This article explores umoja, a Swahili worldview of relational personhood, as an alternative cultural form to rights‐based approaches for seeking gender justice in Zanzibar. Since the colonial era, umoja— which translates roughly as “unity”—has become increasingly gendered in political discourse and used by various civil society and government groups to negotiate diverse visions of gender justice. Based on ethnographic observation of a women's savings cooperative, or vicoba, of working‐class women migrants from the Tanzanian mainland, and a feminist civil society coalition, this work explores umoja as a form of feminist solidarity and as a feminist ethic. As a type of feminist solidarity, umoja is exemplified by the vicoba, which maintains relational dignity among members and structurally mitigates within‐group inequities. As a feminist ethic, umoja involves intricately negotiating subgroup interests amidst constantly shifting individual and group relationships while maintaining conviviality in larger collectivities. By prioritizing collective conviviality, umoja avoids directly confronting patriarchal social structures, which raises questions about its potential to ensure gender justice. However, its emphasis on conviviality also acknowledges a shared humanity, which together with its treatment of inequities as intersectional and relational make umoja a holistic complement or alternative to rights‐based approaches for ensuring gendered social change.

Background Researchers have highlighted a large-scale global unmet need for rehabilitation. While sex and gender have been shown to interact with each other and with other social and structural factors to influence health and wellbeing, less is known about how sex and gender shape rehabilitation participation and outcomes within health systems. Methods Using an intersectional approach, we examine literature that explores the relationship between sex and/or gender and rehabilitation access, use, adherence, outcomes, and caregiving. Following a comprehensive search, 65 documents met the inclusion criteria for this scoping review of published literature. Articles were coded for rehabilitation-related themes and categorized by type of rehabilitation, setting, and age of participants, to explore how existing literature aligned with documented global rehabilitation needs. Responding to a common conflation of sex and gender in the existing literature and a frequent misrepresentation of sex and gender as binary, the researchers also developed a schema to determine whether existing literature accurately represented sex and gender. Results The literature generally described worse rehabilitation access, use, adherence, and outcomes and a higher caregiving burden for conditions with rehabilitation needs among women than men. It also highlighted the interacting effects of social and structural factors like socioeconomic status, racial or ethnic identity, lack of referral, and inadequate insurance on rehabilitation participation and outcomes. However, existing literature on gender and rehabilitation has focused disproportionately on a few types of rehabilitation among adults in high-income country contexts and does not correspond with global geographic or condition-based rehabilitation needs. Furthermore, no articles were determined to have provided an apt depiction of sex and gender. Conclusion This review highlights a gap in global knowledge about the relationship between sex and/or gender and rehabilitation participation and outcomes within health systems. Future research should rely on social science and intersectional approaches to elucidate how gender and other social norms, roles, and structures influence a gender disparity in rehabilitation participation and outcomes. Health systems should prioritize person-centered, gender-responsive care, which involves delivering services that are responsive to the complex social norms, roles, and structures that intersect to shape gender inequitable rehabilitation participation and outcomes in diverse contexts.

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