Gender Disparities In Access Research Articles

Patient and Caregiver Perspectives on Gender Disparity in CKD: An Interview Study.

Chronic kidney disease (CKD) affects more women than men worldwide, however, men comprise the majority of patients who receive kidney replacement therapy. We aimed to describe the perspectives of patients and their caregivers regarding gender disparities in CKD. Semi-structured interviews were conducted with 45 patients with CKD (20 women) and 14 caregivers (12 women) from seven clinics in Austria. The interviews were analyzed thematically. Five themes were identified in this study. Participants perceived that women were "disadvantaged and vulnerable" (silent and intimidated, single mother predicament, impeded access to care and support due to socioeconomic disadvantage, had to fend for themselves); "fulfilling gender roles and norms" (primarily responsible for childcare, pressure to perform well as homemakers, put others' needs before their own, encouraging husband's treatment adherence), and "protecting their own health" (self-disciplined, vigilant, confronted health challenges, advocated for their needs). Men were seen to "place the onus of care on others" (expected help from family, relied on others for decisions). Both men and women experienced a "disease-related identity crisis and distress" (women: impaired body image, mental distress; men: denial and self-destruction, emasculated by sickness). Women with CKD felt vulnerable and were inclined to fulfill gender norms and responsibilities as caregivers but were also vigilant about protecting their own health. Men tended to be reluctant to accept CKD and appeared to depend on others for disease management. Better awareness and addressing these concerns can inform strategies to minimize gender disparities in access to care and outcomes in CKD.

Gender disparity in access to advanced therapies for patients with Parkinson's disease: a retrospective real-word study.

Gender differences in the access to advanced therapies for Parkinson's disease (PD) are poorly investigated. The objective of this study was to investigate the presence of any gender disparity in the access to advanced therapies for PD. Retrospective study. Data from patients with consistent access to the Parkinson's and Movement Disorder Center of L'Aquila over the last 10-year period were screened. Patients selected for advanced therapies were included. Out of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). No sex differences were found in relation to age (MRgFUS group: males vs. females 70.2 ± 8.9 vs. 70.8 ± 8.9, p-value = 0.809; LCIG group: males vs. females 73.5 ± 13.0 vs. 75.5 ± 8.5, p-value = 0.557; DBS group: males vs. females 77.2 ± 8.1 vs. 67.3 ± 8.6, p-value = 0.843; CSAI group: males vs. females 73.3 ± 4.0 vs. 67.0 ± 5.2, p-value = 0.144) and disease duration (MRgFUS group: males vs. females 8.3 ± 4.4 vs. 9.6 ± 6.7, p-value = 0.419; LCIG group: males vs. females 14.5 ± 5.81 vs. 17.3 ± 5.5; p-value = 0.205; DBS group: males vs. females 15.0 ± 9.6 vs. 15.5 ± 7.7, p-value = 0.796; CSAI group: males vs. females 11.7 ± 3.7 vs. 10.3 ± 3.7, p-value = 0.505). The predominance of males is higher than that expected based on the higher prevalence of PD in men. Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation.

Exploring the Factors that Facilitate Gender Disparity in Access to Fertile Farmlands in Nadowli-Kaleo District

The paper explores the factors contributing to gender disparity in access to fertile farmlands in the Nadowli-Kaleo district. It highlights the significant imbalance in land ownership between men and women, influenced by cultural norms, inheritance practices, and patriarchal systems. The study emphasizes the need for interventions to promote gender equity in land ownership and empower women economically. The research employed a case study design to investigate the specific phenomenon of gender disparities in land access in the Nadowli-Kaleo district. This approach allowed for an in-depth exploration of sociocultural, economic, and environmental factors contributing to the gender gap in land ownership. Purposive selection was used to choose 198 participants for the study. The study focused on individuals residing in the Nadowli-Kaleo district, particularly those involved in agriculture and land ownership. The participants ranged from 24 to 65 years old, providing diverse perspectives on the issue of gender disparities in access to farmland. Face-to-face interviews with the assistance of interview guides were utilized to collect data from the participants. The data collected were transcribed, organized, and presented with relevant quotations to support the findings. The study revealed a significant gender disparity in land ownership, with men predominantly owning larger tracts of farmland compared to women who typically owned 1-3 acres or none at all. Factors such as gender, kinship, marital status, and cultural customs were identified as influencing access to land in the district. Based on the findings, recommendations were made.

