1. BWHGA BSFACS 1 Bureau of Women’s Health and Gender Analysis Bureau pour la santé des femmes et l’analyse comparative entre les sexes Health Systems Strengthening Seminar Belize City, May 30 -June 1st, 2006 Gender-Sensitive Indicators in Health Policies and Systems Mireille Kantiebo, BWHGA, Health Canada

2. BWHGA BSFACS 2 OVERVIEW  Federal Commitments to Gender Equality  Health Indicators Framework  Health Canada’s Women’s Health Indicators Initiative  Reflections and learnings about gender-sensitive indicators in health policies and systems

3. BWHGA BSFACS 3  1995 Federal Plan for Gender Equality  1999 Health Canada’s Women’s Health Strategy  2000 Health Canada’s GBA Policy  2000-2005 Agenda for Gender Equality Recommendations of the Standing Committee on the Status of Women Some Key Federal Government Commitments to Gender Equality and Gender-Based Analysis (GBA)

4. BWHGA BSFACS 4 Gender-based Analysis GENDER the socially constructed roles, relationships, values, attitudes, and forms of power that are commonly attributed to either men or women; includes self- representation SEX the genetic, biological and physiological characteristics and processes that generally distinguish males and females Interrelated through complex pathways Note: DIVERSITY analysis overlays GBA

5. BWHGA BSFACS 5 GBA & Health Determinants Income & social status Employment/Working Conditions Education and literacy Social environments Physical environments Healthy child development Personal health practices and coping skills Health services Social support networks Culture GENDER Biology and genetics

6. BWHGA BSFACS 6 Canadian Institute for Health Information and Statistics Canada Indicators Framework Source: Health Indicators Conceptual Framework: Background Paper, March 2001, Available from the Canadian Institute for Health Information

7. BWHGA BSFACS 7 Sources of Indicators data Canadian Institute for Health Information (CIHI) Statistics Canada Health Canada/Public Health Agency of Canada

8. BWHGA BSFACS 8 What are health indicators used for?  Accountability reporting to Canadians  Health surveillance  Policy research / Program Development  Evaluation

9. BWHGA BSFACS 9 Health Indicators in Accountability Reporting  Accountability and provision of information was identified as a commitment made by First Ministers  Health Canada works in collaboration with F/P/T representatives in the development of comparable indicators

10. BWHGA BSFACS 10 Women’s Health Indicators (WHI) Initiative  BWHGA leadership role in fostering development of health indicators sensitive to gender and diversity  Response to key commitments and strategic directions adopted by the BWHGA through HC’s WHS (1999) and GBA policy (2000)  Complementing Statistics Canada and CIHI health inidcators framework as well as First Ministers’ commitment to report to Canadians

11. BWHGA BSFACS 11 VISION: To ensure that gender and diversity perspectives are included and integrated in the broader indicators reporting systems GOAL: To ensure that targeted health policies and interventions are based on more comprehensive (sex, gender and diversity) indicators of health by promoting effective tracking and regular reporting of health and disease among women in Canada to help improve women’s health WHI Initiative – Con’d

12. BWHGA BSFACS 12 WHY Gender and diversity perspectives?  To understand the interrelationships between social context, biological endowment and health outcomes for women, men, boys and girls  To capture the gender differences in health among diverse sub-groups of the population  To contribute to improving women and men’s health outcomes through enhanced reporting systems, policies and programs

13. BWHGA BSFACS 13 WHI initiative - Process outline  Identifying key players/stakeholders  Establishing Working Groups/Advisory Committees  Environmental scan and gap analysis  Holding consultations  Developing Requests for Proposals to fill identified gaps  Funding external research  Developing a dissemination strategy  Promoting the use of gender-sensitive indicators to inform health policies/programs

14. BWHGA BSFACS 14 Making health indicators gender sensitive…  Address conceptual, theoretical and empirical issues in understanding health and illness, and in describing gender relations  Address technical issues associated with indicator data definition, collection and analysis  Identify an appropriate conceptual framework for understanding health which links health determinants and health outcomes and includes gender as a central component;  Establish criteria for gender sensitive indicators (adapted from V. Lin, January 2005 )

15. BWHGA BSFACS 15 Using gender-sensitive health indicators: Case example of application Applying a gender lens to health services utilization: Sex Differences in Use of Health Care: Manitoba Frequently women are described as using health care services more than men, yet when visits to doctors and hospital admission rates are analyzed by sex and gender other information comes to light. Females do visit physicians more often than males but when visits for pregnancy, birth, and other reproductive health reasons are excluded, this difference is cut in half, and women’s hospitalization rates become lower than those of men – MCHP 2005

16. BWHGA BSFACS 16 Progress to Date…  Canada has made a number of investments in health information  A great number of indicators are available to help inform policy and program decisions on a wide variety of health issues and to report on the health of Canadians  However, there are persistent gaps in health information that need to be addressed  Health Canada is funding two external research projects on gender-sensitive health indicators

17. BWHGA BSFACS 17 Key Challenges to Moving Forward…  Enhancing our conceptualizations of the causal pathways by which social and economic circumstances affect health outcomes  Fostering capacity-building that augment the understanding of gender as a central component of health policy making

18. BWHGA BSFACS 18 Moving Forward…  Engage with key stakeholders across sectors to build a comprehensive set of gender-sensitive health indicators to track changes over time in health status and in health care system performance  Promote the use of standardized performance measurement frameworks for a regular assessment and monitoring of health and gender equity, using a core set of quantitative and qualitative gender- sensitive health indicators

19. BWHGA BSFACS 19 If you have any further questions, please contact: Mireille Kantiebo, Senior Researcher, Bureau of Women’s Health and Gender Analysis, HPB, Health Canada. (819)934-8649 E-mail address: mireille_kantiebo@hc-sc.gc.ca