The Sex, Gender and COVID-19 Health Policy Portal collates and reviews health policies from 76 countries to understand whether and how gender is included in these policies, which populations they target and whether human rights and equity are considered in the response.
COVID-19 is a gendered pandemic. The health of people of different genders is being differentially impacted by the virus itself and by measures adopted by governments in response. Biological sex (which influences hormonal, immunological and physiological systems in the body) and gender (socially constructed and influencing roles, norms, expectations, power and position for all people in society) both play an important role in how individuals and communities experience the pandemic.
Data from the GH5050 COVID-19 Sex-disaggregated Data Tracker shows that men and women experience differences in COVID-19 health outcomes across the exposure-to-outcome pathway. Globally, men are less likely to be tested for COVID-19, more likely to be hospitalised, and more likely to die from the virus, compared to women. Data from transgender and non-binary people are regretably absent from national surveillance data.
From an individual’s risk of exposure to the virus to their ability to access services and the severity of disease, gender plays a role in shaping an individual’s experience of COVID-19. In some countries the high proportion of cases among men may result from gender norms around who participates in the paid labour market, while in other settings where women make up the majority of frontline health and social care workers they face increased exposure to infection.
Access to health services may be limited for people without the financial resources, inhibiting women’s access in some settings. The chronic diseases associated with higher COVID-19 death rates are frequently more common in men and often associated with men’s higher rates of exposure to unhealthy behaviours and environments (such as tobacco use, exposure to air pollution, and poor diets).
Evidence from past pandemics suggests that considering gender and intersecting vulnerabilities when designing and delivering interventions will improve health outcomes for everyone. Failing to account for these inequities can leave vulnerable and marginalised groups bearing a disproportionate burden of the pandemic.
The World Health Organization has recommended a number of public health interventions that every country should consider in their pandemic responses. Gender-responsive approaches to many of these areas can improve outcomes and ensure more equitable pandemic responses (see Methods for further details on the WHO framework). Of these, this review has identified six key areas of a gender-responsive health policy response:
For an analysis of the COVID-19-response activities taken by global health actors beyond governments and recommendations for gender-responsive interventions see our 2021 Report Gender Equality: Flying blind in a time of crisis.
Researchers and advocates
GH5050 collated the publicly available health policies from 76 countries along these six policy areas. The WHO Gender Responsiveness Assessment Scale was applied to examine how these policies take gender into account. Policies were reviewed to understand which populations they target (women, men, transgender people, non-binary people, or a combination). GH5050 also reviewed policies’ commitments to equity and human rights. Finally, GH5050 assessed the level of gender parity within national COVID-19 task forces and the gender of task force heads. For more, see Methods.