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Journal of Health Management
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The Challenge of Infectious Disease: Time to Take Gender into Account

R. Tolhurst

Liverpool School of Tropical Medicine, Liverpool, UKE-mails: r.j.tolhurst{at}liv.ac.uk

K. de Koning

Royal Tropical Institute (KIT), Health Care Training, PO Box 95001, 1090 HA Amsterdam, the Netherlands E-mail: k.d.koning{at}kit.nl.

J. Price

Liverpool School of Tropical Medicine, Liverpool, UKjep{at}liv.ac.uk

J. Kemp

Liverpool School of Tropical Medicine, Liverpool, UKjkemp{at}liv.ac.uk

S. Theobald

Liverpool School of Tropical Medicine, Liverpool, UKsjt{at}liv.ac.uk

S.B. Squire

Liverpool School of Tropical Medicine, Liverpool, UKs.b.squire{at}liv.ac.uk

Efforts to address infectious diseases have long been hindered by the failure to take into account the social aspects of these diseases. Gender is a fundamental dimension of these social aspects. There is currently a focus in international health on the import ance of addressing diseases of poverty. Attention to gender is a crucial part of a poverty-focused response to the challenges posed by infectious disease. In this article we provide a framework for analysing gender inequities in infectious disease in developing countries, and briefly draw implications for policy and practice.

Gender identities, status, roles and responsibilities influence vulnerability to dis ease, access to health care, and the impact of disease for women, men, girls and boys. Women's and men's roles affect their risk of infection with specific diseases, whilst gender relations influence their ability to protect their own health. Gender differences in access to and control over resources, in decision-making power in the household and in roles and activities can limit women's ability to access health care for them selves and their children. Gendered norms and identities influence both women's and men's willingness and ability to seek care. The social consequences of infectious disease are often more severe for women than for men, and illness imposes a parti cularly heavy labour burden upon women.

Health services need to adjust their practices to improve the appropriateness of preventive and curative services for infectious disease control for both women and men amongst the poor and disadvantaged. However, measures to reduce gender inequities in health cannot be limited to the health sector alone.

Journal of Health Management, Vol. 4, No. 2, 135-151 (2002)
DOI: 10.1177/097206340200400204


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