Background

Gender analysis in outbreaks and epidemics (O&E) in Nigeria is essential for understanding and addressing the differential impacts of infectious diseases on women, men, girls, and boys. Nigeria, with its large and diverse population of over 200 million, faces recurring health emergencies, including outbreaks of diseases such as COVID-19, Ebola, Lassa fever, and cholera. According to the World Health Organization (WHO), Nigeria experienced multiple disease outbreaks in recent years, with significant impacts on public health and socio-economic well-being. For instance, the 2020 COVID-19 outbreak in the World highlighted the importance of gender-responsive approaches in epidemic response efforts, recognizing that gender disparities can influence disease transmission, access to healthcare, and outcomes of outbreaks.

The Nigerian health sector confronts multifaceted challenges, particularly during health emergencies. This policy brief explores the intersection of gender dynamics with health emergencies during outbreaks and epidemics, emphasizing the imperative of understanding how different genders experience, cope with, and are affected by health crises. Gender disparities in the health emergency landscape in Nigeria pose significant challenges, with existing policies exhibiting shortcomings in addressing gender-specific vulnerabilities. Despite governance changes, enhanced efforts are needed for gender inclusivity in disaster preparedness plans, highlighting the urgency of addressing gender-specific needs in healthcare services during epidemics.

Primarily, women often bear a disproportionate burden in caregiving roles during health crises, amplifying their exposure to infectious diseases. Additionally, cultural norms and societal expectations often restrict women’s mobility and decision-making autonomy during emergencies, hindering their ability to seek timely medical assistance or engage in preventive measures. Consequently, gender disparities in caregiving exacerbate women’s vulnerability to O&E health emergencies, necessitating targeted interventions to address their specific needs and challenges.
In view of these, the African Risk Capacity (ARC) Agency and the Bill & Melinda Gates Foundation (BMGF) signed an agreement Investment Grant on “Gender Responsive Mechanisms for Epidemic Preparedness in ECOWAS to support the member countries of the Economic Community of West African States (ECOWAS) to provide rapid and appropriate gender-sensitive responses to disease outbreaks and epidemics in the region. Under the direction of the ARC O&E and Gender Units and the support of the Country Engagement Managers, A Gender analysis, looking at the linkages between Gender, Health Emergency and Disaster Risk Management in Nigeria was conducted. The TORs included an in-depth gender analysis of the health sector from the Outbreaks and Epidemics (O&E) perspective.
The analysis aimed to identify gaps & challenges and proposed recommendations for gender integration in O&E towards gender transformation of the sector in Nigeria.
With a targeted approach, the project aims to enhance gender-responsive mechanisms for epidemic preparedness in selected countries, placing particular emphasis on Nigeria. The backdrop of this initiative is woven into the fabric of Nigeria’s socio-economic challenges, cultural diversity, and
susceptibility to climate-induced hazards and infectious disease outbreaks.

Key Findings

1. Primary Caregiver Role : Females assume the primary caregiver role in most of households during health emergencies.
2. Consideration of Gender Roles : Almost all Participants acknowledged considering gender roles in health intervention planning.
3. Limited Access for Women : limited access for women during epidemics, with disproportionate challenges faced by women in accessing essential healthcare services.
4. Enhanced Effectiveness through Gender Inclusivity : Involving both men and women significantly enhance the overall effectiveness of health interventions during crises.
5. Inadequate comprehensive gender-sensitive training programs for healthcare workers and other sectors in disaster risk management to address gender-specific health concerns during emergencies.
6. Inadequate data collection mechanisms for distinctive gender insights, capacity development/strengthening, and protocols for systematic gender-disaggregated data collection
7. Persistent Gaps : Though specific measures are taken during emergency planning, responses and during post-disaster, gaps persist in effectively addressing gender-specific needs and vulnerabilities, with varying levels of commitment observed across different aspects of gender integration within health sector and other allied
   organizations.
8. Paucity and weak commitments by stakeholders in advancing gender-responsive policies to mitigate disparities, conducting thorough reviews, engaging stakeholders, and allocating resources to enhance gender responsiveness.
9. Weak collaboration efforts with gender-focused organizations to enhance/develop the gender responsiveness of health services and interventions.
10. Inadequate monitoring, learning, and evaluation frameworks to assess and address gender disparities in health service provision during emergencies.

Policy Recommendations

• Gender-Inclusive Emergency Planning : Develop emergency plans with a gender-inclusive approach, incorporating gender considerations into planning processes to account for the diverse needs of different genders and include others with special needs.
  Advocacy Action : - Advocate for inclusive Disaster Risk Reduction legislative reforms to guarantee gender justice and respect for human rights.

• Community Awareness : Implement targeted awareness campaigns to overcome gender biases and promote equitable access to healthcare by all.
  Advocacy Action : - Lobby for increased funding and resources dedicated to gender-sensitive interventions and training programs.

• Enhanced Data Collection : Strengthen and prioritize data collection mechanisms for distinctive gender insights, investing in technology, training, and protocols for systematic gender-disaggregated data collection at all levels.
  Advocacy Action : - Engage with stakeholders to prioritize gender inclusivity in health emergency response planning and implementation.

• Strengthen Policies : Reinforce gender-responsive policies to mitigate disparities, conducting thorough reviews, engaging stakeholders, and allocating resources to enhance gender responsiveness.
  Advocacy Action : - Collaborate with gender-focused organizations to leverage expertise and resources for addressing gender disparities in health service provision.

• Inclusive Health Policies : Ensure the integration of gender perspectives in health policies, programs, and interventions to promote inclusivity and equitable access to healthcare services for all genders.
  Advocacy Action : - Advocate for gender mainstreaming in all aspects of health governance and programming.

• Gender-Responsive Policies and Planning : Develop and implement gender-responsive policies and emergency plans that consider the unique needs of different genders at all levels genders.
  Advocacy Action : - Prioritize community partnerships and culturally sensitive communication methods for effective dissemination of health information.

• Comprehensive Gender Training : Provide comprehensive gender-sensitive training programs for healthcare workers and other sectors in disaster risk management to address gender-specific health concerns during emergencies.
  Advocacy Action : - Advocate for gender mainstreaming in all aspects of health governance and programming to promote inclusivity.

• Community Engagement and Awareness : Develop tailored communication strategies and inclusive outreach programs to raise awareness and ensure information dissemination reaches all genders.
  Advocacy Action : - Foster collaboration with gender-focused organizations to enhance the gender responsiveness of health services and interventions.

• Data Collection and Monitoring : Strengthen gender-disaggregated data collection mechanisms and monitoring and evaluation frameworks to assess and address gender disparities in health service provision during emergencies.
  Advocacy Action : - Establish robust monitoring systems and allocate resources for continuous assessment to address emerging disparities.

• Collaborative Efforts : Foster collaboration with gender-focused organizations to enhance the gender responsiveness of health services and interventions.
  Advocacy Action : - Facilitate partnerships with organizations specializing in gender issues to leverage expertise and resources.

Addressing gender disparities in O&E emergency is essential for building resilience and promoting inclusivity in emergency healthcare response and recovery efforts in Nigeria. Implementation of the recommended policy interventions and advocacy actions will pave the way for a more equitable, responsive, and resilient healthcare system during emergencies.