Gender dynamics in digital health: overcoming blind spots and biases to seize opportunities and responsibilities for transformative health systems

George, Asha; Morgan, Rosemary; Larson, Eric; LeFevre, Amnesty

doi:10.1093/pubmed/fdy180

Cited by 31 publications

(39 citation statements)

References 11 publications

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“…It is well documented in the literature that racial/ethnic minorities who are socioeconomically disadvantaged face significant barriers to receiving healthcare. [17][18][19] Much of this disparity is thought to be due to lack of timely access to appropriate healthcare, 13,20 and this is likely further compounded with subspecialty care that many movement disorders patients require. Additional problems may include access to technology to conduct visits, including both de-vices and broadband or cellular capability.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine in an Academic Movement Disorders Center during COVID-19

Esper¹,

Scorr

Papazian

et al. 2021

JMD

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ObjectiveaaTelemedicine has rapidly gained momentum in movement disorder neurology during the coronavirus disease (CO-VID-19) pandemic to preserve clinical care while mitigating the risks of in-person visits. We present data from the rapid implementation of virtual visits in a large, academic, movement disorder practice during the COVID-19 pandemic. MethodsaaWe describe the strategic shift to virtual visits and retrospectively examine elements that impacted the ability to switch to telemedicine visits using historical prepandemic in-person data as a comparator, including demographics, distance driven, and diagnosis distribution, with an additional focus on patients with deep brain stimulators. ResultsaaA total of 686 telemedicine visits were performed over a five-week period (60% of those previously scheduled for inoffice visits). The average age of participants was 65 years, 45% were female, and 73% were Caucasian. Men were more likely to make the transition (p = 0.02). Telemedicine patients lived farther from the clinic than those seen in person (66.47 km vs. 42.16 km, p < 0.001), age was not associated with making the switch, and patient satisfaction did not change. There was a significant shift in the distribution of movement disorder diagnoses seen by telemedicine compared to prepandemic in-person visits (p < 0.001). Patients with deep brain stimulators were more likely to use telemedicine (11.5% vs. 7%, p < 0.001). ConclusionaaTelemedicine is feasible, viable and relevant in the care of movement disorder patients, although health care disparities appear evident for women and minorities. Patients with deep brain stimulators preferred telemedicine in our study. Further study is warranted to explore these findings.

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Section: Discussionmentioning

confidence: 99%

Telemedicine in an Academic Movement Disorders Center during COVID-19

Esper¹,

Scorr

Papazian

et al. 2021

JMD

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“…Through this effort, gender analysis was identified as a shared area of interest among the research teams and one that could benefit from additional targeted capacity strengthening efforts. In their paper about gender in the cohort, George et al 26 provide an insightful overview of gender equality analysis in digital health, with specific lessons shared from the projects in this cohort.…”

Section: Concluding Commentsmentioning

confidence: 99%

Digital health, gender and health equity: invisible imperatives

Sinha

Schryer-Roy²

2018

Journal of Public Health

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A growing body of evidence shows the use of digital technologies in health—referred to as eHealth, mHealth or ‘digital health’—is improving and saving lives in low- and middle-income countries. Despite this prevalent and persistent narrative, very few studies examine its effects on health equity, gender and power dynamics. This journal supplement addresses these invisible imperatives by going beyond traditional measures of coverage, efficacy and cost-effectiveness associated with digital health interventions, to unpack different experiences of health workers and beneficiaries. The collection of papers presents findings from a cohort of implementation research projects in Africa, Asia, Latin America and the Middle East, and two commentaries offer observations from learning-oriented evaluative activities across the entire cohort. The story emerging from this cohort is comprised of three themes: (i) digital health can positively influence health equity; (ii) gender and power analyses are essential; and (iii) digital health can be used to strengthen upward and downward accountability. These findings, at the individual project level and at the level of the cohort, provide encouraging recommendations on how to approach the design, implementation and evaluation of digital health interventions to address the Sustainable Development Goals agenda of leaving no one behind.

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“…2 8 In doing so, women's access to mobile phones can challenge power relations and social norms, increasing women's awareness and autonomy. 9 In some settings, this may inadvertently increase risk to women; making them targets for backlash in contexts where conservative gender ideologies dominate. 9 In the health domain, mobile phones are also increasingly becoming a modality for facilitating women's access to health information and engagement with the health system.…”

Section: Introductionmentioning

confidence: 99%

Does women’s mobile phone ownership matter for health? Evidence from 15 countries

et al. 2020

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Mobile phones have the potential to increase access to health information, improve patient–provider communication, and influence the content and quality of health services received. Evidence on the gender gap in ownership of mobile phones is limited, and efforts to link phone ownership among women to care-seeking and practices for reproductive maternal newborn and child health (RMNCH) have yet to be made. This analysis aims to assess household and women’s access to phones and its effects on RMNCH health outcomes in 15 countries for which Demographic and Health Surveys data on phone ownership are available. Multilevel logistic regression models were used to explore factors associated with women’s phone ownership, along with the association of phone ownership to a wide range of RMNCH indicators. Study findings suggest that (1) gender gaps in mobile phone ownership vary, but they can be substantial, with less than half of women owning mobile phones in several countries; (2) the gender gap in phone ownership is larger for rural and poorer women; (3) women’s phone ownership is generally associated with better RMNCH indicators; (4) among women phone owners, utilisation of RMNCH care-seeking and practices differs based on their income status; and (5) more could be done to unleash the potential of mobile phones on women’s health if data gaps and varied metrics are addressed. Findings reinforce the notion that without addressing the gender gap in phone ownership, digital health programmes may be at risk of worsening existing health inequities.

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Gender dynamics in digital health: overcoming blind spots and biases to seize opportunities and responsibilities for transformative health systems

Cited by 31 publications

References 11 publications

Telemedicine in an Academic Movement Disorders Center during COVID-19

Telemedicine in an Academic Movement Disorders Center during COVID-19

Digital health, gender and health equity: invisible imperatives

Does women’s mobile phone ownership matter for health? Evidence from 15 countries

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