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In countries around the world, the COVID-19 pandemic quickly revealed systemic weaknesses in myriad national institutions, from health systems to banks and government agencies. One striking fact that attracted media attention is that people seemed to be dying from COVID-19 at much higher rates in countries with male leaders. This paper goes a step further to see whether the exclusion of women more broadly from economic, social, and political life, as well as high levels of injustice and insecurity, also means that the countries are in bad shape when it comes to major pandemic risks. Investigating the statistical relationship in scores on the INFORM Epidemic Risk Index and the Women, Peace and Security Index for 167 countries, we find a strong statistical correlation which, while not proving causation, does point to key connections. Our analysis suggests that countries most at risk of humanitarian crisis and disaster that would overwhelm national response capacity are those where the status and well-being of women in the country are weak. This is not only harmful to women, but to everyone in society.

Under a centrally planned system, China made significant achievements in gender equality. Half a century later, China has joined the ranks of upper‐middle‐income countries, and decades of rapid growth have accompanied major structural changes in the economy. We assess the evolution of women's economic opportunities during the period, focusing on labour force participation, occupational segregation, leadership in business, and the gender wage gap, as well as informal sector employment and migration. We undertake a review of existing research and conduct new empirical analysis using a combination of data sources, including four waves of Chinese population census data through 2010, and province‐level migration data. We focus especially on migrant women, a group typically excluded from similar studies. Although investments in human capital have advanced prospects for better‐paid jobs for women, we find that rapid economic growth has not alleviated discrimination against women rooted in cultural and social norms and that the implementation of existing laws designed to protect and support women needs to improve.

Summary Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health. In this Series paper, we explore how to address all three through recognition and then with disruptive solutions. We used intersectional feminist theory to guide our systematic reviews, qualitative case studies based on lived experiences, and quantitative analyses based on cross-sectional and evaluation research. We found that health systems reinforce patients' traditional gender roles and neglect gender inequalities in health, health system models and clinic-based programmes are rarely gender responsive, and women have less authority as health workers than men and are often devalued and abused. With regard to potential for disruption, we found that gender equality policies are associated with greater representation of female physicians, which in turn is associated with better health outcomes, but that gender parity is insufficient to achieve gender equality. We found that institutional support and respect of nurses improves quality of care, and that women's empowerment collectives can increase health-care access and provider responsiveness. We see promise from social movements in supporting women's reproductive rights and policies. Our findings suggest we must view gender as a fundamental factor that predetermines and shapes health systems and outcomes. Without addressing the role of restrictive gender norms and gender inequalities within and outside health systems, we will not reach our collective ambitions of universal health coverage and the Sustainable Development Goals. We propose action to systematically identify and address restrictive gender norms and gender inequalities in health systems.

Summary Gender is not accurately captured by the traditional male and female dichotomy of sex. Instead, it is a complex social system that structures the life experience of all human beings. This paper, the first in a Series of five papers, investigates the relationships between gender inequality, restrictive gender norms, and health and wellbeing. Building upon past work, we offer a consolidated conceptual framework that shows how individuals born biologically male or female develop into gendered beings, and how sexism and patriarchy intersect with other forms of discrimination, such as racism, classism, and homophobia, to structure pathways to poor health. We discuss the ample evidence showing the far-reaching consequences of these pathways, including how gender inequality and restrictive gender norms impact health through differential exposures, health-related behaviours and access to care, as well as how gender-biased health research and health-care systems reinforce and reproduce gender inequalities, with serious implications for health. The cumulative consequences of structured disadvantage, mediated through discriminatory laws, policies, and institutions, as well as diet, stress, substance use, and environmental toxins, have triggered important discussions about the role of social injustice in the creation and maintenance of health inequities, especially along racial and socioeconomic lines. This Series paper raises the parallel question of whether discrimination based on gender likewise becomes embodied, with negative consequences for health. For decades, advocates have worked to eliminate gender discrimination in global health, with only modest success. A new plan and new political commitment are needed if these global health aspirations and the wider Sustainable Development Goals of the UN are to be achieved.