Medical Distrust Among Kidney Transplant Candidates.

Medical distrust may hinder kidney transplantation (KT) access. Among KT candidates evaluated for waitlisting, we identified factors associated with high distrust levels and quantified their association with waitlisting. Among 812 candidates (2018-2023), we assessed distrust using the Revised Health Care System Distrust Scale across composite, competence, and values subscales. We used linear regression to quantify the associations between candidate and neighborhood-level factors and distrust scores. We used Cox models to quantify the associations between distrust scores and waitlisting. At KT evaluation, candidates who were aged 35-49years (difference=1.97, 95% CI: 0.78-3.16), female (difference=1.10, 95% CI: 0.23-1.97), and Black (difference=1.47, 95% CI: 0.47-2.47) were more likely to report higher composite distrust score. For subscales, candidates aged 35-49 were more likely to have higher competence distrust score (difference=1.14, 95% CI: 0.59-1.68) and values distrust score (difference=0.83, 95% CI: 0.05-1.61). Race/ethnicity (Black, difference=1.42, 95% CI: 0.76-2.07; Hispanic, difference=1.52, 95% CI: 0.35-2.69) was only associated with higher values distrust scores. Female candidates reporting higher rescaled values distrust scores (each one point) had a lower chance of waitlisting (aHR=0.78, 95% CI: 0.63-0.98), whereas this association was not observed among males. Similarly, among non-White candidates, each 1-point increase in both rescaled composite (aHR=0.87, 95% CI: 0.77-0.99) and values (aHR=0.82, 95% CI: 0.68-0.99) distrust scores was associated with a lower chance of waitlisting, while there was no association among White candidates. Female, younger, and non-White candidates reported higher distrust scores. Values distrust may contribute to the long-standing racial/ethnic and gender disparities in access to KT. Implementing tailored strategies to reduce distrust in transplant care may improve KT access for groups that experience persistent disparities.

#2425 A change in deceased donor allocation policy may provide gender equality in kidney transplantation

Abstract Background and Aims Overcoming gender disparity in access to kidney transplantation is a well-established universal challenge. The SRTR data showed a greater proportion of males than females for kidney transplant waitlists (61% vs 39%). Similarly, of 831 deceased donor kidney transplants (DDKT) conducted between 1997 and 2018 at IKDRC-ITS, 68% have been male and 32% female recipients while majority of donors in living donor kidney transplants (LDKT) were females. Prior to 2020, there duration on transplantation waitlist was the only criteria for deceased donor kidney allocation. In January 2020, SOTTO Gujarat was formed which implements a point system based deceased donor allocation policy including HLA mismatch, Panel Reactive Antibody, Donor Specific Antibody, age and duration on dialysis, amongst others. 2 additional points are allocated to female recipients in this allocation system. The aim is to study the impact of change in DDKT allocation policy on gender disparity. Method This is a retrospective, single-center, observational study. Number of male and female kidney transplant recipients was collected from the medical records held by the department of nephrology between January 2014 to December 2023. The data was categorized as before and after implementation of SOTTO Gujarat guidelines and analyzed. Results A total of 3182 kidney transplants were conducted at our centre over the study period, 2231 were LDKT while only 951 were DDKT. We found the percentage of female LDKT recipients to have remained disproportionately low as compared to male DDKT throughout the study period, while there was a gradually progressive increase in the percentage of female DDKT recipients with almost a doubling of female DDKT recipients from 27.57% in 2019 to 54.19% in 2023. This may be attributed to the compounding effect of allocating points to DSA, PRA, age of patient and gender as female patients tend to have higher PRA and DSA level after sensitization. Conclusion This study provides new insights into steps that can be taken to bridge the gender gap in DDKT. It shows that implementing a point based system for DDKT allocation policy with extra points for female recipients may increase the number of kidney transplants in them. Similar policy may be undertaken by other transplant centers as a bridge to achieve temporary solution till underlying factors leading to gender disparity are better understood and ways to overcome them are formed. Action should be taken to provide for equitable access to females at all stages, from diagnosis to treatment such as intensive and timely counselling. Policies for social empowerment of women must be formed including literacy, better maternal and child healthcare and financial independence. Raising awareness and education at a grassroot level must remain the key component to change public attitude regarding organ donation and ensure equitable access to transplantation for all.

