Gender-Responsiveness of Primary Health Care: How is the Delivery of Primary Care Measured and Assessed Using a Gender-sensitive and Responsive Approach at the Facility Level?

In the past two decades gender-responsive and gender-sensitive assessment of primary health care (PHC) services in a global and specific geographical context have gained considerable attention. This scoping review aims to explore the extent to which primary and secondary care facilities use gender-responsive indicators, provide recommendations for the integration of gender-sensitive assessment within PHC facilities, and expand how we situate them in existing facility monitoring and evaluation efforts. Methods: A systematic scoping review of peer-reviewed and grey literature published between 2002 and 2022 identified studies with evidence of gender-responsive or sensitive assessment tools, frameworks, and model that assess primary care. Findings present substantial information on PHC service delivery measurement, monitoring, targets, and/or assessment, and were thematically analyzed. Results: Out of 1,912 records identified, 9 records were included for data extraction. The records are categorized according to two groups: (i) comprehensive tools, and (ii) fragmented/targeted tools as described below. Comprehensive tools refer to tools that address multiple dimensions of PHC for various population groups, and targeted tools are focused on specific individuals and/or PHC interventions. Among the included tools, frameworks, and model, one record was comprehensive, and eight records were targeted. Conclusion: Since gender is not measured in a systematic way across primary and secondary facilities, the available tools and approaches are often developed using multiple instruments. This is a clear indication that gender is rarely the focus in comprehensive measurement approaches for PHC interventions at primary- and secondary-level facilities, especially for population health measurement.