The Sustainable Development Goals offer the global health community a strategic opportunity to promote human rights, advance gender equality, and achieve health for all. The inability of the health sector to accelerate progress on a range of health outcomes brings into sharp focus the substantial impact of gender inequalities and restrictive gender norms on health risks and behaviours. In this paper, the fifth in a Series on gender equality, norms, and health, we draw on evidence to dispel three myths on gender and health and describe persistent barriers to progress. We propose an agenda for action to reduce gender inequality and shift gender norms for improved health outcomes, calling on leaders in national governments, global health institutions, civil society organisations, academic settings, and the corporate sector to focus on health outcomes and engage actors across sectors to achieve them; reform the workplace and workforce to be more gender-equitable; fill gaps in data and eliminate gender bias in research; fund civil-society actors and social movements; and strengthen accountability mechanisms.

Despite global commitments to achieving gender equality and improving health and wellbeing for all, quantitative data and methods to precisely estimate the effect of gender norms on health inequities are underdeveloped. Nonetheless, existing global, national, and subnational data provide some key opportunities for testing associations between gender norms and health. Using innovative approaches to analysing proxies for gender norms, we generated evidence that gender norms impact the health of women and men across life stages, health sectors, and world regions. Six case studies showed that: (1) gender norms are complex and can intersect with other social factors to impact health over the life course; (2) early gender-normative influences by parents and peers can have multiple and differing health consequences for girls and boys; (3) non-conformity with, and transgression of, gender norms can be harmful to health, particularly when they trigger negative sanctions; and (4) the impact of gender norms on health can be context-specific, demanding care when designing effective gender-transformative health policies and programmes. Limitations of survey-based data are described that resulted in missed opportunities for investigating certain populations and domains. Recommendations for optimising and advancing research on the health impacts of gender norms are made.

This chapter highlights both the scale of the challenge of closing gaps in women’s financial inclusion and the promise of digital approaches. Access to cell phones and mobile money platforms is growing, especially in developing economies, and is reaching rural and marginalized populations that have been traditionally excluded from financial services. However, gender gaps in mobile phone use persist, and about 500 million women worldwide do not own mobile phones. There is substantial evidence that the obstacles to women’s inclusion are not only technical, and that major barriers exist around adverse norms and poverty, in particular. Moreover, financial inclusion is not a panacea to women’s disempowerment. Still, a review of the evidence suggests that the digital innovations underway are demonstrating substantial potential, most notably through the use of mobile phones, and finding ways to bring women into the system via social protection and even wage payments. This is especially welcome given the very large numbers of women who remain excluded from financial services today – especially in sub-Saharan Africa and South Asia. While gender gaps are context-specific and depend on local norms and systems, it cannot be assumed that these will close over time. Deliberate efforts are needed, adopting a multidimensional approach that not only expands women’s access to digital financial services but that also works to transform harmful norms and build a strong enabling environment for expanding women’s economic opportunities.

This chapter examines the interaction of reproductive health with economic factors. It focuses on two issues: labor supply and productivity and out-of-pocket spending. It is well known that poor health reduces labor supply and contributes to lost wages. Empirical evidence documenting the effects of maternal mortality and morbidity on productivity is available for several countries. High fertility can also affect female labor supply, since having children adds to women’s domestic responsibilities, given prevailing gender roles. In studies of female labor supply, labor participation is generally negatively associated with the individual’s number of children. The relationship between fertility, schooling, and economic opportunities is mutually reinforcing. Economic conditions influence the level and shape of women’s agency. Economic conditions influence the level and shape of women’s agency. Poverty and income inequality, especially, drive whether women are able to exercise control over sexual and reproductive decisions.

