Outcomes of gender-sensitivity educational interventions for healthcare providers: A systematic review

Abstract

Background: Although gender plays an important role in health, most healthcare providers lack knowledge in providing gender-sensitive care. Offering gender-sensitivity training for healthcare providers can help to address gender-based health inequalities. Method: A mixed-methods systematic review of gender-sensitivity training programmes or interventions for healthcare providers was undertaken to assess their outcomes and to document areas for future research. Comprehensive searches of seven international databases were conducted for peer-reviewed literature published between 1998 and 2018. Eligible studies included at least one outcome related to gender-sensitivity training for healthcare providers. Results: Twenty-nine studies met the inclusion criteria. Fourteen studies focused on gender-sensitivity in reducing gender bias towards men and women, and 15 studies focused on addressing the needs of lesbian, gay, bisexual and transgender (LGBT) patients. Thirty-seven percent of studies showed a significant improvement in gender-related knowledge, attitudes or practice after the training. Multiple training methods were used to teach gender-sensitive care. Common content of the training included learning sex/gender terminology, understanding gender issues and inequalities in health, stigma and discrimination and communication skills. The duration and frequency of interventions ranged considerably. Sex differences in training outcomes also occurred among the learners. Conclusion: Review findings highlight that although gender-sensitivity training for healthcare providers is increasing, there is insufficient evidence to determine its effectiveness. Additional, more rigorously designed studies are needed to assess the long-term implications on learner behaviours and practices, especially across a wide variety of healthcare providers.

The training needs for gender-sensitive care in a pediatric rehabilitation hospital: a qualitative study

“…It is important to highlight that one of the key issues and challenges with trying to enhance gender-sensitive care training is that it requires people to be self-aware of any potential gender biases that they may have, including an awareness of how their own gender may contribute to the treatment of patients [7,20]. Further, when training in gender-sensitive care has been offered in other settings (e.g., medicine with adult patients) it is often optional training [3]. Some evidence suggests that it may be more effective to offer such training over time and have it integrated into clinical practice to ensure successful uptake [67,68].…”

“…Gender-sensitive care refers to healthcare providers having the knowledge and competence in perceived existing gender norms and differences and incorporating these into their decisions and actions [2,11]. It also refers to addressing gender inequalities and stereotypes and other attributes of care that reflect relational and other preferences (e.g., communication style, same gender clinicianpatient pairing, privacy or safety needs) [3,12,13]. Although there is an increasing awareness of the important role of gender within pediatric health care, there are few existing gender-sensitive approaches [14][15][16].…”

“…Given that gender-based health inequalities are often socially produced, they are therefore, preventable [27]. Although several recent studies have highlighted a critical need for gender-sensitivity training for healthcare providers [2,3,26,[28][29][30][31][32], little is known about the best approaches for providing such training.…”

“…Previous research shows that although sex and gender can play a critical role in the incidence, clinical presentation, manifestation and health outcomes of youth with disabilities they are often viewed as non-sexual and without gender [40][41][42]. Additionally, youth from gender diverse groups such as LGBTQ+ have also largely been ignored within the context of pediatric rehabilitation research and the provision of care [2,3,14,15,20]. Such a lack of attention to these groups is concerning because sexual and gender minority groups often encounter significant challenges within the healthcare system including discrimination and stigma, which could affect poor health outcomes [43][44][45][46][47].…”

“…Gender is an important social determinant of health [1]. Gender-sensitive care is a critical component of patientcentred care [2,3] and refers to healthcare providers perceiving sex (i.e., biological aspects such as genetic makeup, hormones) and gender (i.e., roles and expectations attributed to men and women within society) differences, issues and inequalities and applying these in their clinical practice [3][4][5][6]. Gender is a social construct that varies with roles, norms and values within society and can influence health in several ways including access to resources (e.g., health, food, education), and risktaking behaviours [4].…”