Chapter 17: Gender equity and the politics of health sector reform: overcoming policy legacies and forming epistemic communities
Health care reform presents an opportunity to ameliorate long-standing inequities in existing health systems – or inequitable ‘policy legacies’. Conversely, reforms may introduce new inequities. This chapter argues that policy legacies are gendered in crucial ways, and that reform is most likely to take place in moments of perceived ‘crisis’ in which epistemic communities play an influential role. In this context, the keys to gender equitable health reform are the ability to overcome previous, gender-inequitable policy legacies and epistemic communities that hold principles compatible with gender equity, and which are integrated with members who are conscious of how health systems can shape gender equity. The salience of these twin elements is illustrated through a case study of Peru’s health reforms of the 1990s and early 2000s.
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