Markers of achievement for assessing and monitoring gender equity in a UK National Institute for Health Research Biomedical Research Centre: A two-factor model.

BACKGROUND: The underrepresentation of women in academic medicine at senior level and in leadership positions is well documented. Biomedical Research Centres (BRC), partnerships between leading National Health Service (NHS) organisations and universities, conduct world class translational research funded by the National Institute for Health Research (NIHR) in the UK. Since 2011 BRCs are required to demonstrate significant progress in gender equity (GE) to be eligible to apply for funding. However, the evidence base for monitoring GE specifically in BRC settings is underdeveloped. This is the first survey tool designed to rank and identify new GE markers specific to the NIHR BRCs. METHODS: An online survey distributed to senior leadership, clinical and non-clinical researchers, trainees, administrative and other professionals affiliated to the NIHR Oxford BRC (N = 683). Participants ranked 13 markers of GE on a five point Likert scale by importance. Data were summarised using frequencies and descriptive statistics. Interrelationships between markers and underlying latent dimensions (factors) were determined by exploratory and confirmatory factor analyses. RESULTS: The response rate was 36% (243 respondents). Respondents were more frequently female (55%, n = 133), aged 41-50 years (33%, n = 81), investigators (33%, n = 81) affiliated to the BRC for 2-7 years (39.5%, n = 96). Overall participants ranked 'BRC senior leadership roles' and 'organisational policies on gender equity', to be the most important markers of GE. 58% (n = 141) and 57% (n = 139) respectively. Female participants ranked 'organisational policies' (64.7%, n = 86/133) and 'recruitment and retention' (60.9%, n = 81/133) most highly, whereas male participants ranked 'leadership development' (52.1%, n = 50/96) and 'BRC senior leadership roles' (50%, n = 48/96) as most important. Factor analyses identified two distinct latent dimensions: "organisational markers" and "individual markers" of GE in BRCs. CONCLUSIONS: A two-factor model of markers of achievement for GE with "organisational" and "individual" dimensions was identified. Implementation and sustainability of gender equity requires commitment at senior leadership and organisational policy level.

A formative assessment of gender awareness and ability of staff based on the service programs of the All-China Women's Federation: The case of the "3861 My Home" program.

In order to achieve "gender mainstreaming" which is a global strategy to promote the development of women, it has in recent years been a major task for the All-China Women's Federation (ACWF) to improve the gender awareness and ability of policy makers and implementers. Thus, researchers should constantly propose and evaluate various possible attempts to improve gender awareness and the ability of individuals. There are few empirical studies on the assessment of gender awareness and the improvement of the ability of staff who have been trained and educated. Research studies focusing on the promotion of gender-sensitive awareness and ability of staff by participating in programs are even rarer. This study presents a specific case, namely the evaluation of promoting social service workers' gender awareness and ability within the implementation of the "3861 My Home" program. Based on this case, this study examines how to promote gender awareness and ability of social service workers through the implementation of the service program of Women's Federation, and also assesses the quality of the results of this implementation. Moreover, this study also contributes to the literature pertaining to assessing the development of social service workers' gender awareness and ability. In addition, the study provides an option for enhancing the gender awareness and ability of social service workers in addition to training: The participatory learning or action pertaining to gender awareness and ability based on the Women's Federation programs are able to effectively improve the gender awareness and ability of staff.

An account for barriers and strategies in fulfilling women's right to quality maternal health care: a qualitative study from rural Tanzania.

BACKGROUND: Tanzania has ratified and abides to legal treaties indicating the obligation of the state to provide essential maternal health care as a basic human right. Nevertheless, the quality of maternal health care is disproportionately low. The current study sets to understand maternal health services' delivery from the perspective of rural health workers', and to understand barriers for and better strategies for realization of the right to quality maternal health care. METHODS: Semi-structured in-depth interviews were conducted, involving 11 health workers mainly; medical attendants, enrolled nurses and Assistant Medical Officers from primary health facilities in rural Tanzania. Structured observation complemented data from interviews. Interview data were analyzed using thematic analysis guided by the conceptual framework of the right to health. RESULTS: Three themes emerged that reflected health workers' opinion towards the quality of health care services; "It's hard to respect women's preferences", "Striving to fulfill women's needs with limited resources", and "Trying to facilitate women's access to services at the face of transport and cost barriers". CONCLUSION: Health system has left health workers as frustrated right holders, as well as dis-empowered duty bearers. This was due to the unavailability of adequate material and human resources, lack of motivation and lack of supervision, which are essential for provision of quality maternal health care services. Pregnant women, users of health services, appeared to be also left as frustrated right holders, who incurred out-of-pocket costs to pay for services, which were meant to be provided free.

