By Asha George, Rosemary Morgan, Kate Hawkins, Sassy Molyneux, Sarah Ssali, Sally Theobald, Linda Waldman
The Third Global Symposium on Health Systems, with its focus on people-centredness, culminated in the Cape Town Statement reaffirming that, “health systems need to be reoriented to respond to people’s emerging health needs, be directly accountable to ordinary people, and respect and ensure the rights and dignity of all people.” Its focus spotlighted power and justice in health systems, but what was discussed about gender, equity and rights? This blog draws on documentation from members of the SHAPES Thematic Working Group and our collective experience of the conference.
While ‘equity’ was a theme that was constant across previous symposium programmes, mention of gender and rights increased from 6 times in Montreux and 10 times in Beijing to 53 times in Cape Town. While word counts are an imperfect measure, this is one sign among many that distinguished the Cape Town conference.
Who are the people in people-centred health systems?
‘People’ include women, men, and other genders, negotiating various social hierarchies, power relations and identities in diverse and dynamically changing social contexts. Symposium participants argued for deconstructing the term ‘community’ to understand how varied social determinants, such as gender, race, sexual orientation, (dis)ability, class, age, and migrant or refugee status, intersect to shape a person’s lived experiences, including their access to resources and services.
In reviewing the terms by which diverse people are involved with health systems, participants noted that health systems must not only give people information about their rights, but also support an empowering environment that enables people to realise these rights.
Health workers can be agents of change or gatekeepers that perpetuate inequality; they are both creative and fallible. Discussions about patient-provider relations, as well as citizen and health system interfaces, emphasized engaging intimately with individuals and their attitudes, as well as systemically changing the conditions that frame such interactions.
Dialogue, listening, and the need to foster mutual respect percolated throughout the Symposium. At the opening, we watched videos from a broad array of stakeholders, and keynote speakers argued against silos between those who work on gender, sexuality, rights, equity, economics and health systems. Almost all plenary sessions facilitated informal conversations, inspiring many subsequent interactions and new relationships.
Click here to read the full post where we pose the question: Will the next Symposium sustain attention to gender, rights, and equity?
Find out more about Research in Gender and Ethics (RinGs): Building Stronger Health Systems.