Research for Health Systems Strengthening in Syria (R4HSSS) and the Conflict and Health Research Centre CCRC, Department of War Studies, King's College London, London, UK.
Independent Research Consultant, London, UK.
Global Health. 2023 Mar 23;19(1):21. doi: 10.1186/s12992-023-00920-1.
Active and protracted conflict settings demonstrate the need to prioritise the peace through health agenda. This can be achieved by reorienting attention toward gender diverse leadership and more effective governance within health systems. This approach may enable women to have a greater voice in the decision-making of health and social interventions, thereby enabling the community led and context specific knowledge required to address the root causes of persistent inequalities and inequities in systems and societies.
We conducted a qualitative study, which included semi-structured interviews with 25 key informants, two focus group discussions and one workshop with humanitarian workers in local and international non-governmental organisations (NGOs), United Nations (UN) agencies, health practitioners, and academics, from Sub-Saharan Africa, Middle East and North Africa (MENA), and Latin America. Findings were then applied to the peacebuilding pyramid designed by John Paul Lederach which provides a practical framework for mediation and conflict resolution in several conflict-affected settings. The purpose of the framework was to propose an adapted conceptualisation of leadership to include women's leadership in the health system and be more applicable in protracted conflict settings.
Five interrelated themes emerged. First, perceptions of terms such as gender equality, equity, mainstreaming, and leadership varied across participants and contexts. Second, armed conflict is both a barrier and an enabler for advancing women's leadership in health systems. Third, health systems themselves are critical in advancing the nexus between women's leadership, health systems and peacebuilding. Fourth, across all contexts we found strong evidence of an instrumental relationship between women's leadership in health systems in conflict-affected settings and peacebuilding. Lastly, the role of donors emerged as a critical obstacle to advance women's leadership.
Continuing to empower women against social, cultural, and institutional barriers is crucial, as the emerging correlation between women's leadership, health systems, and peacebuilding is essential for long-term stability, the right to health, and health system responsiveness.
活跃和持久的冲突环境表明，需要通过卫生议程来优先实现和平。这可以通过重新关注卫生系统内性别多样化的领导力和更有效的治理来实现。这种方法可以使妇女在卫生和社会干预措施的决策中有更大的发言权，从而使社区能够获得解决系统和社会中持久不平等和不公平的根源所需的具体知识。
我们进行了一项定性研究，包括对来自撒哈拉以南非洲、中东和北非以及拉丁美洲的地方和国际非政府组织（NGO）、联合国（UN）机构、卫生工作者和学者中的 25 名主要知情人进行半结构式访谈、两次焦点小组讨论和一次研讨会。研究结果随后被应用于约翰·保罗·莱德拉克（John Paul Lederach）设计的和平建设金字塔，该金字塔为在几个受冲突影响的环境中进行调解和冲突解决提供了一个实用框架。该框架的目的是提出一种适应冲突环境的领导力概念化，包括卫生系统中的妇女领导力，并使其更适用于持久冲突环境。
出现了五个相互关联的主题。首先，不同的参与者和背景对诸如性别平等、公平、主流化和领导力等术语的看法各不相同。其次，武装冲突既是推进卫生系统中妇女领导力的障碍，也是促进因素。第三，卫生系统本身在推进妇女领导力、卫生系统和和平建设之间的关系方面至关重要。第四，在所有背景下，我们都发现了强有力的证据表明，在受冲突影响的环境中，卫生系统中的妇女领导力与和平建设之间存在工具性关系。最后，捐助者的作用成为推进妇女领导力的一个关键障碍。
继续赋予妇女权力，克服社会、文化和体制障碍至关重要，因为妇女领导力、卫生系统和和平建设之间的新兴关联对于长期稳定、健康权和卫生系统响应能力至关重要。