Women's autonomy and empowerment in their homes, communities, and societies at large have been shown, through many direct and indirect pathways, to be associated with maternal and infant health. A novel global measure—the Women, Peace, and Security (WPS) Index—that bridges insights from gender and development indices with those from peace and security has recently been developed to capture the constructs of women's inclusion, justice, and security, using indicators and targets in the Sustainable Development Goals. This paper adds to the growing literature about the importance of gender inequality to key mortality outcomes for women and children by investigating the associations between nations' WPS Index scores and maternal mortality ratios and infant mortality rates. We use a range of international databases to obtain country-level data from 144 nations on health, demographic, income, and gender equality indicators. The aim is to highlight the role of women's inclusion, justice, and security in explaining national rates of maternal and infant mortality. Fully adjusted Poisson regression models indicate that a one point (0.01) increase on the WPS Index score is associated with a 2.0% reduction in the number of maternal deaths and a 2.3% reduction in the number of infant deaths. For a country such as Sierra Leone, with a maternal mortality ratio of 1360 maternal deaths per 100,000 live births, a one point improvement in the WPS Index would correspond to a maternal mortality ratio of 1,332, or 28 fewer deaths per 100,000 births. These associations are ecological and apply to the average level of mortality at the country level rather than the likelihood or risk faced at the individual level. Although we cannot claim causality for the observed relations in the cross-country regressions, the findings and recurring patterns are both suggestive and encouraging about the potential contributions of women's inclusion, justice, and security to maternal and infant mortality., Highlights • The Women, Peace, and Security (WPS) Index is a novel composite index, developed in 2019. • The index measures women’s inclusion (economic, political, social); justice; and security (at home and in society). • Using data from 144 nations, we find a significant relationship between the WPS Index and maternal and infant mortality. • The inclusion and security aspects of the WPS Index are especially significant.

Financial inclusion is an area of growing global interest in women's empowerment policy and programming. While increased economic autonomy may be expected to reduce the prevalence of intimate partner violence, the mechanisms and contexts through which this relationship manifests are not well understood. This analysis aims to assess the relationship between women's financial inclusion and recent intimate partner violence using nationally-representative data from 112 countries worldwide. Levels of both financial inclusion and recent intimate partner violence varied substantially across countries (ranging from 2-100%, and 1-46%, respectively), and across regions. In multivariate global analyses, increased levels of women's financial inclusion were associated with lower levels of recent intimate partner violence after accounting for asset-based enablers of economic autonomy and gender norms; this relationship was lost upon the inclusion of measures of national context (i.e., development and fragility). These results underscore that the relationship between financial inclusion and recent intimate partner violence is complex, follows many pathways, and is affected by context. In low and middle income countries, asset-based enablers of economic autonomy, gender norms and national context explained much of the relationship between financial inclusion and recent intimate partner violence. In those low and middle income countries with high levels of controlling behavior by male spouses, financial inclusion was associated with higher levels of recent intimate partner violence. These findings further suggest that initiatives that aim to prevent intimate partner violence by way of increased economic autonomy may be ineffective in the absence of broader social change and support, and indeed, as seen in countries with higher levels of men's controlling behavior, backlash may increase the risk of violence. Efforts to improve women's financial inclusion need to recognize that its relationship with intimate partner violence is complex, and that it requires an enabling environment supportive of women's rights and autonomy.

Global indices are an increasingly popular way to assess progress against such goals, by distilling an array of complex information into a single number or ranking. The new global Women, Peace, and Security (WPS) Index bridges insights from gender and development indices with those from peace and security indices in a way that is simple and transparent and that reflects women’s autonomy and empowerment as agents at home, in the community, and in society. The index is structured around three basic dimensions of women’s well-being: inclusion (economic, social, political); justice (formal laws and informal discrimination); and security (at the individual, community, and societal levels), which are quantified through carefully selected indicators. It ranks 153 countries along these three dimensions in a way that highlights key achievements and deficits, and provides a tool to monitor progress over time. The global rankings highlight priority areas in which policy reforms and investments are needed to accelerate progress, especially in countries that are performing poorly or where achievements are unbalanced across dimensions. This chapter both informs and contributes to an evidence-based narrative that inspires political action and social movements.

