Emerging Gender Impacts
• Exacerbated burdens of unpaid care work on women and girls: Where healthcare systems are stretched by efforts to contain outbreaks, care responsibilities are frequently “downloaded” onto women and girls, who usually bear responsibility for caring for ill family members and the elderly. The closure of schools further exacerbates the burden of unpaid care work on women and girls, who absorb the additional work of caring for children.
• Meeting the needs of women healthcare workers: Women constitute 70% of the workers in the health and social sector globally, and are on the frontlines of the response. Within this sector, an average gender pay gap of 28% exists, which may be exacerbated in times of crises. Women healthcare workers have called attention to their specific needs beyond personal protective equipment, including to meet menstrual hygiene needs. Psychosocial support should also be provided to frontline responders.
• Increasing GBV and protection risks: Experiences have demonstrated that where women are primarily responsible for procuring and cooking food for the family, increasing food insecurity as a result of the crises may place them at heightened risk, for example, of intimate partner and other forms of domestic violence due to heightened tensions in the household. Other forms of GBV are also exacerbated in crisis contexts. For example, the economic impacts of the 2013-2016 Ebola outbreak in West Africa, placed women and children at greater risk of exploitation and sexual violence. In addition, life-saving care and support to GBV survivors (i.e. clinical management of rape and mental health and psycho-social support) may be disrupted in one-stop crisis centers in tertiary level hospitals when health service providers are overburdened and preoccupied with handling COVID-19 cases.
• Impacts on women’s economic empowerment: As noted for the Ebola outbreak, crises pose a serious threat to women’s engagement in economic activities, especially in informal sectors, and can increase gender gaps in livelihoods.
• Impacts on women migrant workers: Women migrant workers, in particular those engaged in domestic and care work, in the region have called attention to the adverse impact of increasingly unpredictable travel bans on their employment, with strong financial implications, and ability to support their families.
• Interrupted access to sexual and reproductive health: Evidence from past epidemics, including Ebola and Zika, indicate that efforts to contain outbreaks often divert resources from routine health services including pre- and post-natal health care and contraceptives, and exacerbate often already limited access to sexual and reproductive health services. Adolescents have particular needs in this regard. Furthermore, critical needs include access to clean and safe delivery, particularly for treatment in complications in pregnancy, treatment of STIs, availability of contraception, and provisions for clinical management of rape.
• Exclusion from leadership roles: Despite women constituting a majority of frontline healthcare workers, placing them in prime positions to identify trends at the local level, they continue to form only small minorities in national and global health leadership. Better inclusion of women frontline workers in health and other sectors in all decision-making and policy spaces can improve health security surveillance, detection, and prevention mechanisms.
• Need for targeted approaches to reaching all social groups with risk communication and services, taking into account gender, age, disability, education, migration status. Evidence from other outbreaks suggests that education status impacted knowledge uptake for certain groups. In addition, recognition needs to be made of the specific health and communication needs of especially marginalized groups, including LGBTIQ persons, people living with HIV, and migrants.