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    <h1 class="centre">Gender Inequality</h1>

<div class="standardMargin">


<p>
<h2>What is this?</h2>
 
<br>
When observing Malaria’s epidemiological facts, we found that women and men are not always affected equally. The origins of this difference happened to be mainly cultural. This brought us to self-reflect on our world of Science & Engineering as well as our community here at Trinity College, Dublin. We used a quantitative approach: a database was gathered to depict sex ratio in Trinity’s academic staff as well as students. 
<br><br>

<h2>In Science, Technology, and Engineering</h2>

As much as we would like to see even numbers of representatives of each gender in any work place, fields of engineering, science, technology and mathematics are not those places-not yet anyway. Why is that so? We will look at some global statistics as well as statistics from our own college to seek an answer to this question.
<br><br>

<b>General picture:</b><br>
<ul>
 	<li>Women earn less than men.</li>
 	<li>Ten years ago 47% of new entrants into maths, science and computing courses at university level were women. However,  the number has fallen down to 40% by 2013.</li> 
 	<li>Less than 7% of positions in technology in Europe are occupied by women.</li>
</ul>
 <br>

 <b>At Trinity College Dublin:</b>
<br><br>
<div class="centre"><img src="https://static.igem.org/mediawiki/2015/9/9a/TrinityDublin15_GenderInequalityGraph.png" width="60%"></div><br>

<ul>
<li>Women account for 39% of all academic staff in College, but only 22% of academics in the Faculty of Engineering, Maths & Science (Annual Equality Monitoring Report 2011-12).</li> 	
<li>At present, 8 out of the 25 Heads of School in College are women.</li>
<li>At Professor and Associate Professor Level, the School of Linguistic, Speech & Communication Sciences has 25% women, while the School of Medicine fares slightly better at 37%. </li>
<li>However, 4 Schools achieve a 50/50 balance among these senior positions. They are the School of Education, School of Law, School of Pharmacy & Pharmaceutical Sciences, and the School of Social Work and Social Sciences.</li>
</ul>
<br><br>
The two main barriers that exist for women to succeed in STEM are ‘unconscious bias’, which causes undervaluation of women, and the fact that women are expected to take care of the household, and have bigger family obligations. 
<br><br>

Moreover, media pictures beauty and style as the most important aspect of life, which turns young girls away from seeking a career in science, technology or maths as they’re not as glamorous. Prof Christine Loscher, director of Dublin City University’s Health Technologies Research and Enterprise Hub wrapped up the goals of today’s female society in a one simple sentence:    ‘I do think that teens today are living in a world where image is more important than it has ever been.’ Hence, women predominate fields that are considered ‘feminine’ such as nursing, psychology, biology, pedagogy and letters. In fact, more than 70% of places in those areas are occupied by women. However, fields of physics, engineering and astronomy were traditionally considered ‘masculine’ and remain so till this day. Nonetheless, a balance of genders is seen in graduates in medicine, administration, law, and veterinary medicine.
<br><br>
The future of women in Science, Technology, Engineering and Mathematics (STEM) is promising. Companies such as SFI (Science Foundation Ireland) are currently working on emending and attenuating any factors, such as the ‘traditional’ outlook, that would limit the amount of women pursuing those degrees/careers. 
<br><br>

<h2>Gender Inequality in Malaria</h2>
<br>
It is widely known that occurrence of some diseases is associated with sex-dependence.  An example of that is haemophilia,  a recessive, sex-linked disorder. As females possess two copies of the X chromosome, inheritance of a mutated one does not lead to manifestation of the mutated gene in the phenotype unless the female carries two copies of the mutated gene, which is however, highly unlikely.  Males, on the other hand, with their sex chromosomes being X and Y, need only one copy of the mutated X chromosome to have haemophilia. 
<br><br>
This difference in susceptibility to haemophilia is based on genetic differences in males and females, that occur naturally, and therefore, in our opinion, should not be considered a subject for gender inequality issues. 
<br><br>
However, is there a disease in which difference in occurrence in males and females is a matter of gender inequality? The answer is yes.
<br><br>
We tend to associate susceptibility to malarial infection with the country of residence as well as the social status of the affected person. Nevertheless, one important issue commonly neglected by the media is that women in some African countries tend to be more prone to infection and death from malaria than men. Why is that? Below you will find a brief summary of the issue.

