No time for complacency on the road to gender equality
Authors: None The Lancet Global Health
Journal: The Lancet Global Health (2020)

International Women's Day, on March 8, is a chance to look ahead to some crucial events later this year on the ongoing agenda to create an equitable world for women and girls. On March 9, the 64th session of the UN Commission on the Status of Women was set to adopt a political declaration reaffirming commitments made in the 1995 Beijing Declaration and Platform for Action. That landmark document, the outcome of the Fourth World Conference on Women in Beijing, China, is celebrating its 25th anniversary this year. The Platform for Action set out comprehensive strategic objectives around 12 areas of concern, including health, and was groundbreaking in its recognition that “[w]omen's health involves their emotional, social and physical well-being and is determined by the social, political and economic context of their lives, as well as by biology”. In an Article in this month's issue, Emma Slaymaker and colleagues explore the changing landscape of women's sexual and reproductive health within a social context using data from nationally representative surveys. They find that, in just over half of the 64 countries studied, the proportion of sexually active women of reproductive age who do not currently want to become pregnant and who are not using a contraceptive decreased between 1995 and 2018. Ecological analysis suggested that these findings were correlated with increases in gender equality and women's time in education, but also with social issues such as higher ages at first sexual intercourse and higher prevalence of multiple partnerships among women. However, the findings varied widely by country and the authors point to the need for contextualised, country-specific policy responses when addressing targets such as Sustainable Development Goal 3.7. The UN Commission's draft political declaration expresses concern that no country has yet fully achieved equality and empowerment for women and girls, that progress in some areas has stalled or even reversed, and that “women and girls who experience multiple forms of discrimination have made the least progress”. Indeed, the world continues to witness shocking cases of denial of the rights of women. In February this year, media accounts picked up on a report from South Africa's Commission for Gender Equality of an investigation into the coerced sterilisation of 48 pregnant black women, most of whom were living with HIV. The women were reportedly sterilised during the course of a caesarean section. Their consent forms had been signed under conditions that did not allow for considered understanding (eg, extreme labour pain) or that were threatening (eg, denial of care if refused). Additionally, some of the women reported discriminatory remarks from health-care staff about their HIV status. Discriminatory and biased social norms remain pervasive throughout most aspects of women's lives, according to a new analysis of the UNDP's Gender Social Norms Index released on March 5. Generated from responses to the World Values Survey, the index reveals that around 90% of both men and women across the 77 countries surveyed exhibit at least one bias around gender equality—eg, whether men make better political leaders or business executives, whether university is more important for men than women, and whether it is justifiable for a man to beat his wife or for a woman to have an abortion. In 15 of 31 countries with time trend data, bias actually increased, particularly among women themselves. Again, one-size-fits-all policies are unlikely to shift long-standing norms particular to different social contexts and cultures. Tailored educational programmes and incentives such as those that enable paternity leave and encourage women to enter male-dominated professions have shown promise and should be seriously considered by governments worldwide. Finally, closer to home, March 5 also saw the release of Elsevier's 2020 gender report, The Researcher Journey Through a Gender Lens. In the high-income and middle-income countries studied, all 15 had made some progress towards gender parity in research authorship between 1999–2003 and 2014–18, but Argentina was the only one to actually reach it. The fields of surgery, cardiology, and pulmonology were the most male-dominated, and those of fertility, birth, and paediatrics were most heavily female-dominated. Japan had the lowest ratio of women to men in all areas of medicine. It is clear that—more than 100 years after International Women's Day was first observed in 1911—we are far from a gender-equal world and that, given some worrying turns in the wrong direction, new threats require vigilance and context-specific action. Trends in sexual activity and demand for and use of modern contraceptive methods in 74 countries: a retrospective analysis of nationally representative surveysProgress towards satisfying demand for contraception should take account of the changing context in which it is practised. To remove the remaining barriers, policy responses—and therefore research priorities—could require a stronger focus on social-structural determinants and broader aspects of sexual health. Full-Text PDF Open AccessPatchy progress on the ICPD: are we asking the right questions?The International Conference on Population and Development (ICPD) agenda, set in 1994 in Cairo and revisited 25 years later in Nairobi in 2019, included goals for equitable education of women, reduction of infant and child mortality, reduction of maternal mortality, and access to reproductive and sexual health services, including family planning, through its well known Programme of Action.1 The ICPD was ground-breaking in recognising the benefits that empowerment of women and girls would have for themselves, their families, and, ultimately, their countries. Full-Text PDF Open Access