In humanitarian operations, it is standard practice to include a gender focus to ensure a more effective intervention and an equitable impact on the population. As I follow the evolution of COVID-19 pandemic, viewing the daily change in the number of cases around the world, I think about the different impact on men and women of varying ages, ethnic groups, and abilities. All countries, including Canada, have an opportunity to apply a gender lens on the pandemic to better understand its impact and create more effective programs/policies. Pulling from the Gender handbook, I want to highlight four key questions that would be useful for such an analysis and providing some examples, primarily from a Canadian context.
1. Is there sex- and age-disaggregated information available about the impact, needs, and capacities of the affected community?
Collecting sex- and age-disaggregated data is the most fundamental tool for gender analysis in any project or intervention. Yet, when we look at the news of COVID-19 worldwide, we rarely hear the number/percent of cases by sex. There has been more messaging about age groups, with a higher death rate among the older population. A recent article by Lien et al. shows that of the twenty countries that report disaggregated data, the majority show a higher mortality rate among men. However, in Canada, where the disaggregated data is not easily accessible at a national level, the numbers show more infections and death among women. If we look at Ontario, where the numbers are publicly available, there are 16,419 men infected (46%) and 19,094 women (54%) as of July 7, 2020. Having the data disaggregated, we can then investigate the factors that lead to increased risk of exposure and infection among women, such as gendered jobs, roles, behaviours, or inequities, and then tailor public health messages accordingly.
In addition to the number of cases, however, there is also a need to collect and analyze disaggregated data about the different impact of the pandemic by sex, age, ethnicity, and other diversity factors. This would include data such as who is accessing emergency relief fund programs, who is accessing support from local community organizations, who is accessing mental health services, among other factors. It can paint the picture of who is being impacted the most. But there should also be further investigation into the different needs and capacities of these groups, so that organizations and governments can adapt their programming to a new reality – adapting their services to meet the new needs or new demographic it serves. Food banks are a good example of a service that could benefit from such an analysis. Food Banks Canada reports that before COVID-19, there were 1.1 million visits to food banks across Canada, and while there is currently no data available, it is assumed that with the increased job losses, more people will be turning to food banks. However, anecdotal evidence suggests that some groups, like single mothers, are not able to make ends meet. But when they have tried to use the food banks, there are many essential items that are not available (e.g. fresh produce, diapers, toilet paper, and tampons) and so continue to struggle. As food banks face growing challenges in fundraising and receiving food donations, it may be an opportune time to revise the model and opt for cash-based interventions, like many humanitarian organizations are doing in crises around the world.
2. How have the roles of women, girls, men, and boys changed since the onset of the crisis?
This question is extremely relevant right now, as the pandemic has caused an upheaval in the daily routines of families. Schools and daycares were closed, employees were asked to work from home, and stay-at-home orders were put in place. Parents had to put on many hats as full-time employees, full-time parents/daycare providers, part-time teachers, and in many cases also juggling the caregiver role for another family member. Even in a society that enjoys a higher level of gender equality, it forced the parents to find ways to divide and juggle all these responsibilities within a 24-hour day, and still find time to sleep. In some cases, this may have meant a more equal division of homemaking responsibilities, or in other cases a complete role reversal if one parent became the full-time, stay-at-home due to job loss or other circumstances. Looking at the roles of youth, they may have taken on more household responsibilities, like child-minding or tutoring. Grandparents may have lost their role looking after kids as they isolated to reduce the risk of infection, further limiting parents’ options for childcare.
But many of the articles I have seen on this subject seem to resonate most with the two-parent, nuclear families. There are many other types of family situations that would have been impacted differently, and arguably more severely, as they would have fewer coping mechanisms. Examples are: single-parent households (often single mothers) who bear the full burden of all the added responsibilities; mixed families where parents are separated and there are shared custody arrangements with children moving between households and increasing the number of contacts and risk of infection; families with front line workers who had to temporarily leave home or parents who cannot work from home and require some form of childcare. As the provinces explore different options for return-to-school programs, it would be advisable to analyze first the gendered impact of the pandemic on families currently, and find a model that does not lay more burden on those parents and families that are already overstretched, that cannot continue to have so many full-time responsibilities, and that cannot choose between kids and a job.