Gender disparity in access to education, under-5 mortality, and economic growth in sub-Saharan Africa.

This paper empirically analyses the impact of gender disparity in access to education and under 5 mortality on economic growth in selected sub-Saharan African (SSA) countries from the period 2005 - 2020. The study engaged a panel data of 17 selected SSA countries sourced from the World Development Indicators (WDI) and the United Nations Institute for Statistics (UNIS) and applied the instrumental variable generalised method of moments analytical approach. The result shows that the interaction between gender parity in access to education and primary school enrolment has a significant impact on economic growth. The study concludes that policies to promote gender parity in access to education would be of paramount importance to increase economic growth towards the actualisation of sustainable development goal related to inclusive and equitable quality education and the promotion of lifelong learning opportunities (SDG4) in SSA countries.

Gender Disparities in Access to Kidney Transplant.

Gender Disparities in Access to Kidney Transplant.

Organizational access points and substance use disorder treatment utilization among Black women: a longitudinal cohort study

IntroductionHealth and social service organizations, including the emergency department (ED) and public assistance programs, constitute a social safety net that may serve as an “access point” for substance use treatment utilization. Racialization of substance use disorder (SUD) and gender disparities in access to treatment contribute to differences in health and social service utilization, including substance use treatment for Black women. We therefore explored the role of various access points in facilitating the use of substance use treatment among Black women with substance use and involvement in the criminal justice system.MethodsWe used data from the Black Women in the Study of Epidemics (B-WISE) project (2008–2011), which recruited Black women who use drugs from community, probation, and prison recruitment settings in Kentucky. B-WISE is a three-wave panel survey collected on a six-month interval. We estimated dynamic panel models to understand whether time-varying use of services influenced women’s substance use treatment utilization over 18-months, adjusting for time-invariant characteristics. We stratified the analysis based on where women were recruited (i.e., community, prison, and probation).ResultsThe sample included 310 persons and 930 person-waves. For the community and prison samples, the use of an ED in the 6 months prior decreased women’s likelihood of subsequent substance use treatment use (Coef: -0.21 (95% CI: -0.40, -0.01); -0.33 (95% CI: -0.60, -0.06), respectively). For the probation sample, receiving support from public assistance (i.e., food stamps, housing, cash assistance) increased the likelihood of subsequent substance use treatment use (0.27 (95% CI: 0.08, 0.46)).ConclusionInteractions with health and social service organizations predicted Black women’s use of substance use treatment services and varied based on their involvement in the criminal justice system. Public assistance venues for Black women on probation may be a point of intervention to increase their access to and use of substance use treatment.

Perspectives of Nephrologists on Gender Disparities in Access to Kidney Transplantation.

Gender disparities in access to kidney transplantation are apparent, with women being up to 20% less likely to receive kidney transplant compared with men across different settings and socioeconomic backgrounds. We aimed to describe nephrologists' perspectives on gender disparities in access to kidney transplantation. Fifty-one nephrologists (55% women) from 22 countries participated in semistructured interviews from October 2019 to April 2020. We analyzed the transcripts thematically. We identified three themes: caregiving as a core role (coordinators of care for partners, fulfilling family duties over own health, maternal protectiveness, and inherent willingness and generosity), stereotyping and stigma (authority held by men in decision making, protecting the breadwinner, preserving body image and appearance, and safeguard fertility), social disadvantage and vulnerability (limited information and awareness, coping alone and lack of support, disempowered by language barriers, lack of financial resources, and without access to transport). Gender disparities in access to kidney transplantation are perceived by nephrologists to be exacerbated by gender norms and values, stigma and prejudice, and educational and financial disadvantages that are largely encountered by women compared with men across different socioeconomic settings.

