Gender in Health Governance Tool

By: Mahesh Shukla, MD, MPA and Belkis Giorgis, PhD

Photo: Rui Pires

Why is Gender-Responsiveness in Health Governance so Important? Mahesh Shukla, MD, MPA,

Gender-responsiveness in governance has the potential to enhance positive health outcomes not only for women but also for the entire community. Women play three important roles in a health system: 1) as decision makers; 2) as health care providers; and 3) as users of services. Nevertheless, governance structures in health systems and health institutions are most often dominated by men. As a result, issues faced by women related to leadership, governance, and management roles; women in the health workforce; and women as users of services are too often ignored or minimized.

It is the responsibility of those working in the health system to help move institutions along the spectrum of gender-responsiveness from “gender-exploitative” to “gender-transformative.”[1]

There are multiple ways in which gender-responsiveness can be facilitated by governance practices (See box at end of article). One critical way this happens is when governance decision-makers assess the gender responsiveness of their governance decision-making processes and outcomes.

The Gender in Health Governance Tool—A Simple Test

The following is a simple test that governance decision makers should read prior to making a substantive decision. Then after the decision has been made, they should then take the test to see where their decision-making falls on a gender responsiveness scale.

  • The maximum score that can be earned is 100.
  • Score of 84 and above: indicates a “gender transformative” governance decision   
  • Score of 51-83: indicates a “gender responsive” governance decision
  • Score of 17-50: indicates a “gender aware” governance decision
  • Score of 16 or below: indicates a “gender exploitative” or gender blind governance decision


[1] The Interagency Working Group on Gender (IGWG) developed a conceptual framework known as the Gender Integration Continuum that defines the concepts of gender blind, gender exploitative, gender accommodating, and gender transformative in the context of gender integration. See The Interagency Gender Work Group (IGWG). A Manual for Integrating Gender Into Reproductive Health and HIV Programs: From Commitment to Action. 2nd Edition. August, 2009:

By Mahesh Shukla, MD, MPA, Public Sector Governance Senior Technical Advisor and Belkis Giorgis, PhD, Senior Technical Advisor for Gender on the Leadership, Management & Governance Project, contributed to this article.

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