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探讨健康与性别平等之间的关系:孕产妇、生殖和性健康服务扮演什么角色?

Investigating the relationship between health and gender equality: What role do maternal, reproductive, and sexual health services play?

机构信息

French Institute for Demographic Studies (INED), Aubervilliers, France.

Centre for research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy.

出版信息

Health Policy. 2024 Nov;149:105171. doi: 10.1016/j.healthpol.2024.105171. Epub 2024 Sep 25.

DOI:10.1016/j.healthpol.2024.105171
PMID:39368211
Abstract

Examining the causal nexus between health services and gender equality is of paramount significance in policy formulation and academic inquiry. This paper concentrates on maternal, sexual, and reproductive health, offering a critical narrative review of empirical research exploring the causal relationship between enhanced women's health, stemming from either overall healthcare amelioration or specific interventions, and broader gender equality objectives. A conceptual framework is devised to elucidate the causal pathways between health and gender equality across various dimensions. The final review encompasses 30 empirical papers, revealing both direct and indirect effects of improved maternal, reproductive, and sexual health outcomes on labour participation and educational investment, with fertility decisions and autonomy serving as primary intermediary factors. Evidence predominantly indicates that interventions like contraception, family planning, and abortion policies yield enduring effects beyond health, influencing reproductive choices. Specific medical procedures, such as caesarean deliveries and sterilization, also impact fertility and labour market outcomes. Furthermore, public healthcare infrastructure contributes to combating gender-based violence by facilitating incident reporting and access to protection. Recognizing, documenting, and monitoring these co-benefits arising from improved women's health are pivotal for delineating future health sector priorities and advancing the global gender equality and sustainable development agenda.

摘要

探讨卫生服务与性别平等之间的因果关系,对于政策制定和学术研究至关重要。本文聚焦于孕产妇、性健康和生殖健康,对实证研究进行了批判性叙述性综述,以探讨妇女健康的改善(源于整体医疗保健的改善或具体干预措施)与更广泛的性别平等目标之间的因果关系。本文构建了一个概念框架,以阐明健康和性别平等在不同维度之间的因果途径。最终的综述包括 30 篇实证论文,揭示了改善孕产妇、生殖和性健康结果对劳动力参与和教育投资的直接和间接影响,生育决策和自主权是主要的中介因素。证据主要表明,避孕、计划生育和堕胎政策等干预措施除了对健康产生持久影响外,还会影响生殖选择。具体的医疗程序,如剖腹产和绝育,也会影响生育和劳动力市场的结果。此外,公共医疗基础设施通过促进事件报告和获得保护,有助于打击基于性别的暴力。认识、记录和监测这些改善妇女健康带来的共同效益,对于确定未来卫生部门的优先事项以及推进全球性别平等和可持续发展议程至关重要。

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