Inequitable access to sport in juvenile justice across the USA: findings from a national survey.

The USA incarcerates more young people than any other industrialized nation in the world, and black youth are much more likely to be incarcerated than white youth. Young people who interface with the criminal justice system are at higher risk for poor health upon release and the justice system is believed to be a contributor to racial health disparities. Sport participation during incarceration has the potential to improve health and health equity, but the evidence on the health benefits of youth sport participation has almost exclusively focused on school and community settings in the USA with little attention to non-traditional settings, such as the justice system. Given the poor health consequences of incarceration, the potential of sport to improve health, and the lack of research on this phenomenon in the USA, our objective was to describe the landscape of sport programming in juvenile correctional facilities and provide a baseline understanding upon which future research can build. Through a cross-sectional survey of all long-term secure juvenile correctional facilities in the USA (n = 211), we found 55.1% operate a sport program. Among facilities with programs, there was a range of sport program offerings. Gender disparities in access to various types of programs exist, with girls generally having less opportunity than boys. Most facilities reported a purpose of positive youth development in the operation of their programs. These findings have important implications for health promotion and the further integration of sport and juvenile justice as part of a public health agenda.

Gender Disparities in Critical Care Procedure Training of Internal Medicine Residents.

Procedural training is a required competency in internal medicine (IM) residency, yet limited data exist on residents' experience of procedural training. We sought to understand how gender impacts access to procedural training among IM residents. A mixed-methods, explanatory sequential study was performed. Procedure volume for IM residents between 2016 and 2020 was assessed at two large academic residencies (Program A and Program B: 399 residents and 4,020 procedures). Procedural rates and actual versus expected procedure volume by gender were compared, with separate analyses by clinical environment (intensive care unit [ICU] or structured procedural service). Semistructured gender-congruent focus groups were conducted. Topics included identity formation as a proceduralist and the resident procedural learning experience, including perceived gender bias in procedure allocation. Compared with men, women residents performed disproportionately fewer ICU procedures per month at Program A (1.4 vs. 2.7; P < 0.05) but not at Program B (0.36 vs. 0.54; P = 0.23). At Program A, women performed only 47% of ICU procedures, significantly fewer than the 54% they were expected to perform on the basis of their time on ICU rotations (P < 0.001). For equal gender distribution of procedural volume at Program A, 11% of the procedures performed by men would have needed to have been performed by women instead. Gender was not associated with differences in the Program A structured procedural service (53% observed vs. 52% expected; P = 0.935), Program B structured procedural service (40% observed vs. 43% expected; P = 0.174), or in Program B ICUs (33% observed vs. 34% expected; P = 0.656). Focus group analysis identified that women from both residencies perceived that assertiveness was required for procedural training in unstructured learning environments. Residents felt that gender influenced access to procedural opportunities, ability to self-advocate for procedural experience, identity formation as a proceduralist, and confidence in acquiring procedural skills. Gender disparities in access to procedural training during ICU rotations were seen at one institution but not another. There were ubiquitous perceptions that assertiveness was important to access procedural opportunities. We hypothesize that structured allocation of procedures would mitigate disparities by allowing all residents to access procedural training regardless of self-advocacy. Residency programs should adopt structured procedural training programs to counteract inequities.

