Gender blind? An analysis of global public-private partnerships for health.
Gender blind? An analysis of global public-private partnerships for health.
复制标题
DOI：
10.1186/s12992-017-0249-1
复制
发表时间：
2017-05-12
影响因子：
10.8
通讯作者：
Kapilashrami A
中科院分区：
文献类型：
--
作者：
Hawkes S;Buse K;Kapilashrami A
全球卫生公私伙伴关系日益成为全球卫生架构的核心部分，拥有财政和规范权力。性别是健康状况的一个重要决定因素，影响着健康决定因素、健康行为和卫生系统反应的差异。我们确定了18个GPPH-定义为具有正式治理机制的全球机构，其中包括公共和私营营利部门行为者-并对每个机构进行了性别分析。通过伙伴关系的机构运作，性别平等主流化工作做得很差。这些伙伴关系中有一半在其总体机构战略中没有提到性别问题，只有三个伙伴关系有具体的性别战略。15个理事机构的男性人数多于女性，比例高达5：1。很少有伙伴关系在其年度报告或覆盖面/影响结果中报告按性别分列的数据。大多数伙伴关系的工作重点是孕产妇和儿童健康以及传染病-没有一个直接涉及非传染性疾病，尽管性别问题在确定非传染性疾病主要负担的风险方面发挥着重要作用。针对这些调查结果，我们提出了两个行动领域。第一，促进两性平等全球方案必须认真对待如何“处理”两性平等问题;必须通过经常活动、交付成果和问责制度将其纳入主流。第二，整个全球卫生界需要更加重视应对非传染性疾病的重大负担，包括应对风险的性别性质。鉴于在处理许多非传染性疾病的决定因素方面存在着固有的利益冲突，因此，新出现的全球公共卫生伙伴关系模式是否是处理非传染性疾病的适当模式是有争议的。
The Global Public Private Partnerships for Health (GPPPH) constitute an increasingly central part of the global health architecture and carry both financial and normative power. Gender is an important determinant of health status, influencing differences in exposure to health determinants, health behaviours, and the response of the health system. We identified 18 GPPPH - defined as global institutions with a formal governance mechanism which includes both public and private for-profit sector actors – and conducted a gender analysis of each. Gender was poorly mainstreamed through the institutional functioning of the partnerships. Half of these partnerships had no mention of gender in their overall institutional strategy and only three partnerships had a specific gender strategy. Fifteen governing bodies had more men than women – up to a ratio of 5:1. Very few partnerships reported sex-disaggregated data in their annual reports or coverage/impact results. The majority of partnerships focused their work on maternal and child health and infectious and communicable diseases – none addressed non-communicable diseases (NCDs) directly, despite the strong role that gender plays in determining risk for the major NCD burdens. We propose two areas of action in response to these findings. First, GPPPH need to become serious in how they “do” gender; it needs to be mainstreamed through the regular activities, deliverables and systems of accountability. Second, the entire global health community needs to pay greater attention to tackling the major burden of NCDs, including addressing the gendered nature of risk. Given the inherent conflicts of interest in tackling the determinants of many NCDs, it is debatable whether the emergent GPPPH model will be an appropriate one for addressing NCDs.