Association for Academic Surgery presidential address: sticky floors and glass ceilings.

This 2017 Presidential Address for the Association for Academic Surgery was delivered on February 8, 2017. It addresses the difficult topic of gender disparities in surgery. Mixing empirical data with personal anecdotes, Dr. Caprice Greenberg provides an insightful overview of this difficult challenge facing the surgical discipline and practical advice on how we can begin to address it.

La mujer cubana: evolución de derechos y barreras para asumir puestos de dirección / Cuban women: evolution of rights and barriers to occupy direction posts

Los derechos de las mujeres cubanas a través de la historia han ido evolucionando como resultado de una incansable lucha. Se realiza una revisión de esta problemática para valorar objetivamente dicha evolución y las barreras que aún existen para que las féminas ocupen cargos de dirección. Se establecen diferentes etapas para el análisis. Se precisaron los momentos de inicio de su derecho al voto, a la igualdad ante el matrimonio y al reclamo del divorcio, comprobándose que estos derechos conquistados por ellas fueron el fruto de grandes luchas por sus reivindicaciones políticas, sociales y culturales. Se expone que existen aún numerosos aspectos que constituyen barreras a la ocupación de cargos de dirección por parte de la mujer, entre ellos los conflictos entre lo laboral y lo doméstico, la necesidad de viajes y traslados al centro laboral diariamente, las responsabilidades familiares, los horarios excesivos y la poca flexibilidad en los mismos, así como el poco tiempo para dedicar a las actividades sociales y recreativas y al cuidado personal (AU).

The rights of Cuban women have evolved through the history as a result of an indefatigable fight. A review of this problem was carried out to objectively appraise that evolution and the barriers still existing for women to occupy managerial positions. Several stages are established to perform the analysis. It was confirmed the date women were given the right to vote, the equality of rights in the marriage and the right of asking for the divorce, stating that these rights conquered by them were the result of a long struggle for their political, social and cultural demands. It is exposed that there are still several aspects arising as barriers against women occupying direction posts, among them the conflicts between work tasks and house tasks, trips for working reasons, daily displacement to work, the excessive hours and the little flexibility in them, and also the few time for social and leisure time activities, and for personal care (AU).

La mujer cubana: evolución de derechos y barreras para asumir puestos de dirección / Cuban women: evolution of rights and barriers to occupy direction posts

Los derechos de las mujeres cubanas a través de la historia han ido evolucionando como resultado de una incansable lucha. Se realiza una revisión de esta problemática para valorar objetivamente dicha evolución y las barreras que aún existen para que las féminas ocupen cargos de dirección. Se establecen diferentes etapas para el análisis. Se precisaron los momentos de inicio de su derecho al voto, a la igualdad ante el matrimonio y al reclamo del divorcio, comprobándose que estos derechos conquistados por ellas fueron el fruto de grandes luchas por sus reivindicaciones políticas, sociales y culturales. Se expone que existen aún numerosos aspectos que constituyen barreras a la ocupación de cargos de dirección por parte de la mujer, entre ellos los conflictos entre lo laboral y lo doméstico, la necesidad de viajes y traslados al centro laboral diariamente, las responsabilidades familiares, los horarios excesivos y la poca flexibilidad en los mismos, así como el poco tiempo para dedicar a las actividades sociales y recreativas y al cuidado personal (AU).

The rights of Cuban women have evolved through the history as a result of an indefatigable fight. A review of this problem was carried out to objectively appraise that evolution and the barriers still existing for women to occupy managerial positions. Several stages are established to perform the analysis. It was confirmed the date women were given the right to vote, the equality of rights in the marriage and the right of asking for the divorce, stating that these rights conquered by them were the result of a long struggle for their political, social and cultural demands. It is exposed that there are still several aspects arising as barriers against women occupying direction posts, among them the conflicts between work tasks and house tasks, trips for working reasons, daily displacement to work, the excessive hours and the little flexibility in them, and also the few time for social and leisure time activities, and for personal care (AU).

Good practice or positive action? Using Q methodology to identify competing views on improving gender equality in academic medicine.