Addressing Gender Disparities in Access to Education: A Systematic Review

Addressing Gender Disparities in Access to Education: A Systematic Review

Assessment of agricultural practices by Ethiopian women farmers: existence of gender disparities in access to mycotoxins training

Abstract Ethiopia is one of the countries with the lowest gender-equality performance in sub-Saharan Africa being ranked 121/134 in terms of the magnitude and scope of gender disparities by the United Nations Women’s Organisation. Within the farming communities, women represent 70% of the labour force, but they are neglected from accessing training events run by Ethiopian Universities (e.g. Haramaya University). A survey to assess the existence of gender disparities among Ethiopian women farmers with respect to agricultural labour and mycotoxins knowledge was conducted on three hundred and forty-nine women from the Oromia and Amhara regions. A higher illiteracy rate was found in women compared to men from both Oromia and Amhara regions. Women played a key role in agricultural activities while having limited access to modern technologies compared to their male counterparts. Women were mainly responsible for sorting spoiled crops. Especially in Amhara, these were intended for home consumption, representing a serious health risk for local people. Overall, women from Amhara were more aware than women from Oromia about what mycotoxins are (e.g. aflatoxins), their impact and risk of occurrence in crops. Women in Amhara were also more intended to act towards mycotoxins in the future compared to women from Oromia. Only 0.24% of women have previously attended a training on mycotoxins. The radio seemed to be the most efficient way to deliver training to Ethiopian women farmers from these regions. Mycotoxins trainings were the second option of choice by all women surveyed. Such findings clearly stated the existence of gender inequality in the two Ethiopian regions considered. Empower women’s knowledge about mycotoxins will not only benefit agricultural income and the national economy, but it will also provide women the recognition they equally deserve alongside their male counterparts in future agricultural training programs and interventions.

Gender Disparity in Access to Higher Education: A Review of the Literature with Special Reference to the Omani Context

‘Education for All’ is the call of UN and its sub-organisation the United Nations Educational, Scientific and Cultural Organisation (UNESCO) that emphasises that education is a human right for all. However, access to education has been challenged with many obstacles, especially in higher education. One of these challenges is gender inequality, a significant factor that educational providers and policymakers must consider. This paper reviews pertinent literature to discuss higher education access and equality globally, and then sheds light on gender equality, with a special reference to the Omani context. The Omani experience with regard to access reflects gender disparity although statistics show that more female students are admitted to higher education institutions than males. This article questions the 50:50 admission policy that has resulted in admitting males with lower scores while depriving many eligible females of the very same opportunity. The article suggests investigating the causes behind this policy further and making amendments to ensure quality and good achievement in education by both genders and equality for access to HE. Keywords: Higher Education, gender, disparity, Oman, access

A Retrospective Cohort Study of Women and Men Living with HIV, Attending an HIV Clinic in Australia.

To compare women with men presenting with HIV to a public health HIV clinic, to identify the special characteristics and health care needs of women living with HIV in the Barwon South West region in Victoria. A retrospective cohort study of 35 women and 135 men living with HIV who attended the clinic between 2009 and 2020. Gender differences were assessed using nonparametric analyses. The women were diagnosed with HIV younger than the men (mean 29.5 years vs. 36.7 years) and more were born in Africa (28.6% vs. 5.2%). More men than women presented with sexually transmittable infections (38.5% vs. 14.3%) at the time of diagnosis, and were diagnosed through a sexual health screen (37% vs. 17%). The proportions of men and women who used alcohol and other drugs (recent to their diagnosis) were similar (68.1% vs. 48.6%), and there was no difference in proportions presenting with AIDS-defining illnesses (p = 0.425), or CD4 cell count (advanced: ≤200 cells, relatively well: ≥201 cells, p = 0.241), but the women had a lower viral load (p < 0.001). In this study of 170 people living with HIV, nearly one-half of the men with known HIV history were diagnosed through sexual health screens, but women's HIV was mostly detected through targeted screening. Results highlight gender disparity in access to sexual health screening and assessment, including low awareness of sexual health risks for women, and endorse the view that HIV is a heterosexual sexually transmittable infection in women.

