Bringing gender sensitivity into healthcare practice: A systematic review

Abstract

Objective

Despite the body of literature on gender dimensions and disparities between the sexes in health, practical improvements will not be realized effectively as long as we lack an overview of the ways how to implement these ideas. This systematic review provides a content analysis of literature on the implementation of gender sensitivity in health care.

Methods

Literature was identified from CINAHL, PsycINFO, Medline, EBSCO and Cochrane (1998–2008) and the reference lists of relevant articles. The quality and relevance of 752 articles were assessed and finally 11 original studies were included.

Results

Our results demonstrate that the implementation of gender sensitivity includes tailoring opportunities and barriers related to the professional, organizational and the policy level. As gender disparities are embedded in healthcare, a multiple track approach to implement gender sensitivity is needed to change gendered healthcare systems.

Conclusion

Conventional approaches, taking into account one barrier and/or opportunity, fail to prevent gender inequality in health care. For gender-sensitive health care we need to change systems and structures, but also to enhance understanding, raise awareness and develop skills among health professionals.

Practice implications

To bring gender sensitivity into healthcare practice, interventions should address a range of factors.

Introduction

Men and women are not the same when it concerns their health; risks, symptoms, (presentation of) complaints and experience of a disease may vary. That sex and gender matter in health(care) has been demonstrated in a vast amount of studies [1], [2], [3], [4], [5], [6], [7]. If sex and gender differences are not systematically taken into account by health professionals inequities may arise. Some recommendations have been given to enhance gender sensitivity in health care [8]. Gender sensitivity means that health professionals are competent to perceive existing gender differences and to incorporate these into their decisions and actions. It is commonly accepted that gender does not exist in a vacuum; gender is part of a socio-political and cultural context. Healthcare organizations are gendered, which means that male and female patients are treated differently and that male and female physicians behave differently [9]. Intersectionality goes beyond gender sensitivity and includes the consideration of other dimensions of difference, like social class and ethnicity. The interaction between these dimensions shapes patients’ health needs [10], [11], [12].

Whereas concerns about gender and health(care) have come to the fore in the scientific arena, gender sensitivity will not automatically be adopted in health care [13]. Implementation literature suggests that innovations within health care generally require comprehensive approaches at different levels [14]. Ideally implementation on an individual professional level parallels implementation at organizational level [15]. For example, a gender-training program can raise the awareness and knowledge of professionals, but organizational learning is required to change working routines.

Despite the body of literature on gender dimensions and disparities between the sexes in health, practical improvements will not be realized effectively as long as we lack an overview of the ways how to implement these ideas [16]. Insight in the obstacles and facilitating factors to enhance gender sensitivity in practice is needed [17]. This article aims to fill that gap providing a systematic analysis of the opportunities and barriers for the implementation of gender sensitivity in health care.