Gender equity and health sector reforms in low and middle-income countries

Abstract

Health sector reforms have been taking place in rich and poor countries alike at an accelerating pace over the last two decades. While some common themes can be discerned, such as responding to changing population needs and managing the rising costs of healthcare, a range of drivers underlies health sector reform (HSR) policies and approaches in different places and times. The gender implications of HSR did not, however, receive much attention until relatively recently. This chapter discusses some key narratives of HSR in low and middle-income countries, where the pressures to reform and the challenges faced have been particularly intense. After considering definitions and concepts, it outlines major strands of HSR, contextualizing them in relation to different regional experiences. It then discusses the gender issues that they have raised, using illustrations from different country settings. It concludes by reflecting on the gaps and omissions in HSR programmes from a gender perspective and notes other international development initiatives that have come to the fore in the past decade and influenced thinking about healthcare, bringing more awareness of gender issues and implications and contributing to changing the terms of the debate about gender and health systems development.