GENDER PERSPECTIVES AND QUALITY OF CARE - TOWARDS APPROPRIATE AND ADEQUATE HEALTH-CARE FOR WOMEN

Gender inequalities in health are a consequence of the basic inequalit y between men and women in many societies. Despite the importance of s ocio-economic factors, women's health is also greatly affected by the extent and quality of health services available to them. Both non-gove rnmental women's organizations and feminist health researchers have in recent years identified major gender inequalities in access to servic es and in the way men and women are treated by the health care system. Firstly, although women are major health care users as well as provid ers, they are under-represented in decision-making in health care. Sec ondly, no justice is done in general to existing differences in positi on and needs of women and men in defining quality of health care, i.e. gender aspects. Among women's organizations, there is general agreeme nt that ''gender sensitive health care should be available, accessible , affordable, appropriate and acceptable''. In addition, health care f or women should be adequate and not depart from a male model of health and illness. In this paper, we pay attention to inappropriate health care for women on the one hand, as illustrated by the increasing medic alization of women's reproductive life [menstruation, menopause, pregn ancy and childbirth and (in)fertility]. On the other hand, we discuss gender bias in the management of serious, life-threatening diseases su ch as cardiovascular disease, lung cancer, and kidney failure, as a fo rm of inadequate care. These examples are followed by a global vision on quality of care from a gender perspective, as formulated by the wom en's health care movement in the Netherlands and at the Fourth Interna tional Conference on Women in Beijing. If anything, the recommendation s agreed upon in Beijing will have to ensure the consolidation and enh ancement of good quality health care for women around the world. The f inal discussion, attempts to give some general recommendations for ach ieving more adequate (gender sensitive) and appropriate (non-medicaliz ing) health care for women. These recommendations pertain to health an d health care research, policy, education, and organization from a wom en's perspective. Copyright (C) 1996 Elsevier Science Ltd.