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Advances in Gender-Transformative Approaches to Health Promotion.

Gender is an important determinant of health, but explicit attention to gender is often missing in health promotion. We build on Pederson and colleagues' gender-transformative framework for health promotion to propose four guiding principles for gender-transformative health promotion. First, health promotion must address gender norms directly if it is to improve health outcomes. Second, it should move beyond individual change to engage explicitly with structural and social determinants of health. Third, it should address underlying gender-related determinants in order to influence health outcomes. And fourth, it requires complexity-informed design, implementation, and evaluation. We provide background on key concepts that are essential for designing, implementing, and evaluating gender-transformative health promotion: gender norms, socioecological approaches, and the gender system. We give examples of the four principles in practice, using the case of postnatal mental health promotion in Australia and sexuality education in Mexico. These four principles can be applied to health promotion efforts across contexts and outcomes to address the harmful gender norms that contribute to poor health as a part of broader efforts to improve health and well-being.