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Health Policy Plan. 2016 Dec;31(10):1492-1514. Epub 2016 Jul 1.

Does addressing gender inequalities and empowering women and girls improve health and development programme outcomes?

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Iris Group, Chapel Hill, NC 27514, USA.
Iris Group, Chapel Hill, NC 27514, USA
George Warren Brown School of Social Work, Washington University, St Louis, MO 63105, USA.
Department of Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27599, USA.
Thrive 4-7, Morrisville, NC 27560, USA.
Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA.


This article presents evidence supporting the hypothesis that promoting gender equality and women's and girls' empowerment (GEWE) leads to better health and development outcomes. We reviewed the literature across six sectors-family planning (FP); maternal, newborn and child health (MNCH); nutrition; agriculture; water, sanitation and hygiene; and financial services for the poor-and found 76 studies from low and middle-income countries that met our inclusion criteria. Across these studies, we identified common GEWE variables that emerged repeatedly as significant predictors of sector outcomes. We grouped these variables into 10 thematic categories, which we termed 'gender-related levers'. These levers were then classified by the strength of evidence into Wedges, Foundations and Facilitators. Wedges are gender-related levers that had strong associations with improved outcomes across multiple sectors. They include: 'control over income/assets/resources', 'decision-making power' and 'education'. Elements of these levers overlap, but combined, they encapsulate agency. Increasing female agency promotes equality and broadly improves health and development for women, their families and their communities. The second classification, Foundations, displayed strong, positive associations across FP, MNCH and nutrition. Foundations have a more proximal relationship with sector outcomes and include: 'equitable interpersonal relationships', 'mobility' and 'personal safety'. Finally, the third group of levers, Facilitators, was associated with improved outcomes in two to three sectors and include: 'access to information', 'community groups', 'paid labour' and 'rights'. These levers make it easier for women and girls to achieve their goals and are more traditional elements of development programmes. Overall, gender-related levers were associated with improvements in a variety of health and development outcomes. Furthermore, these associations were cross-sectoral, suggesting that to fully realize the benefits of promoting GEWE, the development community must collaborate in co-ordinated and integrated ways across multiple sectors. More research is needed to identify the mechanisms by which gendered interventions work and under what circumstances.


Agency; agriculture; development; empowerment; family planning; gender; maternal and child health; nutrition; public health; water

[Indexed for MEDLINE]

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