While central notions around agency are well established in academic literature, progress on the empirical front has faced major challenges around developing tractable measures and data availability. This has limited our understanding about patterns of agency and empowerment of women across countries. Measuring key dimensions of women's agency and empowerment is complex, but feasible and important. This paper systematically explores what can be learned from Demographic and Health Survey (DHS) data for fifty-eight countries, representing almost 80 percent of the female population of developing countries. It is the first such empirical investigation. The findings quantify some important correlations. Completing secondary education and beyond has consistently large positive associations, underlining the importance of going beyond primary schooling. There appear to be positive links with poverty reduction and economic growth, but clearly this alone is not enough. Context specificity and multidimension...

The purpose of this study was to assess via longitudinal analysis whether women's economic empowerment and financial inclusion predicts incident IPV. This prospective study involved analysis of three waves of survey data collected from rural young married women (n=853 women) in Maharashtra at baseline and 9&18 month follow-ups. This study, which was in the field from 2012 to 2014, was conducted as part of a larger family planning evaluation study unrelated to economic empowerment. Participants were surveyed on economic empowerment, as measured by items on women's income generation and joint decision-making of husband's income, and financial inclusion, as measured by bank account ownership. Women's land ownership and participation in microloan programs were also assessed but were too rare (2-3% reporting) to be included in analyses. Longitudinal regression models assessed whether women's economic empowerment predicted incident IPV at follow-up. At Wave 1 (baseline), one in ten women reported IPV in the past six months; 23% reported income generation; 58% reported having their own money; 61% reported joint control over husband's money, and 10% reported bank ownership. Women's income generation and having their own money did not predict IPV over time. However, women maintaining joint control over their husband's income were at a 60% reduced risk for subsequent incident IPV (AOR=0.40; 95% CI=0.18, 0.90), and women gaining joint control over time were at a 70% reduced risk for subsequent incident IPV (AOR=0.30; 95% CI=0.13, 0.72), relative to women whose husbands maintained sole control over his income. Women who initiated a new bank account by Wave 3 also had a 56% reduced likelihood of reporting incident IPV in this same wave (AOR=0.44; 95% CI=0.22, 0.93), relative to those who maintained no bank account at Waves 1 and 3. These findings suggest that women's joint control over husband's income and her financial inclusion as indicated by bank ownership appear to reduce risk for IPV, whereas her income generation or control over her own income do not. Awareness of and participation in financial inclusion services may help reduce women's risk for IPV in rural India and elsewhere.

Mesurer le progres humain : la contribution de l’Indice de Developpement Humain et des indices associes Depuis son lancement en 1990, l’Indice de Developpement Humain (IDH) a ete un repere important dans les tentatives d’elargissement des mesures de progres, et il sert de multiples fonctions pour les scientifiques, les decideurs politiques, et les militants. Cet article passe en revue les contributions de l’approche du developpement humain et, en particulier, de l’IDH dans le contexte des debats autour de la Commission sur la Mesure de la Performance Economique et du Progres Social. Nous mettons en exergue les analyses et recherches qui ont fait de l’IDH un outil de grande utilite pour la politique depuis 1990.

In our paper “The HDI 2010: New Controversies, Old Critiques”, published in theJune 2011 issue of the Journal of Economic Inequality, we responded to several ofMartin Ravallion’s criticisms of the HDI functional form, arguing that they were forthe most part misplaced [1]. In his article in this issue, Ravallion [2] presents severalcounterarguments. He argues that the fact that the HDI is not a comprehensiveobjective function should not deter us from studying its trade-offs; that the HDRin practice advocates for maximization of the HDI; and that concavity in income isnot an exclusive property of the new HDI’s functional form. He also restates hiscriticisms of the relative weights of longevity and education and the gradient of thevaluation of longevity in income.We agree that the incompleteness of the HDI should not deter us from studyingthe trade-offs of the index. In fact, we are puzzled as to why Ravallion characterizesour argument as being that one should “not care about the trade-offs.” We soughtto stress the relevance of understanding these trade-offs and their properties, writingthat they “are extremely relevant as they tell us about the marginal contributions ofimprovements in different dimensions to furthering capabilities.”What we do argue is that the interpretation of these trade-offs should be consistentwith the nature and purpose of the HDI, which is best viewed as that of providing anindex of capabilities. Thus we caution against interpreting the trade-offs implicit in theindex as social valuations and trying to directly derive policy recommendations from them.In particular, we take issue with Ravallion’s interpretation of a positive incomegradient in the valuation of longevity as a life being worth more in rich countries.

