Intended for healthcare professionals

Education And Debate

Role of gender in health disparity: the South Asian context

BMJ 2004; 328 doi: (Published 01 April 2004) Cite this as: BMJ 2004;328:823
  1. Fariyal F Fikree (, program associate1,
  2. Omrana Pasha, manager, research projects2
  1. 1 International Program Division, Population Council, 1 Dag Hammarskjold Plaza, New York 10017, USA
  2. 2 Women's and Children's Center, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA
  1. Correspondence to: F F Fikree
  • Accepted 11 March 2004

South Asia's girls and women do not have the same life advantage as their Western counterparts. A human rights based approach may help to overcome gender related barriers and improve the wellbeing of men, women, and children.


Behaviour has an important role in health disparities—for example, young men take greater risks, causing injury and violent death, and men smoke more.1 In industrialised countries women are born with an advantage; their healthy life expectancy is two years longer and their life expectancy six years longer than those of men.2 This advantage is prominent in childhood; girls are more likely to survive the first five years of life than boys.2 However, does this female advantage endure in parts of the world where gender discrimination exists? We present the case of South Asia to illustrate the role that gender has on health.

The role of gender in South Asia

From many perspectives women in South Asia find themselves in subordinate positions to men and are socially, culturally, and economically dependent on them.3 Women are largely excluded from making decisions, have limited access to and control over resources, are restricted in their mobility, and are often under threat of violence from male relatives.4 Sons are perceived to have economic, social, or religious utility; daughters are often felt to be an economic liability because of the dowry system.5

We believe that individual and societal beliefs about and attitudes towards appropriate gender specific roles, and the choices of individuals and households on the basis of these factors, mean that women are disadvantaged with regard to health and health care. There are some instances in which gender differences hurt men's health—for example, men are more likely to be involved in road crashes or occupational accidents as they are more likely to be outside the home or in a …

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