title: Monitoring gender equity in health using gender-sensitive indicators: a cross-national study.
abstract: BACKGROUND
  As gender is known to be a major determinant of health, monitoring gender equity in health systems remains a vital public health priority. Focusing on a low-income (Peru), middle-income (Colombia), and high-income (Canada) country in the Americas, this study aimed to (1) identify and select gender-sensitive health indicators and (2) assess the feasibility of measuring and comparing gender-sensitive health indicators among countries.
  
  
  METHODS
  Gender-sensitive health indicators were selected by a multidisciplinary group of experts from each country. The most recent gender-sensitive health measures corresponding to selected indicators were identified through electronic databases (CINAHL, PsycINFO, MEDLINE, Embase, LILACS, LIPECS, Latindex, and BIREME) and expert consultation. Data from population-based studies were analyzed when indicator information was unavailable from reports.
  
  
  RESULTS
  Twelve of the 17 selected gender-sensitive health indicators were feasible to measure in at least two countries, and 9 of these were comparable among all countries. Indicators that were available were not stratified or adjusted by age, education, marital status, or wealth. The largest between-country difference was maternal mortality, and the largest gender inequity was mortality from homicides.
  
  
  CONCLUSIONS
  This study shows that gender inequities in health exist in all countries, regardless of income level. Economic development seemed to confer advantages in the availability of such indicators; however, this finding was not consistent and needs to be further explored. Future initiatives should include identifying health system factors and risk factors associated with disparities as well as assessing the cost-effectiveness of including the routine monitoring of gender inequities in health.
authors.affiliation: University Health Network Women's Health Program, Toronto, ON, Canada. natalia.diaz.granados@utoronto.ca
authors.forename: Natalia
authors.initials: N
authors.lastname: Diaz-Granados
authors.forename: Kristen Blythe
authors.initials: KB
authors.lastname: Pitzul
authors.forename: Linda M
authors.initials: LM
authors.lastname: Dorado
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.forename: Sarah
authors.initials: S
authors.lastname: McDermott
authors.forename: Marta B
authors.initials: MB
authors.lastname: Rondon
authors.forename: Jose
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Javier
authors.initials: J
authors.lastname: Saavedra
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Torres
authors.forename: Marie
authors.initials: M
authors.lastname: Des Meules
authors.forename: Donna E
authors.initials: DE
authors.lastname: Stewart
mesh_terms: D002170:Canada; D003105:Colombia; D016206:Databases, Bibliographic; D005006:Ethnicity / Q000145:classification / Q000193:education; D005191:Family Characteristics; D005240:Feasibility Studies; D005260:Female; D005783:Gender Identity; D006297:Health Services Accessibility / Q000592:standards; D006305:Health Status Indicators; D054625:Healthcare Disparities / Q000592:standards*; D006798:Housing / Q000145:classification / Q000592:standards; D006801:Humans; D008297:Male; D009026:Mortality / Q000208:ethnology; D010568:Peru; D011203:Poverty; D015203:Reproducibility of Results; D012737:Sex Factors; D012959:Socioeconomic Factors; D014505:Urban Population / Q000145:classification; D016387:Women's Health; D014933:Women's Rights