3. How has the availability and accessibility of opportunities for men and women changed, such as access to education, employment, livelihoods, health services, and ownership/control of assets?
This is a key question, albeit a big one, in the context of this pandemic. It has disrupted employment and livelihoods on global scale and the long-term effects are yet to be seen. Jobs in the retail, bar/restaurant, travel, and tourism sectors are scarce and businesses big and small are suffering. Disaggregated data on the change of employment will likely show trends that vulnerable groups are disproportionately affected. Women and minority groups often work minimum-wage jobs in these and other sectors, and the layoffs are putting them into more vulnerable situations. The Women’s National Housing and Homelessness Network highlight how COVID-19 is exacerbating housing challenges for women, particularly those who already live in precarious financial situations, who are single mothers, and who are at risk of eviction. As the economy slowly reopens, women face additional challenges accessing employment opportunities because they tend to take the lead caregiver role when there is no school or daycare option, and will be unable to return to work unless child care is available.
The change in accessibility of health services is also an essential element. Non-essential health services were suspended, which meant some men and women were not able to receive necessary care or treatments. In some cases, this has had negative unintended consequences. Access to sexual and reproductive health services for women is essential to ensure a safe pregnancy and delivery. In Canada, women continued to have access to hospitals and birth centres for delivery, albeit with the added stress of being exposed to COVID-19. However, many women’s access to birth control was disrupted, as doctors could not perform routine procedures for long-acting reversible contraception (or vasectomies for men for that matter). On an international level, as Doctors Without Borders report, women’s access to these services has been reduced due health centre closures, refusal of service, and restrictions on movement. With many countries experiencing strict lockdowns, quarantines, and curfews, more women are delivering at home without any professional assistance or sanitary conditions, which increases the risk of infant or maternal mortality. UNFPA also estimates that 47 million women could lose access to contraception, resulting in upwards of seven million unplanned pregnancies.
If we examine the different health needs of men, youth, and seniors, we will find other changes in accessibility to services. For men, this might be an increased need for services to cope with the mental health issues arising from financial stress or other factors. Male and female youth may also see an increased need in mental health services as well as they deal with the isolation and lack of social connections. For seniors, many health services may become inaccessible as this high-risk group’s mobility becomes more limited to avoid potential exposure. And of course, let’s not forget the issue of long-term care in Canada, where the majority of COVID-19 deaths have occurred, and which shed light on the deficiencies on this system of care for seniors before, during, and presumably after, the crisis.
4. What are the protection and Gender-Based Violence risks facing women, girls, men and boys?
Confinement. Lockdown. Stay-at-home orders. School closures. Family members are trapped inside together, food insecurity is rising, and stress levels are high from economic hardships and juggling all the full-time responsibilities discussed above. Women, girls, boys, and seniors face a heightened risk of gender-based violence – sexual, physical, and emotional. The isolation from friends, family, teachers, or co-workers, means it is more likely to stay hidden or go unnoticed. Furthermore, the women’s shelters may be unable to manage an increased demand. Shelters in Canada have already been operating at or over capacity; this is compounded by the reduced capacity in order to follow the public health guidelines on distancing. With nowhere to go, it is more likely that they will return to the abusive situation. The risk is high worldwide, with UNFPA estimating that if lockdowns continue for 6 months, there could be 31 million additional cases of GBV worldwide. As we fight an “invisible enemy” with the pandemic, we cannot let ourselves become blind to the health risk from domestic violence that someone close to us may be experiencing. As video conferencing becomes the norm, keep your eyes out for the Signal for Help, a simple sign that can let someone know help is needed.
These four simple questions can help decision-makers view the impact and potential responses from a more holistic perspective. Although many decisions must be made quickly, it is important to base them on the disaggregated data on the different impact, needs, and capacities of the population. There is an abundance of technology to collect data quickly and efficiently, and the population is highly connected. The short-term effort to collect the data would have a long-term benefit and cost-savings by creating effective policies/programs that provide support when and how people need it the most.