Poverty status of rural households in Nigeria: a gendered perspective

PurposePoverty is endemic in rural Nigeria and gender disparity in access to productive resources is a major cause of poverty in the area. Poverty status of rural households along gender line was, therefore, investigated in this study.Design/methodology/approachPanel data from 2010/2011 (wave 1) and 2015/2016 (wave 3) of the Living Standard Measurement Survey (LSMS) for Nigeria were used for the study. Data were analysed using Foster, Greer and Thorbecke (FGT) poverty indices and binomial panel logistic model.FindingsPoverty measures for women-led households in farming activities were 58.5, 27.8 and 17.1%; men-led farming households had 59.8, 27.4 and 16.3% gender-neutral had 56.8%, 27 and 16.9% in the first panel. Poverty indices increased in the women-led and men-led farming households in the second panel. Poverty incidence was higher amongst farming households than the non-farming counterparts. Correlates of poverty status differ amongst the gender-groups were household size, farming, tertiary education, access to credit and geographical locations.Originality/valueGender disparity is perceived in this study along the line of differences in gender composition of rural households. A gender-blind approach to poverty alleviation programmes likely will not enhance reduced poverty in rural Nigeria. Closing the gender poverty gap will ensure achievement of the first sustainable development goal of poverty eradication.

347.6: Racial-Ethnic and Sex Disparities in Access to Renal Transplant Waitlisting Vary by Age in the United States

Background: Transplantation provides numerous benefits, but racial/ethnic and gender disparities in access to renal transplantation exist globally. However, in the United States, the interaction between race/ethnicity and gender in transplant access has not been well explored. Further, it is unclear how age at diagnosis modifies these disparities. Methods: We used the United States Renal Data System to identify a retrospective cohort of incident adult dialysis patients from January 1, 2005 – December 31, 2017 and followed through 2018. We used multivariable Cox regression to model the association between combined race/ethnicity and sex (race x gender) group and time to renal transplant waitlisting. We adjusted for clinical and sociodemographic factors and included a time-dependent covariate reflecting a 2014 change in the national kidney allocation policy (KAS) aimed to improve equity. We incorporated a race x gender x age group interaction term to test for effect modification by age group. We also conducted stratified analyses per age group. Results: After excluding prior renal transplant recipients (n=5,227) and pre-emptive transplants (n=3,486), we identified 1,337,386 US incident dialysis patients of whom 19.4% were waitlisted (median time to waitlisting (interquartile range): 350 days (184, 651)). Most patients were over 50; 50-59 (n=215,028, 19.8%), 60-69 (24.8%), or 70 or greater (37.2%). Waitlisting was highest among Asian women aged 18-39 (n=6,260, 69.7%) and lowest among Hispanic women aged 70 or greater (n=2,315, 1.9%). We found significant effect modification by age in the association of demographic group and time to waitlisting (p-value: <0.0001). Across all age groups, Black women experienced reduced access to transplant waitlisting compared to age-matched white men; this disparity was worst among the oldest (aged 70 or greater) (adjusted hazard ratio (aHR): 0.60, 95% confidence interval (CI): 0.56, 0.64) and youngest (aged 18-39) Black women (aHR: 0.77, 95% CI: 0.74, 0.79). Furthermore, older Hispanic and white women (60-69 and 70 or greater) exhibited reduced transplant access compared to aged-matched white men and men within their own race/ethnic group. Hispanic women aged 70 or greater experienced worst disparity with 42% reduced likelihood of waitlisting compared to white men (aHR: 0.58, 95% CI: 0.53, 0.64). Conclusions: The interaction between race/ethnicity and gender in access to renal transplant waitlisting in the United States varies significantly by age. Older Black and Hispanic women and younger Black women have significantly reduced access to transplantation compared to other groups, even after adjusting for clinical and sociodemographic factors. More work is needed to understand and ameliorate these intersections of gender, race/ethnicity, and age-related disparities to promote equity in access to renal transplantation. This research was supported by University of Chicago Medicine’s Center for Healthcare Delivery Science and Innovation (HDSI), the Bucksbaum Institute for Clinical Excellence at the University of Chicago, and the National Kidney Foundation of Illinois. We also acknowledge the University of Chicago Research Computing Center for computational support of this work. The data reported here have been supplied by the United States Renal Data System (USRDS) and the United States Census Bureau. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the U.S. Government.

