Halder Charls Erik, Hasan Md Abeed
Global Public Health Specialist, Chattogram, Bangladesh.
Humanitarian and Conflict Response Institute, University of Manchester, Manchester, United Kingdom.
PLoS One. 2025 Jul 1;20(7):e0310878. doi: 10.1371/journal.pone.0310878. eCollection 2025.
The health system is required to be safe, equitable, and accessible to all ages, gender, and vulnerable groups, including older persons and persons with disability, and address their specific needs and concerns. However, limited evidence is available on the effectiveness and practicality of gender and protection mainstreaming interventions in health response in humanitarian crises.
The overall objective of the research was to explore practices, gaps, and challenges and generate recommendations regarding gender and protection mainstreaming in health response to the Rohingya refugee crisis in Cox's Bazar, Bangladesh.
The research employed a qualitative case study design to explore the practice of gender and protection mainstreaming in health response in Cox's Bazar. Data collection methods include an extensive literature review and in-depth interviews with professionals. The professionals interviewed from the area of health and protection, specifically gender, child protection, emergency health intervention, and primary health activities. Data were analyzed using thematic analysis related to gender and protection mainstreaming. Limitations were assessed as to researcher bias because the researcher did all the coding; however, an open recording process, inter-literature cross-potentiation, and ethical considerations of research helped add to the reliability of the research. Exclusion criteria were defined to ensure data consistency, removing insufficiently detailed responses not pertinent to the research objectives.
The study found a range of good practices on gender and protection mainstreaming in health response, e.g., placement of a gender action plan, monitoring system for gender and disability inclusion, emergency preparedness and response system, availability of sex-segregated toilets and waiting spaces, availability of gender-based violence service and engagement of female community health workers. The study also revealed some best practices which have the potential to scale up, e,g. psychosocial spaces at health facilities for children, palliative care for terminally ill patients, integrated medical and protection services, and facilitation of community health facility support groups. Critical gaps were found in the areas of women's leadership, coordination, capacity building, targeted interventions for vulnerable groups, infrastructural adaptation and consultation with the community on their concerns.
We urge policymakers, sector coordinators, health program management, healthcare workers, and global stakeholders to address the gaps and challenges, learn and scale up the best practices, and take action to implement the study's recommendations to maximise gender and protection mainstreaming in health response.
卫生系统必须安全、公平，且所有年龄、性别和弱势群体，包括老年人和残疾人都能使用，并满足他们的特殊需求和关切。然而，关于在人道主义危机的卫生应对中纳入性别平等和保护主流化干预措施的有效性和实用性的证据有限。
该研究的总体目标是探索实践、差距和挑战，并就孟加拉国科克斯巴扎尔应对罗兴亚难民危机的卫生工作中纳入性别平等和保护主流化提出建议。
该研究采用定性案例研究设计，以探索科克斯巴扎尔卫生应对中纳入性别平等和保护主流化的实践。数据收集方法包括广泛的文献综述和对专业人员的深入访谈。接受访谈的专业人员来自卫生和保护领域，特别是性别、儿童保护、紧急卫生干预和初级卫生活动领域。使用与纳入性别平等和保护主流化相关的主题分析对数据进行分析。由于所有编码均由研究人员完成，因此评估了研究人员偏差的局限性；然而，开放的记录过程、文献间的交叉强化以及研究的伦理考量有助于提高研究的可靠性。定义了排除标准以确保数据一致性，排除与研究目标无关的不够详细的回复。
该研究发现了一系列在卫生应对中纳入性别平等和保护主流化的良好做法，例如制定性别行动计划、性别和残疾包容监测系统、应急准备和响应系统、提供男女分开的厕所和等候空间、提供基于性别的暴力服务以及女性社区卫生工作者的参与。该研究还揭示了一些有扩大规模潜力的最佳做法，例如卫生设施中为儿童设立的心理社会空间、为绝症患者提供的姑息治疗、综合医疗和保护服务，以及促进社区卫生设施支持小组。在女性领导力、协调、能力建设、针对弱势群体的有针对性干预措施、基础设施改造以及就社区关切问题进行协商等方面发现了重大差距。
我们敦促政策制定者、部门协调员、卫生项目管理人员、医护人员和全球利益相关者解决这些差距和挑战，学习并扩大最佳做法，并采取行动实施该研究的建议，以在卫生应对中最大限度地实现性别平等和保护主流化。
