Dr. Emmanuela Gakidou on helping women make the best choices for themselves

As part of our series for International Women's Day, we spoke with the professor of Health Metrics Sciences at IHME about how better data and information can help women lead healthier and happier lives

For the past two decades, Dr. Emmanuela Gakidou has been one of the world's most prominent advocates for gender equality in global health.

Two years ago, the professor of Health Metrics Sciences and senior director of Organizational Development and Training at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, created a new team at the institute to improve the measurement of health conditions and determinants of health that disproportionately affect women. The Gender Equality Metrics team also highlights areas where not enough is known about the health of women around the world and spearheads data collection efforts in these areas.

Dr. Gakidou, one of the founding members of IHME, has also repeatedly called for violence against women to be treated with the same urgency as other global health priorities.

We spoke with Dr. Gakidou about the work of her team and her hopes for women’s health on this year’s International Women's Day.

You spearheaded the creation of the Gender Equality Metrics team at IHME. What prompted you to create this team?

Dr. Gakidou: The Gender Equality Metrics team looks at the billions of results the Global Burden of Disease study produces through a gender lens. We're trying to answer questions like: 'What are the most significant gender gaps? What are some health conditions where women should be doing better compared to men? What are some parts of the world where women are fairing significantly worse than men?' In addition to answering questions about which health conditions or regions of the world we should be focusing on, we also want to highlight data gaps. Even though we know a lot about the health of women and men around the world, significant data gaps remain that do not allow us to explore gender gaps and as much as we would like. Our team is also highlighting areas where we don't know enough about the health of women around the world and we're hoping to spearhead data collection so we can accurately measure what's happening.

What is the Gender Equality Metrics team hoping to accomplish?

Dr. Gakidou: We have a vision to improve the measurement of health conditions and determinants of health that disproportionately affect women as well as improve the estimation of some conditions that predominantly affect women that are currently neglected in the health measurement area. One of those areas is gender-based violence, where the available information is much weaker than the magnitude of the problem. What our team is hoping to do is both improve the information, but also catalyze the collection of additional information so we can share it with policymakers and hopefully improve the situation for women that suffer abuse globally.

What are some of the specific challenges in terms of the measurement of health inequalities and how can they be addressed?

Dr. Gakidou: There are always challenges in measuring anything in global health because there are a lot of health conditions and a lot of populations that are hard to reach. Specifically in the measurement of inequalities, the biggest challenge in my opinion is getting information from populations that are currently not represented in the available measurement systems. That might be displaced populations or refugees in many countries. That might be the populations that are most disadvantaged from a socioeconomic position. The normal data collection efforts may not make a concerted effort to reach these populations. When one is interested in measuring health and equalities, it's really important to measure the entire distribution from the worst off to the best off. Frequently, our measurement processes are lacking in the most disadvantaged part of the distribution.

Your team published a paper in The Lancet about the effects of COVID-19 on gender equality. What were your key findings and takeaways?

Dr. Gakidou: During the pandemic, we were trying to explore the impacts of COVID-19 as a pandemic on women compared to men. Not just the direct effects of how many people are infected or die from the disease, but some of the indirect effects. The first thing we found was that it was very understudied, so we didn't have a lot of information to fully understand the impacts of the pandemic on gender equality.

A lot of the available data we did have came from unusual data collection platforms. For example, Meta was launching daily surveys through Facebook to capture the experiences of people around the world during the pandemic. They were asking some questions that were very important for gender equality. For example: 'Who in the household was taking care of individuals? Who in the household may have had to forego employment to stay at home and take care of either children or the elderly?'

What we found when we analyzed a lot of the available data from around the world was that women disproportionately took on the burden of home care. Taking care of household responsibilities, whether that was children or older family members, or just doing chores around the household. They also disproportionately had employment loss compared to men.

There were many areas where we were not able to study the impacts of the pandemic adequately. For example, on education, we don't yet have a lot of data on who was disproportionately affected by school closures around the world. There are some early indications that suggest that the impacts were more severe for girls compared to boys in terms of who returned to school and who was able to access online learning. That's an area where the data gaps are pretty severe, and it has long-term implications for the health and well-being of women around the world.

In an article for IWD a couple of years ago, you called for violence against women to be addressed with the same urgency as other global health priorities. How could we make that happen?

Dr. Gakidou: Violence against women, in my opinion, has not been treated as a public health issue in the same way as other health conditions. There are many reasons for this. It involves many sectors, not just the health sector. I think there is an opportunity for the global health community to highlight this as a problem that should be taken as seriously as other health conditions that women face.

The Executive Director of the UNFPA, Natalia Kanem, has a platform to eliminate violence against women. She has declared gender-based violence the most prevalent violation of human rights in the world and has also highlighted online violence as a growing and urgent concern. I think with her leadership and other global leaders also supporting the effort, we can move the needle to recognize that this is a very important issue. Particularly when violence is experienced in childhood, it affects the entire lifespan for the girl or later woman. Similarly for boys – violence is not just suffered by girls. If we start recognizing the long-term implications and how much better off all societies would be if we prevented the violence from occurring, I think the benefits would be huge later on. If you take another lens – currently, there are a very large number of individuals around the world, billions, who have suffered abuse and violence. They're not getting adequate care and treatment if we're not measuring the challenge accurately and we're not treating the problem as a serious health issue.

Part of your role at IHME is overseeing the Development and Training team – what advice do you have for women in global health, especially those just starting their careers?

Dr. Gakidou: My advice for women in global health is to do the best you can and stay in the field. This field is in need of a lot of strong, powerful voices that can help shape the future for the generations to come. We need all of you in global health committed to making the world healthier and safer.

On this year’s IWD, what is your biggest hope for women and health?

Dr. Gakidou: Well, if one can dream, my hope would be that every girl and woman around the world can achieve their potential and lead a happy and safe life. In terms of health, specifically, my hope would be that every girl and woman around the world has access to all the information they need to make the best choices about their health and well-being.