<br><br>
<h2>Exposure to Malaria</h2>
<br>

Segregation of responsibilities between men and women in a household is common (not only in poor countries), and in many cases it affects probability of contracting malaria. However, it must be noted that women are not always the disadvantaged side.
<br><br>

<ul>
<li>Since Plasmodium falciparum is most likely to bite in hot and humid areas, men working in mines/forests have greater occupational risk.</li>
<li>Women responsible for providing water for the household from the streams may be particularly exposed to mosquitos, which tend to reside in such places.</li>
</ul>

<br>
These are only two examples of how gender patterns of behaviour are important to malarial susceptibility. However, it still does not seem to raise the issue of gender inequality, as both sexes are affected, with the only difference being the area of contraction.
<br><br>

<h2>Access to and Control over Health Care Resources</h2>
<br>

This issue is primarily the one that creates the division between the two genders contracting a disease, such as the likes of malaria. ‘Access’ refers to the ability to use a health resource while ‘control’ depicts the ability to make decisions about the use of that particular resource. 
<br>
<br>
Women in some African countries, such as Ethiopia, need permission from their husbands/fathers to get treatment for themselves or their children. Usually, they are reluctant to go to health care centres because if the doctors/nurses working there are male, cultural norms restrict them from going to get checked because they may be perceived as sexually disloyal.
<br>
<br>
Workload leaves the women with little time to attend to their own and their children's health so they are not in the habit of expressing their needs. Their inability to play the sick role due to household work, as well as generally being uneducated about such diseases, leads them to overlook a serious issue such as malaria.
<br>
<br>
Women also rely on their husband’s income/economic status to get to the treatment centre in case they’ve contracted malaria. If the husband makes a decision that it is futile to go to health care centres and instead decides that traditional/local healers will do the job, the wife cannot get the necessary means like money and transport to get to the nearest health care centre, which is usually a considerable distance away. In short, perceptions of quality of care at health centre are linked to previous experiences e.g. time taken (waiting time), staff availability/attitudes, in addition to drug availability and quality.
<br>
<br>
The applicability of ITNs (Insecticide-treated nets) is sharply linked to culturally acceptable sleeping patterns, in which gender plays a significant part. In some occurrences, young children sleep with the mother and are thus, sheltered by her bed-net if she has one. On the other hand, if a household only has one bed-net, precedence may be given to the male head of the household as he is the chief breadwinner. In other settings, men have very little access to the nets if they primarily sleep outside. Furthermore, women frequently have to demand their husband's permission for money to re-treat the nets, as it requires money to do so.
<br>
<br>
These points were proven by WHO as they found excess morbidity among women who were not employed, women living in lower socio-economic neighbourhoods, and those living in households without modern amenities due to lack of education and decision-making roles.
<br><br>

<h2>Pregnancy and Adolescence</h2>
<br>

<ul>
<li>Infection rate of malaria is greater in pregnant women because of their decreased immunity. </li>
<li>Especially vulnerable are pregnant adolescent girls, who might not seek timely care for malaria. </li>
</ul>
<br>
Even though one study in Uganda and Nigeria showed that pregnant adolescents acknowledged the significance of seeking preventive care for malaria, there were quite a few limitations that restricted access to health services, principally the stigma accompanying adolescent pregnancy and the unhelpful approach of health 
workers.
<br><br>
<div class="centre"><img src="https://static.igem.org/mediawiki/2015/d/da/TrinityDublin15_PregnantWoman.png" width="25%"></div>
<br><br>

<h2>Possible Solutions</h2>
<br>

In rural areas where health services are a long distance from villages, the provision of community-based malaria treatment through home management of malaria will greatly increase access and the attendance of men and women with their children for treatment and/or testing for malaria. 
<br><br>
Cheaper and more freely available artemisinin based drugs would mean that women will have better access to the medication when required as it will be more readily available in local dispensaries and also be much more affordable. 
<br><br>
The Global Fund endorses fair rights-based attitudes to health as their core principles and consequently, identifies that some population groups – such as women and girls– require explicit attention. The Global Fund funds numerous methods to attain equality comprising: 
<br><br>

<ul>
<li>Targeted services addressing rights and health needs of women and girls;</li> 
<li>Community systems strengthening to support and mobilize community demand;</li> 
<li>Interventions to address sociocultural and behavioral risk factors including harmful gender norms.</li> 
</ul>

<br>
Based on the Global Fund’s Gender Equality Strategy, the Global Fund promotes programs and seeks proposals that scale up services and interventions that reduce gender-related risks and vulnerabilities to three diseases (HIV, TB & Malaria) and address structural inequalities and discrimination to improve the health and lives of all women and men.
<br><br>
On the current situation of distribution of drugs  to the  locals, executive director Kathleen Monroe of Zagaya stated that: <q>In most African countries the cost is subsidized or free. The governments buy the drugs in huge bulk amounts and every year there are contracts and the price is set, and they’re the ones  responsible  for  distribution.  Countries  where governments  are  corrupt,  they  simply don’t abide by the fixed price rule. They sell it off to highest bidder of another country or just  don’t  distribute,  period.  Africa  is  a  big  country  and  every  country’s  government  is different, which is why there are tonnes of NGOs working to fix it where governments are corrupt. </q>

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