Examining the Intersection between Gender, Community Health Workers, and Vector Control Policies: A Text Mining Literature Review.

Ana Carolina Nunes,Clare Wenham,Ana De Menezes,Denise Nacif Pimenta,Theresia Nkya,Morgana Martins Krieger,Gabriela Lotta,Brunah Schall

doi:10.4269/ajtmh.21-0619

Abstract

ABSTRACT.Gender intersects with healthcare systems; this is equally true for arboviral vector control efforts. However, there is as yet no comprehensive analysis as to how vector control is gendered. Hence, our objective is to provide the first thematic scoping and spatial distribution of the literature on gender, community health workers, and vector control. The authors use a systematic review approach to collect the academic literature on gender, community health workers, and vector control in Web of Science, Scopus, and PubMed (7,367 articles). After applying the exclusion criteria, 2,812 articles were analyzed using machine learning techniques: text mining and quantitative text analysis. The authors use topic modeling to assess the thematic scope of the literature and analyze the spatial distribution of themes. Our results show that the literature’s spatial scope is strongly represented by the global south as research was conducted mainly in Latin America, Africa, and Asia, places with greater incidence of vector-borne disease and with health systems, which incorporate community healthcare workers. However, there are significant spatial heterogeneities in where and how research is conducted. The topic analysis reveals that the literature predominantly considers issues of sex (e.g., pregnancy) and gender as it relates motherhood. Gendered considerations occur upon implementation of vector control policies, rather than being mainstreamed into their development and delivery. There is a need to deepen the analysis to allow for gendered aspects to be understood beyond binary sex differences and/or reproductive health.

Highlights

Arboviruses and vector control remains a key public health issue for many locations in the Global South: Brazil has recently suffered from the largest dengue outbreak to date; similar trends can be found in Angola, Republic of the Congo, and Democratic Republic of the Congo.[1]
Women are involved as unpaid or underpaid community health workers (CHWs)[7,8] who keep communities informed, help identify disease, and distribute medications or interventions that help prevent infections. These roles in vector control programs traditionally have followed wellestablished cultural gender norms:[3,9] activities linked to community and domestic care are mostly developed by women
A more detailed analysis (Figure 2) on the distribution of CHWs and vector control policies research shows that 10 countries contain the highest number of publications: Uganda (14), Zambia (14), Brazil (14), Kenya (11), Burkina Faso (9), Myanmar (8), India (7), Cambodia (7), Ethiopia (6), and Senegal (6)

Summary

Introduction

Arboviruses and vector control remains a key public health issue for many locations in the Global South: Brazil has recently suffered from the largest dengue outbreak to date; similar trends can be found in Angola, Republic of the Congo, and Democratic Republic of the Congo.[1]. From India’s National Village Health Guides Scheme to Kenya’s Community Health Volunteer Program, CHWs have a fundamental role in identifying the most vulnerable individuals to infectious diseases as well as facilitating the provision of treatment to families in their community. They provide this service while recognizing that the various CHWs programs are specific to their social, cultural, and economic contexts

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Conclusion