Published in News
The key to improving global health equity is recognizing and addressing the factors that contribute to health inequities within and between countries. Dr. Anu Oommen shares her insights on how we can promote equity in healthcare, especially for women and girls, through her GACD SHE-CAN project.
The 2023 International Women’s Day theme of Embracing Equity is an opportunity to highlight 1) the need for equity in access to healthcare no matter your gender, and 2) in building the evidence for how best to provide equitable healthcare the critical role that women are playing in in the field of global health research. For both of these it’s important to recognize the unique challenges and opportunities that women may face.
We talked to female researchers who are undertaking Global Alliance for Chronic Diseases (GACD) projects to gain their insights and perspectives on what it means to work in this important area.
Dr. Anu Oommen is a female researcher from India who works to improve global health equity, especially for women and girls. Her work focuses on non-communicable diseases (NCDs), which are diseases that cannot be transmitted from person to person, such as cancer, diabetes, and heart disease.
In order to promote equity in health globally, Dr. Oommen believes it is important to identify the factors that lead to health inequities both within and between countries. There are many contributing factors – including economic differences, conflict, poverty, gender, age, marital status, geographical location, caste/tribe, economic status, occupation, and ethnicity. Policies and guidelines must take into account these factors and recognise particular populations or communities that face inequity may need modified protocols and approaches for care. These communities themselves must be fully engaged with any potential study to understand their needs, and to co-design, implement and evaluate unique solutions.
Dr. Oommen’s SHE- CAN project (led by Prof Julia Brotherton, a leading researcher in cervical cancer) within the GACD cancer programme is a collaborative effort between ACPCC, IARC, RTI, CMC Vellore, THI Sittilingi, Governments of Mizoram and Tamil Nadu (India), that aims to develop and test HPV-based cervical screening approaches in vulnerable populations in India. By working with tribal, rural, and urban slum-dwelling women to develop feasible approaches to HPV screening, the project spotlights the need for adaptable pathways in national guidelines that ensure no group is left out during the eventual launch of HPV-based cervical screening.
From her own research experience, Dr. Oommen suggests applying a gender lens from the early ‘needs assessment’ right through to ‘ outcome assessment’ to ensure that any research on NCDs takes into account the unique needs and experiences of women and girls. All indicators of ill health and service provision must be examined to see if women and girls suffer more or less from the NCD in question and whether they face greater or fewer hurdles to services. The effect of biological aspects of a girl’s or woman’s usual life, such as menstrual disorders, menopause, pregnancies, on future risk of NCDs needs to be studied, and how interventions for problems associated with these can reduce future NCDs.
Gender inequality can affect research study outcomes, particularly in the area of NCDs, because research can falsely show better outcomes of interventions if no gender disaggregated analysis is done, and better effects of interventions may be shown if mainly men took part and women did not. Research designs should be careful to reduce inequitable participation and ensure outcomes are informative.It’s crucial to involve diverse communities in the research process to ensure that research addresses their unique needs and experiences.
As a global health research leader herself Dr. Oommen reflects that women should be equitably and meaningfully engaged in all aspects of research whether as participant or as researcher. This means promoting education of girls in general, fostering womens’ aspirations, enabling training of women researchers and offering equitable opportunity in career progression. We need to understand and support the female perspective in health and illness, as well as support women in health care research to have their voices heard, though mentorship and funding opportunities.
(Dr. Anu Oommen is Professor, Community Health Department at the Christian Medical College Vellore in India and PhD student at the Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne.)