Evidence map›Paper›PMID 31155270›Full record

ReviewLancet (London, England)2019

Disrupting gender norms in health systems: making the case for change.

Katherine Hay, Lotus McDougal, Valerie Percival, Sarah Henry, Jeni Klugman, Haja Wurie, Joanna Raven, Fortunate Shabalala, Rebecca Fielding-Miller, Arnab Dey and 13 more

Registry-linked trialAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Lancet (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07759908 (Effects of a Synbiotic Intervention on Perimenopausal/Menopausal Symptoms), which is not on this map. Cited by 186 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
186citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07759908 nacompletednot on this mapstarted 2025, after this paper: background citation

Effects of a Synbiotic Intervention on Perimenopausal/Menopausal Symptoms: A Randomized, Double-Blind, Placebo-Controlled Trial

TypeinterventionalSponsorUniversity College CorkRan2025 to 2025Enrolled49ConditionsMenopause, Perimenopause, Perimenopausal WomenArmsFemmebiome Meno, Placebo
3 · Its place in the literature

Who cites it

186 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Article
  13. Article
  14. Breaking the Glass Ceiling? Gender Dynamics in Turkish Dental Faculty Leadership.European journal of dental education : official journal of the Association for Dental Education in Europe · 2026
    Article
  15. Article
  16. Observational
  17. Article
  18. Article
  19. Article
  20. Article

126 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Katherine HayBill & Melinda Gates Foundation, Seattle, WA, USA.
Lotus McDougalCenter on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA.
Valerie PercivalNorman Paterson School of International Affairs, Carleton University, Ottawa, ON Canada.
Sarah HenryDepartment of Pediatrics, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.
Jeni KlugmanGeorgetown Institute for Women, Peace and Security, Georgetown University, Washington, DC, USA; Women and Public Policy Program, Harvard Kennedy School, Cambridge, MA, USA.
Haja WurieCollege of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
Joanna RavenLiverpool School of Tropical Medicine, Liverpool, UK.
Fortunate ShabalalaFaculty of Health Sciences, University of eSwatini, Mbabane, eSwatini.
Rebecca Fielding-MillerCenter on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA.
Arnab DeySambodhi Research & Communications, Noida, Uttar Pradesh, India.
Nabamallika DehingiaSambodhi Research & Communications, Noida, Uttar Pradesh, India.
Rosemary MorganJohns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA.
Yamini AtmavilasBill & Melinda Gates Foundation, Seattle, WA, USA.
Niranjan SaggurtiPopulation Council, New Delhi, Delhi, India.
Jennifer YoreCenter on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA.
Elena BlokhinaVladman Institute of Pharmacology, Department of Psychiatry, First Pavlov State Medical University of St Petersburg, Saint Petersburg, Russia.
Rumana HuqueThe ARK Foundation, Dhaka, Bangladesh.
Edwine BarasaKemri-Wellcome Trust, Kenya Research Programme, Nairobi, Kenya.
Nandita BhanCenter on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA.
Chandani KharelHERD International, Thapathali, Kathmandu, Nepal.
Jay G SilvermanCenter on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA.
Anita RajCenter on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA. Electronic address: anitaraj@ucsd.edu.
Gender Equality, Norms, and Health Steering Committee

Funding

Social-structural and spatial determinants of HIV testing and linkage to care among high risk women in TanzaniaK01MH112436 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIELDING-MILLER, REBECCA KATHLEEN · 2017 to 2021
$941k
NIMHD NIH HHS L60 MD011114NIMH NIH HHS K01 MH112436Wellcome Trust
6 · The paper itself

Abstract

Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health. In this Series paper, we explore how to address all three through recognition and then with disruptive solutions. We used intersectional feminist theory to guide our systematic reviews, qualitative case studies based on lived experiences, and quantitative analyses based on cross-sectional and evaluation research. We found that health systems reinforce patients' traditional gender roles and neglect gender inequalities in health, health system models and clinic-based programmes are rarely gender responsive, and women have less authority as health workers than men and are often devalued and abused. With regard to potential for disruption, we found that gender equality policies are associated with greater representation of female physicians, which in turn is associated with better health outcomes, but that gender parity is insufficient to achieve gender equality. We found that institutional support and respect of nurses improves quality of care, and that women's empowerment collectives can increase health-care access and provider responsiveness. We see promise from social movements in supporting women's reproductive rights and policies. Our findings suggest we must view gender as a fundamental factor that predetermines and shapes health systems and outcomes. Without addressing the role of restrictive gender norms and gender inequalities within and outside health systems, we will not reach our collective ambitions of universal health coverage and the Sustainable Development Goals. We propose action to systematically identify and address restrictive gender norms and gender inequalities in health systems.

Indexed as

FemaleGlobal HealthHealthcare DisparitiesHumansMaleNurse's RoleOccupational HealthSexism

Identifiers

PMID31155270
PMCPMC7233290

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.