Perceptions of Gender Disparities in Access to Surgical Care in Malawi: A Community Based Survey.

Gender disparities in surgical care exist but have been minimally studied, particularly in low- and middle-income countries. This study explored perceptions and gender differences in health-seeking behavior and attitudes toward surgical care in Malawi among community members. A survey tool was administered to adults ≥18years old at a central hospital, district hospital, and two marketplaces in Malawi from June 2018 to December 2018. Responses from men and women were compared using chi-squared tests. Four hundred eighty-five adults participated in the survey, 244 (50.3%) men and 241 (49.7%) women. Women were more likely to state that fear of surgery might prevent them from seeking surgical care (29.1% of men, 43.6% of women, P = .0009). Both genders reported long wait times, medicine/physician shortages, and lack of information about when surgery is needed as potential barriers to seeking surgical care. More men stated that medical preference should be given to sons (17.1% of men, 9.3% of women, P = .01). Men were more likely to report that men should have the final word about household decisions (28.7% of men vs 19.5% of women, P < .0001) and were more likely to spend money independently (68.7% of married men, 37.5% of married women, P < .0001). Few participants reported believing gender equality had been achieved (61% of men and 66.8% of women). A multi-pronged approach is needed to reduce gender disparities in surgical care in Malawi, including addressing paternalistic societal norms, education, and improving health infrastructure.

A gender lens is needed in hepatitis C elimination research.

The World Health Organisation has established a goal of eliminating the hepatitis C virus (HCV) as a public health threat by 2030. Considerable effort is being directed towards research to support and enhance HCV treatment uptake among people who inject drugs, but there is a distinct lack of attention given to gender in this work. We argue that a gender lens is needed to make visible the limitations of current HCV elimination research, and support the development of innovative, inclusive approaches to HCV treatment. Partnerships between researchers and people who inject drugs are essential in this work, particularly in the development and evaluation of programs by and for women who inject drugs. Failure to acknowledge the gendered dimensions of HCV elimination risks entrenching gender disparities in access to treatment and cure.

"Some They Need Male, Some They Need Female": A Gendered Approach for Breast Cancer Detection in Uganda.

IntroductionThere are several challenges associated with breast cancer detection in Uganda and other low-and-middle-income countries. One of the identified challenges is attributed to the health workers' gender, which facilitates gender disparities in access to breast cancer detection services. Although this challenge is well acknowledged in existing literature, there are hardly any studies on how it can be addressed. Therefore, drawing on an intersectionality lens, our study examined how to address gender disparities facilitated by health workers' gender in accessing breast cancer detection services in Uganda.Materials and MethodsWe collected qualitative data through semi-structured interviews with twenty participants comprising community health workers, primary health care practitioners, non-governmental organizations, district health team, and the Ministry of Health. For the data analysis, thematic analysis was conducted on NVivo using Braun and Clarke's non-linear 6-step process to identify the themes presented in the results section.ResultsFour themes emerged from the data analysis: understanding a woman's gender constructions; health workers' approachability; focus on professionalism, not sex; and change in organizational culture. These themes revealed participants' perceptions regarding how to address gender disparities relating to the role health workers' gender play in breast cancer detection. Through the intersectionality lens, our findings showed how gender intersects with other social stratifiers such as religious beliefs, familial control, health worker's approachability, and professionalism within the health workforce.ConclusionOur findings show that the solutions to address gender disparities in breast cancer detection are individually and socially constructed. As such, we recommend a gendered approach to understand and redress the underlying power relations perpetuating such constructions. We conclude that taking a gendered approach will ensure that breast cancer detection programs are context-appropriate, cognizant of the prevailing cultural norms, and do not restrict women's access to breast cancer detection services.