The Sex, Gender and COVID-19 Health Policy Portal

The Sex, Gender and COVID-19 Health Policy Portal offers the most comprehensive review of the recognition of and response to sex and gender in national COVID-19 public health policies globally. Launched in the context of mounting calls for governments to adopt gender-responsive approaches to the pandemic, the Policy Portal finds little evidence that sex and gender have been considered in policies that directly impact people’s health outcomes.

From the early stages of the COVID-19 pandemic, sex and gender have had a measurable impact on people’s health. From an individual’s risk of exposure to the virus to their ability to access testing, vaccination and health services and their likelihood of developing severe disease, sex and gender play a determining role. Data collected in the COVID-19 Sex-Disaggregated Data Tracker has demonstrated that, although there is some variation among countries, in general, men are less likely than women to be tested for COVID-19, but more likely to be hospitalised and more likely to die from the virus

The Sex, Gender and COVID-19 Health Policy Portal collates and reviews over 450 policies and policy excerpts from 76 countries across all WHO regions and World Bank income groups. Policies are collected under six key areas derived from the WHO pandemic response recommendations: vaccination, public health messaging, clinical management, protection of healthcare workers, disease surveillance, and maintenance of essential health services. All policies have been collected from official Government sources. The policies were examined using the WHO gender-responsiveness assessment scale to understand whether and how they respond to gender inequalities, as well as which populations they target (men, women, transgender people and non-binary people) and whether human rights and equity are considered.

In all six policy areas reviewed, evidence from past pandemics suggests that taking gender and intersecting characteristics, such as age, disability, ethnicity, pregnancy and socio-economic status, into account when designing and delivering interventions to address COVID-19 may improve health outcomes for everyone. Yet the Sex, Gender and COVID-19 Health Policy Portal reveals a pervasive gender-blindness that spans policy areas, geographical regions and country income levels. While these findings do not speak to the effectiveness of health measures implemented by governments, they shed light on governments’ stated commitments in relation to protecting the health of their populations.

• Among 388 policies (excluding surveillance policies, which were assessed differently), just 9% were found to address the role of gender in driving health outcomes - ranging from 6% of clinical guidelines and health worker protection guidance to 12% of public health messaging policies.
• Less than one-third of policies (143/458) identified the population beneficiaries (men, women and/or transgender people) of the policy action. Most of the policies that identified a specific population were focused on women’s health, and specifically maternal health. A small number of policies (13) mentioned interventions targeting men, and only one policy mentioned transgender people.
• A majority of vaccine policies (72%) were found to make a commitment to equity, including through the identification of priority vaccination groups. Apart from vaccine policies, however, only a small proportion of policies contain any equity commitments (31%) or human rights commitments (17%).

‘[We] will carry out targeted consultations with vulnerable groups to understand concerns/needs in terms of accessing information [… We will] consider provisions for childcare, transport, and safety for any in-person community engagement activities [for women]... [and] develop education materials for pregnant women on basic hygiene practices, infection precautions, and how and where to seek care based on their questions and concerns.’
Eswatini - gender-specific public health messaging strategy

‘Special considerations and programs should be implemented for vulnerable populations (elderly, patients with chronic diseases, pregnant and lactating women and children)'... [We will] consider and address obstacles to women’s and girls’ access to psychosocial support services, especially those subject to violence or who may be at risk of violence.'
Suriname - gender-specific clinical COVID-19 guidelines

‘Employers should develop fair and workable human resource plans for emergency situations while taking into consideration gender roles (e.g., women’s tendency to take on more caregiving responsibilities in family and home settings)… [Risk-mitigation measures for healthcare workers include] 'Provid[ing] gender sensitive supports to workers, such as transportation, lodging, and child/elder/pet support as needed.'
Canada - gender-specific guidelines for the protection of healthcare workers

'A decision was made to examine the health of Icelanders from a gender and equality perspective, to assess whether healthcare service provision takes the different needs of women and men into consideration.'
Iceland - gender-specific approach to maintaining essential services

'[We will] conduct a regularly updated, multi-sectoral gender analysis with sex, age and disability disaggregated data collection to identify inequalities, gaps, and capacities to assess the specific impacts of the crisis on the women, girls, men and boys of the affected population.’
Pakistan  - gender-specific approach to COVID-19 surveillance