The Value of Intersectionality within Health Systems Research
This year’s RESYST annual meeting included not one but two training sessions on how to apply an intersectionality lens to health systems research. For many researchers, this was their first exposure to intersectionality and the potential value of this approach. The training was carried out by members from RinGs – a cross-consortium research initiative on gender and ethics – and increasingly intersectionality – Rosemary Morgan, based at Johns Hopkins Bloomberg School of Public Health, and Sassy Molyneux and Kui Muryara from Kemri-Wellcome Trust Kenya.
What is intersectionality?
Intersectionality is a research approach that explores the interaction of different social categories such as race, ethnicity, gender, class, religion and sexuality. These categories might be fixed (e.g. race, ethnicity) or fluid (e.g. geography, occupation, migration status, professional identity). They intersect in dynamic and interactive ways to privilege or disadvantage (oppress) different people depending on their characteristics and contexts.
What is the value of intersectionality for health systems research?
While intersectionality is not a new concept, having been implemented in such areas as public health, health disparities research, mental health, and the social sciences, it is relatively new for health systems research.
Within health systems research:
- Intersectionality encourages a different way of looking at health systems: how problems are defined, how solutions are developed and implemented, and how policy, services, programs, and interventions are designed and evaluated.
- Intersectionality supports people-centred health systems. At the heart of health systems are people: health systems seek to serve people, are made up of people, operate through chains of relationships and are ideally based on value driven decisions based on justice, rights, respect, and equality. Intersectionality can help us to explore how power relations and inequities manifest within the health system and use that knowledge to develop socially just policies, services, and outcomes for all people.
- Intersectionality can help us to understand how inequities manifest within different areas of the health system, for example, in terms of service delivery - differential access to health services, inequities in quality of care, treatment choices, and treatment.
The purpose of the training session during the annual RESYST meeting was to introduce researchers to intersectionality and its value within health systems research, and provide practical examples of how it can be operationalized within their data collection and analysis. RinGs supports health systems researchers within RESYST and other member RPCs to think about the benefit an intersectionality lens will bring and how they can effectively incorporate it within their health systems research. We support individual researchers to apply this lens both prospectively – through the development of new research projects – and retrospectively – through analysing their existing data using an intersectional lens.
Questions for researchers to think about when applying an intersectionality lens
Even small steps to incorporate intersectionality can help deepen our understanding of health systems and the power relations and intersecting factors that affect how they function. For RESYST, intersectionality work to date has been a process of experimentation and of sharing new learning with the wider group of researchers to take forward in their work. We look forward to it playing a more prominent role in the future!
RESYST and RinGs have produced a research brief on Using Intersectionality to better understand health system resilience. The brief aims to help researchers hoping to adopt an intersectionality lens for their work in the future.