TUM Schoool of Governance, Technical University of Munich, München, Germany
Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
BMJ Open. 2021 Aug 12;11(8):e048292. doi: 10.1136/bmjopen-2020-048292.
OBJECTIVES: The COVID-19 pandemic threatens to widen existing gender inequities worldwide. A growing body of literature assesses the harmful consequences of public health emergencies (PHEs) for women and girls; however, evidence of what works to alleviate such impacts is limited. To inform viable mitigation strategies, we reviewed the evidence on gender-based interventions implemented in PHEs, including disease outbreaks and natural disasters. METHODS: We conducted a rapid scoping review to identify eligible studies by systematically searching the databases MEDLINE, Global Health and Web of Science with the latest search update on 28 May 2021. We used the Sustainable Development Goals as a guiding framework to identify eligible outcomes of gender (in)equality. RESULTS: Out of 13 920 records, 16 studies met our eligibility criteria. These included experimental (3), cohort (2), case-control (3) and cross-sectional (9) studies conducted in the context of natural disasters (earthquakes, droughts and storms) or epidemics (Zika, Ebola and COVID-19). Six studies were implemented in Asia, seven in North/Central America and three in Africa. Interventions included economic empowerment programmes (5); health promotion, largely focused on reproductive health (10); and a postearthquake resettlement programme (1). Included studies assessed gender-based outcomes in the domains of sexual and reproductive health, equal opportunities, access to economic resources, violence and health. There was a dearth of evidence for other outcome domains relevant to gender equity such as harmful practices, sanitation and hygiene practices, workplace discrimination and unpaid work. Economic empowerment interventions showed promise in promoting women's and girls' economic and educational opportunities as well as their sexual and reproductive health during PHEs. However, some programme beneficiaries may be at risk of experiencing unintended harms such as an increase in domestic violence. Focused reproductive health promotion may also be an effective strategy for supporting women's sexual and reproductive health, although additional experimental evidence is needed. CONCLUSIONS: This study identified critical evidence gaps to guide future research on approaches to alleviating gender inequities during PHEs. We further highlight that interventions to promote gender equity in PHEs should take into account possible harmful side effects such as increased gender-based violence. REVIEW REGISTRATION: DOI 10.17605/OSF.IO/8HKFD.
目的:新冠疫情大流行有可能在全球范围内扩大现有的性别不平等。越来越多的文献评估了公共卫生紧急事件(PHEs)对妇女和女童的有害后果;然而,减轻此类影响的有效措施的证据有限。为了提供可行的缓解策略,我们回顾了在 PHEs 中实施的基于性别的干预措施的证据,包括疾病暴发和自然灾害。
方法:我们通过系统地搜索数据库 MEDLINE、全球健康和 Web of Science,检索了截至 2021 年 5 月 28 日的最新文献,进行了快速范围审查,以确定合格的研究。我们使用可持续发展目标作为指导框架,确定了性别(不平等)平等的合格结果。
结果:在 13920 条记录中,有 16 项研究符合我们的资格标准。这些研究包括在自然灾害(地震、干旱和风暴)或流行病(寨卡、埃博拉和新冠疫情)背景下进行的实验(3 项)、队列(2 项)、病例对照(3 项)和横断面(9 项)研究。6 项研究在亚洲实施,7 项在北美/中美洲实施,3 项在非洲实施。干预措施包括经济赋权方案(5 项);以生殖健康为重点的健康促进(10 项);以及地震后的重新安置方案(1 项)。纳入的研究评估了性和生殖健康、平等机会、获得经济资源、暴力和健康等领域的基于性别的结果。与性别平等相关的其他结果领域,如有害习俗、卫生和卫生习惯、工作场所歧视和无酬工作,证据很少。经济赋权干预措施有望在 PHEs 期间促进妇女和女童的经济和教育机会以及她们的性和生殖健康,但需要更多的实验证据。
结论:本研究确定了关键的证据差距,以指导未来关于减轻 PHEs 期间性别不平等的方法的研究。我们进一步强调,促进 PHEs 中性别平等的干预措施应考虑到可能产生的有害副作用,如性别暴力增加。
审查注册:DOI 10.17605/OSF.IO/8HKFD。
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