This article was first published in the Policy and Practice Blogs of the Communications Initiative Network on 8 April 2020.

COVID-19, like all health emergencies, is not gender-neutral, and neither should the global health response be. Many of the official strategies and guidelines tackling the current novel coronavirus crisis are uninformed by gender analysis, despite existing evidence of the impact of gender norms, roles and relations on health emergencies. Gender-informed approaches in COVID-19 –related communications are also largely missing.

COVID-19 exposes women, men and people with non-binary identities to different vulnerabilities. Gender-based violence (GBV) is increasing, women and girls' access to essential sexual and reproductive health services [PDF] is dwindling, and women continue to shoulder the burden of care work - at homes and in hospitals - while men largely lead natonal and global health structures. The long-term economic and social impacts of the crisis are likely to hit women the hardest. Men may have higher risks of contracting the virus due to immunological differences and health behaviours impacted by gender norms, such as smoking. The LGBTQI [lesian, gay, bisexual, transgender, queer/questioning, and intersex] community is particularly vulnerable, not least due to the discrimination they face in health settings.

Effective gender-responsive programming, including for communications, community engagement and social mobilization, is critical as countries continue efforts to tackle the virus. Gender-responsive programming gets to the root of understanding the dynamics of gender norms, roles and inequalities, and takes measures to actively address these for better health outcomes for all. Yet, many of the official communications guidelines designed to inform COVID-19 response are lacking a gender lens.

What does gender-responsive communications look like, then? In short, it utilises inclusive communications approaches based on a solid gender analysis shaped by intersectional approaches. Gender-responsive communications means asking questions like: "How are women, men and people with non-binary identities affected differently by COVID-19? What are their specific vulnerabilities? How do gender norms, roles and relations influence people's access to critical resources, information and decision-making? What about the impact of gender norms, roles and relations on communications channels, messages and preferences? What gender-related barriers exist to information and participation?"

Addressing barriers through a gender lens

Gender-responsive communications is based on the understanding that people experience health emergencies, like COVID-19, differently - and this difference is shaped by gendered norms and roles in societies, embedded in unequal power relations. Communications plans and interventions, such as communication for development (C4D) strategies or rapid community engagement assessments, need to be informed by comprehensive gender analysis and data disaggregated by sex, age, ethnicity, disability and other critical factors influencing health outcomes.

Gender-related barriers to information and digital exclusion are influenced by multiple factors - from gendered norms, roles and biases to the lack of education and economic resources, all shaped by gender inequality. Two-thirds of the world's illiterate adults are women. Men are 21% more likely to be online than women, rising to 52% in lower income countries, and women are on average 26% less likely than men to have a smartphone [PDF] - 70% in South Asia. This influences the communication products and channels women have access to, making it critical that all interventions are targeted in accessible and relevant formats, whether for example through radio, visual print materials, or face-to-face outreach.

Gender-related barriers to healthcare and health information are formed also by women’s limited access to decision-making in many contexts. This further restricts access to information about the outbreak and the availability of services which can further impact gendered differences in exposure patterns. Research into Ebola suggests that the exclusion of women from meetings at which Ebola responses were considered further fuelled the spread of the disease.

Women must be fully engaged in and their realities considered in risk communication, community engagement and outreach strategies. As women perform three times as much unpaid care work at home as men, it is no surprise that women shoulder the majority of the responsibility of taking care of children, the elderly and the ill during the current crisis, making them more vulnerable to contracting the virus while dealing with the double burden.

The effectiveness of health promotion materials during the West African Ebola outbreak was limited by a lack of understanding of local gender norms and women's caretaking responsibilities. Posters and radio spots advised against touching and cleaning up after those who appeared ill - this type of messaging was of course ignorant to the responsibilities women had as primary caretakers in the family. Asking questions such as "how do I manage a family of children, including infants and toddlers, in quarantine? "How do I transport someone to a hospital without promoting infection?" would generate more gender-responsive communication interventions.

GBV, especially domestic violence, increases during emergencies, COVID-19 being no different. Movement restrictions, self-isolation measures and the increased economic uncertainty and anxiety all add to the GBV "shadow pandemic". The outbreak has also disrupted access to critical sexual and reproductive health services. These issues must also be considered in COVID-19-related communications. Communications about GBV hotlines, mobile and remote services and accessible information about case management, psychosocial support and referrals must be prioritised to respond to GBV survivors' increasing needs. SMS [text messaging] and chat services can support in remote service delivery, especially in basic first-line support in contexts where women have access to mobile phones.

Realising that language and visual representations are part of constructing reality is also key. Communications and outreach materials should not reinforce gender stereotypes, for example by only depicting women in contexts of childcare, domestic work or caregiving. COVID-19 communications provides an opportunity for global health actors to accelerate work around dismantling gendered stereotypes in household work, promoting an equal approach to sharing care responsibilities. Language matters too as we talk about police officers (not policemen) overseeing quarantine restrictions, nurses (not male nurses) saving lives or the cleaners (not cleaning ladies) providing indispensable services.

Towards meaningful participation

Gender inequality is manifested in the way global health is generally orchestrated - delivered by women and led by men. Women make up 70% of the global health workers tackling the pandemic on the frontlines, but form only a small minority of leaders in global health organisations. Not only should achieving gender parity at the top levels be an urgent priority for global health actors, but teams delivering community outreach and social mobilization must be gender-balanced and represent the communities they serve.

A key part of gender-responsive outreach and communications for COVID-19 is ensuring the full inclusion of women and girls, LGBTQI communities and other marginalised groups. Communications plans for COVID-19 must be designed with inputs and meaningful participation from women's groups and community networks. Women should be empowered to act as change agents and message multipliers within their communities. As recent technical guidance [PDF] on risk communications and community engagement on marginalised and vulnerable people highlights: "Women's access to information on outbreaks and available services are constrained when community engagement teams are dominated by men."

In addition to working towards gender balance, the inclusion and engagement of gender experts in all stages of community engagement and risk communications planning and implementation should be prioritised. For meaningful results, gender needs to be embedded already in the budgeting stage for any interventions.

Effective communications is integral in the battle against the novel coronavirus. Gender-responsive communications approaches will further strengthen interventions to halt the spread of the virus and save lives, while contributing to longer-term results for gender equality. COVID-19 response provides an opportunity to address the inequalities exacerbating the pandemic's impact and to influence a wide range of health outcomes globally, even beyond the current outbreak.