OBJECTIVES: The number of women entering medicine has increased significantly, yet women are still under-represented at senior levels in academic medicine. To support the gender equality action plan at one School of Medicine, this study sought to (1) identify the range of viewpoints held by staff on how to address gender inequality and (2) identify attitudinal barriers to change. DESIGN: Q methodology. 50 potential interventions representing good practice or positive action, and addressing cultural, organisational and individual barriers to gender equality, were ranked by participants according to their perception of priority. SETTING: The School of Medicine at the University of Leeds, UK. PARTICIPANTS: Fifty-five staff members were purposively sampled to represent gender and academic pay grade. RESULTS: Principal components analysis identified six competing viewpoints on how to address gender inequality. Four viewpoints favoured positive action interventions: (1) support careers of women with childcare commitments, (2) support progression of women into leadership roles rather than focus on women with children, (3) support careers of all women rather than just those aiming for leadership, and (4) drive change via high-level financial and strategic initiatives. Two viewpoints favoured good practice with no specific focus on women by (5) recognising merit irrespective of gender and (6) improving existing career development practice. No viewpoint was strongly associated with gender, pay grade or role; however, latent class analysis identified that female staff were more likely than male to prioritise the setting of equality targets. Attitudinal barriers to the setting of targets and other positive action initiatives were identified, and it was clear that not all staff supported positive action approaches. CONCLUSIONS: The findings and the approach have utility for those involved in gender equality work in other medical and academic institutions. However, the impact of such initiatives needs to be evaluated in the longer term.

Lessons Learned from a Student-Led Breastfeeding Support Initiative at a US Urban Public University.

Despite US laws requiring most workplaces to provide "reasonable" unpaid break time and a private space for female employees to express breast milk, much of the statutory language is vague and open to interpretation, potentially leading to suboptimal implementation. College and university campuses in the US represent a particular concern, as students are typically not employed by their school and thus not protected by state and federal labor laws. This article describes the work of 2 graduate students to successfully establish a dedicated space at their US urban public university for the purpose of expressing breast milk. A 3-pronged strategy was implemented to create a dedicated lactation space: (1) collecting data to support the establishment of the room, (2) raising awareness of legislation related to protection of breastfeeding, and (3) community organizing and advocacy. After nearly 18 months of advocacy and planning, the campus' dedicated lactation room was opened for use in March 2012. Two years later, the room remains a valuable resource and is used, on average, 8.4 times per weekday during a typical school week. Several lessons learned are described, and the strategies employed can be tested and applied in other US academic settings to assist in advocating for more supports for breastfeeding mothers. However, it is also imperative that US legislation be amended to include language that explicitly protects students so that women do not need to make the choice between continuing their education and continuing to breastfeed.

"Stop importing weapons of family destruction!": cyberdiscourses, patriarchal anxieties, and the men's backlash movement in India.

A critical, albeit understudied, dimension of the backlash against women's anti-violence advocacy is the rise of Indian men's rights organizations formed to lobby for changes to, and in some cases, the complete abolition of vital legal protections for women. Utilizing cyber forums, public protests, and print media, these groups disseminate narratives of women wreaking destruction on the Indian family through their alleged misuse of "gender-biased" laws. These activities are significant because they operate as transnational sites of meaning making about the realities of violence against women in India and because they conspire in a distortion of reality that jeopardizes ongoing advocacy efforts.

Construction and Validation of a Women's Autonomy Measurement Scale with Reference to Utilization of Maternal Health Care Services in Nepal.

INTRODUCTION: Women's autonomy is one of the predictors of maternal health care service utilization. This study aimed to construct and validate a scale for measuring women's autonomy with relevance to developing countries. METHODS: We conducted a study for construction and validation of a scale in Rupandehi and further validated in Kapilvastu districts of Nepal. Initially, we administered a 24-item preliminary scale and finalized a 23-item scale using psychometric tests. After defining the construct of women's autonomy, we pooled 194 items and selected 24 items to develop a preliminary scale. The scale development process followed different steps i.e. definition of construct, generation of items pool, pretesting, analysis of psychometric test and further validation. RESULTS: The new scale was strongly supported by Cronbach's Alpha value (0.84), test-retest Pearson correlation (0.87), average content validity ratio (0.8) and overall agreement- Kappa value of the items (0.83) whereas all values were found satisfactory. From factor analysis, we selected 23 items for the final scale which show good convergent and discriminant validity. From preliminary draft, we removed one item; the remaining 23 items were loaded in five factors. All five factors had single loading items by suppressing absolute coefficient value less than 0.45 and average coefficient was more than 0.60 of each factor. Similarly, the factors and loaded items had good convergent and discriminant validity which further showed strong measurement capacity of the scale. CONCLUSIONS: The new scale is a reliable tool for assessing women's autonomy in developing countries. We recommend for further use and validation of the scale for ensuring the measurement capacity.

[Nikolai Illarionovich Kozlov--a scientist, a doctor, an outstanding organizer of Military Medicine (To the 200th anniversary of the birth)].

