[Gender, equality, and health services access: an empirical approximation]. / Género, equidad y acceso a los servicios de salud: una aproximación empírica.

This piece describes the conceptual framework and the objectives that guided a research initiative in the Region of the Americas that was called "Gender, Equity, and Access to Health Services" and that was sponsored in 2001 by the Pan American Health Organization. The piece does not summarize the results of the six projects that were carried under the initiative, whose analyses have not all been completed. Instead, the piece discusses some of the foundations of the initiative and provides a general introduction to the country studies that were done. The six studies were done in Barbados/Jamaica, Brazil, Chile, Colombia, Ecuador, and Peru. The primary objective of the initiative was to stimulate the use of existing quantitative information in the countries, with the goal of starting a process of systematically documenting two things: 1) the unfair, unnecessary, and avoidable inequalities between men and women in their access to health care and 2) the linkages between those inequalities and other socioeconomic factors. The concept of gender equity that guided this examination of health care was not the usual one calling for the equal distribution of resources. Rather, it was the notion that resources should be allocated differentially, according to the particular needs of men and of women, and that persons should pay for health services according to their economic ability rather than their risk level. The starting point for the initiative was the premise that gender inequities in utilizing and paying for health care result from gender differences in the macroeconomic and microeconomic distribution of resources. The piece concludes that achieving equity in health care access will require a better understanding of the gender needs and gender barriers that are linked to social structures and health systems.

Equidad, género y salud / Equity, gender, and health

El objetivo de este documento es presentar los fundamentos éticos y empíricos del mandato OPS de "incorporación de la perspectiva de género en las políticas y estrategias de salud". Dicho mandato apunta a la indentificación y corección de las inequidades de género que vulneran el ejercicio ciudadano del derecho a la salud por parte de mujeres y hombres. El acento en género no es de nimguna manera, reduccionista. Por el contrario, esta visión parte del reconocimiento esencial de que las desigualdades de género se articulan y potencian con otras desigualdades de poder. Lo que se pretende resaltar es, precisamente, que un análisis de la salud que no integre la dimensión de género no puede dar cuenta cabal de la realidad. Y, más aén, que desde una perspectiva de justicia social, no es de ninguna manera suficiente ni coherente enfrentar las desigualdades entre grupos económicos o étnicos, sin que paralelamente se aborden dentro de tales grupos, las desigualdedes injustas entre hombres y mujeres.