Gender health and policies: the state of the art from exposure to solutions.

OBJECTIVE To synthesize the determinants of gender inequalities through a narrative review that: (i) describes gender related variables that can create different levels of health; (ii) describes key points that may assist in policy development and its reorientation towards gender differences; (iii) debates potential approaches in understanding gender issues. METHODS Review of the international literature through online databases (Pubmed), search engines, publications and documents from "grey literature". INCLUSION CRITERIA publications from 1997, English language; keywords used: gender based analysis; gender and public policy; women's health; gender differences; health policy; gender impact assessment. Among the 300 papers retrieved, 55 were selected for relevance. RESULTS We performed a narrative synthesis of the included literature, regarding: (i) gender differences and their determinants; (ii) elements for the changing; (iii) possible approaches; (iv) gender influences the pursuit of health and health care access through specific variables; (v) health policies can modify these variables only by a minimal percentage. These interventions should guarantee equity and allow efficient resources allocation. The gap between political announcements and real policy implementation remains unchanged. (vi) Standard approaches to the topic are not feasible due to the scarcity of a specific literature and the numerous cultural differences. CONCLUSIONS . Gender analysis of policies suggests they can differently affect women in comparison to men. However, reforms, strategies and interventions introduced in the last two decades, have achieved a limited success towards better gender equality in health. The main aim is to attack the structural sources of gender inequity in the society.