Gender Issues Influencing Zika Response in Ecuador

By February 2016, the World Health Organization declared Zika virus infection a Public Health Emergency of International Concern due to its associations with microcephaly and other neurological disorders. As of the last Pan American Health Organization report on Zika cases in January 2018, there have been 2,397 confirmed cases of Zika, 3,954 suspected cases of Zika, and 14 confirmed cases of microcephaly in Ecuador, although this is probably underreported. Ecuador's sociodemographic overview reveals economic and human development indicators that are relevant to the Zika response. The country's labor force participation rate for women is substantially lower than it is for men, with women participating more in the informal sector and earning much less than men. This division of labor is influenced by gender norms, with men perceived as the financial providers and women expected to take care of the home and children. This burden of care could be further skewed in families that have children with Congenital Syndrome associated with Zika (CSaZ) and other disabilities that require higher social, financial, and labor costs. The Zika response programs in Ecuador promote practices to prevent vector-borne and sexually transmitted Zika, as well as health system strengthening activities to link families with children affected by Zika to the care they need. However, these programs need to integrate gender-sensitive interventions that address the variances of needs and behaviors of women, men, boys, and girls. The desk review highlights key insights to guide programmatic strategies and provides initial recommendations based on the findings. One of the key factors in the Zika response is the division of labor and care, which is influenced by gender norms. In Ecuador, women are expected to take care of the home and children, while men are perceived as the financial providers. This burden of care could be further skewed in families that have children with CSaZ and other disabilities that require higher social, financial, and labor costs. The review highlights the need to consider the burden of care when health providers support families and bring them together as couples. Single-headed households also need special consideration, as the burden of care can be enormous. Another key factor is reproductive health, which is also influenced by gender norms. In Ecuador, women's reproductive health is often neglected due to the societal expectation that they should prioritize childcare and domestic responsibilities. This can lead to inadequate access to family planning services, which is critical for preventing Zika. The review highlights the need to address these gender norms and ensure that women have equal access to reproductive health services. The review also highlights the need to address gender-based violence, which is a significant concern in Ecuador. The country has a high rate of intimate partner violence, which can exacerbate the burden of care for women and make it more difficult for them to access healthcare services. The review recommends that Zika response programs include interventions to prevent and respond to gender-based violence. In terms of maternal and child health systems, the review highlights the need to address the disparities in healthcare access and quality between different socioeconomic groups. In Ecuador, women from lower socioeconomic backgrounds have limited access to healthcare services, which can exacerbate the burden of care for them. The review recommends that Zika response programs include interventions to improve healthcare access and quality for marginalized populations. The review also highlights the need to address the specific needs of adolescents and youth, who are disproportionately affected by Zika. In Ecuador, adolescents and youth have limited access to healthcare services, which can exacerbate the burden of care for them. The review recommends that Zika response programs include interventions to improve healthcare access and quality for adolescents and youth. Finally, the review highlights the need to address the specific needs of ethnic minorities, including indigenous groups and Afro-Ecuadorians. In Ecuador, these groups have limited access to healthcare services, which can exacerbate the burden of care for them. The review recommends that Zika response programs include interventions to improve healthcare access and quality for ethnic minorities. In conclusion, the Zika virus outbreak in Ecuador has highlighted the need for gender-sensitive interventions in the response and prevention programs. The desk review has identified key insights to guide programmatic strategies and provided initial recommendations based on the findings. The review highlights the need to address the division of labor and care, reproductive health, gender-based violence, maternal and child health systems, adolescents and youth, and ethnic minorities in the Zika response programs.