers in public health emergencies. Their care responsibilities increase manifold, often at the cost of their safety and well-being. They may reduce their paid working hours in order to shoulder more care responsibilities, with consequences for their economic empowerment and their household incomes. Women are also disproportionately represented in care professions. In these formal roles , they work disproportionately greater hours and then hold dual care responsibilities within the household and health and long-term care settings. Many women in the care professions are also migrants, having travelled to work as carers in more developed economies, leaving their children and families behind and remitting money back to support their families. Public health emergencies can push them too deep into precarity as migrant workers. According to UN Women, in Sub-Saharan Africa, almost 70 per cent of community health workers work for little or no compensation and often have to use their income to support their professional care roles. The COVID-19 crisis highlighted the need for safe, free and accessible care facilities for children, disabled and older persons for workers and their dependents.
- Gender-based violence: Across the globe, women, girls, LGBTQIA+ individuals, and gender non-conforming individuals remain vulnerable to gender-based violence. In a public health crisis, gender-based violence becomes heightened, exacerbated by the stress and anxiety resulting from health fears, economic difficulties, social isolation, and limited mobility. During COVID-19 lockdowns, women lived at homes with their abusers without helplines. In many countries, helplines for women, children and the disabled were suspended. It is essential that GBV support services are made available during emergencies to provide remedial support to victims and also prevent GBV. Public health emergency responses should be mainstreamed into GBV prevention and remedial services.
- Adverse childhood and adolescent experiences: Public health emergencies can leave children and adolescents to take on additional care responsibilities such as caring for sick people, doing extra childcare, cooking, washing dishes and clothes on top of schoolwork and taking care of themselves. Increased instances of child abuse and marriages were also noted during COVID-19. Children and adolescents are vulnerable to violence; women, lesbians, gays, bisexuals, and transgender people are more at risk (LGBTQ+).
- Intersectional inequalities: Gender is one axis of inequality that intersects with other axes, including race and ethnicity, national origin, migrant status, religion, age, sexuality, and (dis)ability. The elderly, chronically ill and persons with disabilities were disproportionately impacted by the coronavirus, for example. A global human rights survey conducted by Women Enabled International in March 2020 revealed that COVID-19-related lockdowns and measures led to gaps in access to healthcare facilities and support, access to food and hygiene items, and increased risk of violence, loss of employment and exacerbated prevailing lack of social protection for women with disabilities. Similarly, individuals working in women’s, men’s, and LGBTQ people’s health and wellbeing lay out the different ways that women, men, and gender and sexual minorities are affected by COVID-19. This requires an approach recognising the distinct pathways to support marginalised LGBTQ+ communities.
- Vaccine-equity: Members of groups who face structural and cultural barriers related to accessing healthcare may receive treatments, including vaccines, later than other groups in their society or country. For example, the healthcare needs of women and girls may not be prioritised in certain communities or they may face mobility restrictions that limit their access to care. Researchers may decline to test interventions on women due to concerns about pregnancy and fetal development, reducing knowledge about women pregnant peoples’ bodies and further compounding women and pregnant peoples’ marginalisation from care. In the COVID-19 pandemic, women, especially pregnant and lactating people, emerged as a vulnerable group; there was significant variation across countries in vaccinating them. Some countries restricted access, and some recommended it, in spite of World Health Organisation’s recommendations.
- Budgeting and policy frameworks: Policy responses perform better when they account for gender, and public health emergencies are no exceptions. Policy interventions must account for, address, and attempt to ameloriate the gendered effects of crisis. During COVID-19, strict lockdowns severely restricted women’s mobility and access to employment and care support and increased child marriages alongside other abuses, such as gender-based violence. COVID-19 drew attention to the gendered impacts of the pandemic’s affects on livelihoods, families, communities, and the world economy. Drawing on gender-sensitive approaches, the world community can minimise the risks and focus on building resilience in families and communities. One of the threats to gender-sensitive methods is the lack of inclusion of women in decision-making in scientific and policy communities.
- Climate change: Climate change is a public health emergency with profound economic, political, and social stability implications. It is a complex environmental phenomenon caused by human activities to accelerate industrialisation, urbanisation, and capitalist growth. The physical impacts of climate change include floods, storms, and heat waves, which are likely to result in several infectious diseases, such as pneumonia and influenza, as well as non-infectious diseases, such as asthma and pulmonary fibrosis. The disruption in agriculture and ecosystems has severe implications for food security, leading to political instability, conflicts, and displacement of people. The Preamble to the Paris Agreement under the UN Framework Convention on Climate Change (UNFCCC) has recognised the obligations and the need for gender equality and intergenerational equity. The World Health Organisation’s Women, Children and Adolescent Health (WCAH), in their background paper to COP 27, has recognised the adverse effects of climate change and its impact on exacerbating pre-existing vulnerabilities associated with age, gender, caste, class, and ethnicity. The increasing importance of women, children, and adolescent’s health and well-being reflects on the intersections of societal inequalities and the need for a multisectoral response to complex environmental and humanitarian catastrophes. These inequalities have their roots in historical colonialism, poverty and inegalitarian social relations between women and men, children, and adults. These factors lead to less effective mitigation and adaptation measures for climate change.
Our group has developed Gender Matrixes and Toolkits – to enable organisations to use in their gender-responsive public health emergencies framework. We will work towards supporting institutions globally to strengthen gender-sensitive responses to public health emergencies.
In early February 2020 a small group of academics from public health, international relations, public policy, and development economics saw the need to better understand and address the gendered effects of COVID-19 and government responses to the outbreak, having previously examined the intersection between gender and health emergencies during Ebola, Zika, Cholera, and beyond.
They were funded by Canadian Institute of Health Research (CIHR) to study the gendered effects of COVID-19 in Canada, the UK, China, and Hong Kong through a rapid multi-method gender analysis of pandemic preparedness and response mechanisms.
In March 2020, the team published a highly influential commentary on COVID-19: The Gendered Impacts of the Outbreak in the Lancet. This led to the creation of an international Gender and COVID-19 Working Group that has over 300 members across academia, civil society, government, and multi-lateral organizations. The Working Group communicates regularly via a google group and holds monthly virtual meetings.
In June 2020, through funding from Bill & Melinda Gates Foundation, this work expanded to include five additional countries spanning the globe: Bangladesh, Nigeria, Kenya, the Democratic Republic of Congo, and Brazil. The international multi-disciplinary team has since begun to advance the most comprehensive, comparative gender-analysis of the outbreak to date with the aim of developing knowledge to mitigate against negative downstream effects of global public health policies created in response to the pandemic.