Abstract
This article poses questions, challenges, and dilemmas for health system researchers striving to better understand how gender shapes accountability mechanisms, by critically examining the relationship between accountability and gender in health systems. It raises three key considerations, namely that: (1) power and inequities are centre stage: power relations are critical to both gender and accountability, and accountability mechanisms can transform health systems to be more gender-equitable; (2) intersectionality analyses are necessary: gender is only one dimension of marginalisation and intersects with other social stratifiers to create different experiences of vulnerability; we need to take account of how these stratifiers collectively shape accountability; and (3) empowerment processes that address gender inequities are a prerequisite for bringing about accountability. We suggest that holistic approaches to understanding health systems inequities and accountability mechanisms are needed to transform gendered power inequities, impact on the gendered dimensions of ill health, and enhance health system functioning.
Highlights
Accountability for Health Equity: Galvanising a Movement for Universal Health CoverageErica Nelson, Gerald Bloom and Alex Shankland
1 Introduction Accountability and gender are both critical dimensions of health systems
The IDS Bulletin is published by Institute of Development Studies, Library Road, Brighton BN1 9RE, UK This article is part of IDS Bulletin Vol 49 No 2 March 2018: ‘Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage’; the Introduction is recommended reading
Summary
Accountability for Health Equity: Galvanising a Movement for Universal Health CoverageErica Nelson, Gerald Bloom and Alex Shankland. It explores three key considerations regarding the relationship between gender and accountability, namely that: (1) power relations are critical to both gender and accountability and, while gender is a pervasive driver of inequity in health systems, accountability mechanisms can address and transform health systems to be more gender-equitable; (2) gender is only one dimension of marginalisation and intersects with other social stratifiers, such as race, class, education, etc.
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