To Kozlov N.I. (1814-1889) belong numerous achievements in the organization of military medical unit during the Crimean (1853-1856) and the Russian-Turkish (1877-1878) wars, the introduction of women's medical education in Russia, establishment of an improvement system for the military doctors, edition for their medical guidelines, the organization of military health care in Russia.

Female genital mutilation in Sierra Leone: who are the decision makers?

The objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). Generally, decisions to perform FGM were made by women, but father was mentioned as the one who decided by 28% of the respondents. The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals' associations need to consider how to prevent further medicalization of the practice.

La presencia de la mujer en la gestión en el área de la higiene y la epidemiología en Cuba, 1959-2009 / The woman's presence in the management of the field of hygiene and epidemiology in Cuba, 1959-2009

INTRODUCCIÓN: La epidemiología, desde la perspectiva de la salud pública como política de Estado, tiene como objeto de estudio básico la situación de salud de poblaciones, es decir, perfiles de problemas de colectivos humanos para el control de estos. El sistema de género es un conjunto de prácticas, símbolos, representaciones, normas y valores sociales que las sociedades elaboran a partir de la diferencia sexual anatómica- fisiológica, y que dan sentido a la situación de impulsos sexuales, a la reproducción de la especie humana y en general a la relación entre las personas. A pesar de los logros alcanzados en Cuba, que indudablemente han disminuido las brechas de género, existen determinadas formas de pensar y de actuar que inciden en las desigualdades presentes entre hombres y mujeres. OBJETIVOS: Describir la incorporación de la mujer a la dirección del área de la higiene y la epidemiología durante los tres períodos de la salud pública cubana. MÉTODOS: Se realizó un estudio histórico lógico, tomando como guía la periodización de la salud pública cubana desde la colonia hasta los años actuales de la Revolución cubana. RESULTADOS: En los dos primeros períodos de la salud pública cubana muy poca fue la participación de la mujer en los procesos de dirección del área higiénica epidemiológica. Entre 1959 y 1979 predominaron las directivas especialistas en administración de salud. por primera vez una mujer asumió la conducción del Instituto de Higiene. Se evidencio que el área más fortalecida por mujeres directivas en esta etapa fue la docente. Entre 1970 y 1979 se graduaron las primeras mujeres especialistas y comenzaron a ocupar cargos de dirección las epidemiólogas, nutriólogas e higienistas comunales. De 1980 a 1989 se puso en evidencia un auge en todo lo relacionado con la participación de la mujer en la dirección del área de higiene y epidemiología, muy revelador en la conducción de los servicios y la docencia. Por primera vez una mujer ...(AU)

INTRODUCTION: The objective of the epidemiology from the public health perspective as a state policy, is to study basically the health situation of populations, that is, the profiles of human groups to its control. The gender system is a series of practices, symbols, representations, guidelines and social values that the societies create from the anatomical-physiological sexual difference and give sense to situation of sexual urges, to reproduction of human species and in general to relationship among persons. Despite the achievements obtained in Cuba, which undoubtedly have reduced the gaps of gender, there are determined ways of thinking and of acting to lapse into inequalities present among men and women. OBJECTIVE: To describe the woman's incorporation to management of hygiene and epidemiology area during three periods of Cuban public health. METHODS: An historical-logical study was conducted taking into account as a guide the frequency of the Cuban public health from the colonial period up to the present years of Cuban Revolution. RESULTS: During the two first periods of the Cuban public health there was few involvement of woman in the management processes of the hygiene-epidemiology area. Between 1959 and 1979 there was predominance of specialist boards in health administration where for the first time a woman managed the Institute of Hygiene. It was evidenced that the more area strengthened by staff women in his period was the teaching one. Between 1970 and 1979 the first women were graduate as specialists and started to hold posts as manager as community epemiologists, nutritionists and hygienists. From 1980 to 1989 it was evidenced a climax in all related to involvement of woman in the hygiene and epidemiology area management, especially in the conduction of services and teaching. Finally, after 1990, there remains an increase of involvement of woman in the management of hygiene and epidemiology emphasizing the management of ...(AU)

Gender inequity in Saudi Arabia and its role in public health.

In Saudi Arabia, local interpretations of Islamic laws and social norms have a negative impact on the health and well-being of women. The objective of this literature review was to discuss gender inequity in Saudi Arabia and its relation to public health. Despite the scarcity of recent statistics and information regarding gender inequity in Saudi Arabia, this review is an attempt to explore this sensitive issue in this country. Women's roles and rights in Saudi society were examined, including education, marriage, polygamy, fertility, job opportunities, car driving and identification cards. Further research to assess knowledge, attitudes and practices towards health care of Saudi men and women is recommended.