Assessing the Gender-Responsiveness of Bhutan’s Cervical Cancer Plan and Related Strategies

Cervical cancer is the leading cause of mortality among women in many low- and middle-income countries (LMICs), prompting renewed attention through global, regional and national strategies. Bhutan’s cervical cancer strategy was introduced in 2019, positioning it as one of the few South Asian countries with a separate strategy. Considering the gender-health intersection, an analysis of Bhutan’s policies relevant to cervical cancer was conducted by operationalizing the World Health Organization’s Gender-Responsive Assessment Scale (GRAS) and Gender Assessment Tool (GAT). Bhutan’s cervical cancer strategy and other relevant strategies were assessed across a set of criteria with questions aimed at assessing the commitment to gender equality, sex-based considerations, inclusive participation, engagement of key stakeholders, incorporation of differential needs and gender norms, roles and relations while scrutinizing potential exclusions or assumptions based on sex. The present study indicates that, despite the progress made in general on prioritizing cervical cancer at the national level, achievement of a gender transformative design has not been achieved—although the program and linked policies demonstrate gender specificity and sensitivity to a large extent. The overall cancer policy appeared to be gender-blind. Two specific interventions are proposed: (1) to apply an intersectional approach to cervical cancer care and (2) to move away from the one-size-fits-all advocacy strategy. Future strategies could enhance the adoption of gender-transformative approaches by making efforts to consider how unequal gender norms, roles and relations influence the given health issue and also address the needs of relevant subgroups in tackling it. The evolution of the cervical cancer program in Bhutan, complemented by the gender analysis of cervical cancer-related strategies, offers lessons for countries to step up cervical cancer prevention and treatment initiatives by applying a gender lens.