This paper investigates the relative importance of changes in social safety net support and labor market in explaining the decline in the purchasing power of Russian households that occurred during the period 1994–96. Drawing on three cross-sections of the Russian Longitudinal Monitoring Survey, we find that labor market changes have been the main cause of the observed decline in cash consumption. Among these changes, reductions in the impact of the time spent in employment and increasing frequency of wage arrears are most important, more so than increases in open unemployment or the fall in real wages among workers who were fully paid. The contribution of falling state transfers to cash consumption is nonetheless substantial. We also find that the sources of the decline in household welfare vary substantially across quintiles in the distribution.

It is no surprise that the breakup of the Soviet Union and the overall demise of the planned economy has had a profound effect on the welfare of the Russian people. But the absence of reliable survey data has constrained our understanding of the impact that transition has had on the distribution of income. This article draws upon several rounds of a nationally representative household survey to document the sharp increases in the incidence and severity of poverty that have occurred during the transition. We investigate the routes by which macroeconomic and structural developments have been transmitted through the labor market and examine the performance of an increasingly overburdened, unfocused, and inadequate system of social protection. There is no evidence to suggest that the poor have shared in Russia's emerging economic recovery, and the emergence of a core group of long-term poor appears to be a distinct possibility. Copyright 1998 by Oxford University Press.

Since its introduction in the first Human Development Report in 1990, the Human Development Index (HDI) has attracted great interest in policy and academic circles, as well as in the media and national audiences around the world. Its popularity can be attributed to the simplicity of its characterization of development - an average of achievements in health, education and income – and to its underlying message that development is much more than economic growth. The index was originally conceived by the late Pakistani economist Mahbub ul Haq, in collaboration with Amartya Sen and other scholars, as a response to their dissatisfaction with GDP as the standard measure of development. As Haq noted, “Any measure that values a gun several hundred times more than a bottle of milk is bound to raise serious questions about its relevance for human progress.” Yet the HDI’s very simplicity prompted critiques from the start, with some contending that it was too simplistic, while others who accepted its self-imposed limitations still questioned its choice of indicators and its computational methodology. This article discusses the concept and key insights learnt from the HDI, provides a detailed review of key critiques of the HDI, today and in the past, and explains the recent changes introduced to the HDI formula and indicators. Recent controversies are highlighted and placed in the context of longer running debates. The innovations to broaden the measurement of deprivations and disparities in human development are introduced, with some key global and regional insights.

Gender inequality remains a major barrier to human development. Girls and women have made major strides since 1990, but they have not yet gained gender equity. In this paper, we review ways to measure and monitor gender inequality, providing a critique of existing measures including the first global gender indices that were launched in the 1995 Human Development Report – the Gender-related Development Index and the Gender Empowerment Measure - and introduce a new index that is presented in the 2010 Human Development Report. The Gender Inequality Index, which addresses the key criticisms of previous measures, is unique in including critical issues of educational attainment, economic and political participation, and reproductive health issues and in accounting for overlapping inequalities at the national level. As such, it represents an important advance on existing global measures of gender equity. Measures of the disadvantages for women raise awareness of problems, permit monitoring of progress towards gender equity objectives and help keep governments accountable. In this light, the Gender Inequality Index is designed to reveal the extent to which the realization of a country’s human development potential is curtailed by gender inequality, and provides empirical foundations for policy analysis and advocacy efforts. We also compare our results with the results of alternative gender inequality indices, finding significant variation in rankings across the various indices due largely to differences in the elements of gender inequality they seek to measure.