Exploring Gender-Equitable Digital Health Solutions: Insights from the Gender Study in Ethiopia

Written by: Patty Mechael (health.enabled), Getasew Amare & Betelhem Abebe (University of Gondar), and Xueli Qiu (Johns Hopkins Bloomberg School of Public Health)

On October 2, 2024, stakeholders gathered together in Addis Ababa for eye-opening presentations and insightful discussions to advance a new gender study within Ethiopia's Digital Health Information (DHI) landscape for immunization. Supported through health.enabled’s engagement with Gavi, the Vaccine Alliance on the monitoring, evaluation and learning of the Gavi DHI Strategy and convened by the Center for Digital Health and Implementation Science at the University of Gondar, the Gender Study Workshop gathered stakeholders from various sectors, all focused supporting various aspects of immunization, digital health, and gender in Ethiopia. With guidance on gender, gender dynamics, and equity from the Johns Hopkins Bloomberg School of Public Health’s Gender Equity Unit, the event marked a pivotal step to analyze the state of gender as a first step in incorporating gender-transformative approaches into digital health information and immunization strategies.

The Purpose and Scope of the Gender Study

While immunization rates for boys and girls are fairly equal across most countries, research indicates that gender still intersects with other barriers affecting access, use, and effectiveness of digital health information. Factors like the gender digital divide, differential data access, and workplace dynamics can reinforce inequities within health systems. The gender study aims to examine these dynamics and develop strategies to bridge these gaps, ensuring that digital health tools serve everyone equally.

The study is structured around Ethiopia’s Digital Health Information for Immunization Roadmap, which prioritizes integrating gender considerations into all levels of digital health planning and execution. By understanding and addressing gender dynamics, this research intends to support more inclusive digital health strategies that reach traditionally marginalized groups. Insights from the workshop will contribute to refining the study’s research protocol, identifying priority sites, and establishing measurement indicators that reflect gender-intentional impacts.

Preliminary Findings from Desk Review

The desk review on gender in digital health for immunization in Ethiopia highlighted significant gender disparities, including the persistent gender digital divide and a shortage of women in leadership and decision-making roles. Despite efforts like the 2022 DHI roadmap aimed at fostering an integrated, gender-intentional information system for better immunization coverage, barriers remain. Women face challenges in accessing digital tools and health services, limiting their participation in immunization programs. These issues are compounded by broader gender inequalities in education, economic opportunities, and political representation. Moreover, though the Ethiopian government has introduced various policies to promote gender equality, gaps still persist, such as economic disparities and limited female representation in policy making and technology development. These gaps continue to impact equitable digital health access, use, and outcomes.

A Participatory Approach to Gender-Equitable Solutions

A primary goal of the workshop was to introduce stakeholders to the gender study’s objectives and foster collaborative input into its approach. Activities ranged from introductory sessions to hands-on exercises, each designed to bring participants’ expertise and perspectives on integrating gender inclusivity into digital health initiatives.?

1. Introduction and Context Setting

The workshop began with a brief on the importance of gender-equitable digital health solutions and the specific challenges within Ethiopia’s context. Stakeholders were introduced to the study's objectives, emphasizing the role of digital health in reaching marginalized populations and the unique barriers posed by gender dynamics in health policy making and delivery. Participants engaged in icebreakers, which set a collaborative tone and encouraged open sharing of perspectives.

2. Rapid Stakeholder Mapping

In this activity, participants were grouped to map out the digital health and immunization ecosystem in Ethiopia, focusing on gender distribution across roles. The exercise identified critical roles that require gender-sensitive adaptations to enhance access and equity. For example, certain leadership and policy making roles within immunization and digital health initiatives are predominantly held by men, a trend that influences decision-making and prioritization in immunization and digital health implementations. The mapping also highlighted that frontline health workers, who are usually women, often lack appropriate training to use digital tools and data effectively.

3. Research Approaches and Prioritization

Stakeholders discussed and refined the study’s research methodology. Participants identified key policies, stakeholders, and research sites essential for effective data collection. Using interactive posters, participants marked priority areas and shared recommendations. This encouraged diverse input on the research framework, including which gender-related policies should be reviewed and which stakeholders would provide the most impactful insights.

Preliminary Outcomes and Next Steps

The outcomes of this workshop have positively shaped the study’s direction. Insights from stakeholder mapping and participatory design activities underscored the importance of addressing gender disparities in immunization and digital health at multiple levels—from policy design to field-level implementation. Stakeholders emphasized that simply introducing digital tools is not enough. These tools must be designed and deployed in ways that acknowledge and mitigate gender barriers to access and use. The results will provide a foundation for establishing gender-equitable digital health for immunization practices that can be applied not only within Ethiopia, but also as a model for similar contexts globally.

Building a Gender-Equitable Digital Health Future

This event marked an inspiring step along Ethiopia’s journey toward a gender-equitable digital health landscape. With continued collaboration and a commitment to inclusivity, Ethiopia’s digital health initiatives can pave the way for a health ecosystem that recognizes and values the unique contributions and needs of all genders. The results of this study promise to inform not only national policy but also global best practices for achieving equitable health outcomes through inclusive digital innovation.