A common assumption is that strengthening the health system will automatically lead to better health for men and women. However, health systems are not neutral: they reflect gender norms, and as such, can reinforce gender inequalities and discrimination. Health system reform has largely paid little attention to how health service integration, human resource policies, information systems and financing affect gender equity and women as well as men. Without such an analysis, health reform can have a negative impact on women’s health and access to services. Moreover, integrating gender equity into health system reform could be a tool to promote gender equality throughout society.

This brief examines the reform of health systems in post-conflict settings through a gender lens, using the World Health Organization’s health system building blocks as a framework. Research into the importance of reconstructing health systems after a crisis or war is relatively new, therefore literature discussing challenges and best practices related to gender equity is weak and the evidence base limited. Further study is clearly needed into the impact of strengthening the health system on gender equity. 

Key messages

  • The impact of health system reform on gender equity in post-conflict countries has largely been overlooked. This is a missed opportunity amid the policy and programmatic options created by donor resources and the social and political flux of the early post-conflict phase.

  • Priority areas for action include promoting gender equity for women in the health workforce, ensuring financing mechanisms are gender equitable, and ensuring leadership for gender equity during health system reform. These are vital in all settings, but particularly after conflict, where a window of opportunity exists for social reform and change such as the advancement of women to health leadership positions.

  • Action in this area will not only have repercussions for the promotion of gender equity in health, but also for the foundation of gender equality in society which in turn contributes to social well-being and increased security and peacebuilding.