Gender equity and social inclusion

Sex- and gender-responsive diagnostic tools and systems are essential to close diagnostic gaps and ensure that everyone has equitable access to reliable diagnosis, regardless of their gender or sex.

Sex and gender can affect all aspects of health R&D, health-related behaviours, and access to diagnostics. Gender refers to the socially constructed roles, behaviours, expressions, and identities of women, men, and gender-diverse people, while sex refers to the different biological and physical characteristics of females, males and intersex people. Sex and gender play an often-underestimated role throughout the research, development and implementation of diagnostic tools.

Everyone, regardless of their sex and gender, will need a diagnostic test at some point in their lives, yet inequalities can undermine access to testing. In particular, gender inequalities create informational, financial, and cultural barriers that limit access to testing, and these are different depending on someone’s gender. Gender can influence trust in testing services, directly or indirectly leading to fear of procedures, diagnosis, and stigma. In addition to needing tests for conditions and diseases common to all, such as HIV/AIDS, tuberculosis, and COVID-19, females require additional tests during their lives, such as antenatal tests related to pregnancy. Many of these tests are often unavailable where they are needed in health systems. Men and boys can also be affected by gendered aspects of testing, as for certain conditions, men experience lower rates of diagnosis and a longer time to diagnosis than women.

Despite the fact that diagnostics are indispensable sources of information for people, communities, and healthcare and surveillance systems, there is a critical gap in sex-disaggregated data and gender analysis for diagnostics. This makes it challenging to identify the underlying causes of sex-/gender-related barriers around diagnosis and develop evidence-based, sex- and gender-responsive solutions.

Our sex and gender framework is embedded across all our programmes to ensure that equality is at the centre of our work. We are also working to fill the knowledge and data gaps around the impact of sex and gender on diagnosis, so we can develop gender-responsive and transformative solutions that make access to diagnosis more equitable. Our strategic aims are to:

1. Embed sex/gender into policies, processes, and programme strategies. We embed sex and gender across our internal policies, processes and programme strategies. By building in specific sex and gender objectives for all programme strategies, we ensure that our programmes keep sex/gender equality at the centre of their work.
2. Fill data gaps and contribute to end-to-end gender-responsive diagnostics systems. We are working to identify data gaps around gender and sex in diagnosis and solutions to fill these gaps. As part of these efforts, we are developing a standardized set of questions and identifying concrete outputs across the diagnostic value to chain to ensure the work conducted by FIND and partners is sex/gender-responsive. In addition, adoption of the SAGER guidelines in our scientific publications policy is key to ensuring we stay on track.
3. Expand FIND sex/gender requirements and training to FIND partners. We ensure partners sign up to relevant policies related to gender, and diversity, equity and inclusion, among others. We provide training sessions to FIND staff and key partners as part of gender mainstreaming efforts and we are developing specific sex/gender guidance for clinical trials.
4. Advocate for gender equity in the diagnostics ecosystem for health leadership and health impact. We undertake advocacy to ensure that country strategies include integrated sex and gender considerations. We produce country analyses and undertake advocacy actions to support these efforts.