literature review for gender equality

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Research Article

Twenty years of gender equality research: A scoping review based on a new semantic indicator

Contributed equally to this work with: Paola Belingheri, Filippo Chiarello, Andrea Fronzetti Colladon, Paola Rovelli

Roles Conceptualization, Formal analysis, Funding acquisition, Visualization, Writing – original draft, Writing – review & editing

Affiliation Dipartimento di Ingegneria dell’Energia, dei Sistemi, del Territorio e delle Costruzioni, Università degli Studi di Pisa, Largo L. Lazzarino, Pisa, Italy

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Visualization, Writing – original draft, Writing – review & editing

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Software, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations Department of Engineering, University of Perugia, Perugia, Italy, Department of Management, Kozminski University, Warsaw, Poland

Roles Conceptualization, Formal analysis, Funding acquisition, Writing – original draft, Writing – review & editing

Affiliation Faculty of Economics and Management, Centre for Family Business Management, Free University of Bozen-Bolzano, Bozen-Bolzano, Italy

• Paola Belingheri, 
• Filippo Chiarello, 
• Andrea Fronzetti Colladon, 
• Paola Rovelli

• Published: September 21, 2021
• https://doi.org/10.1371/journal.pone.0256474
• Reader Comments

9 Nov 2021: The PLOS ONE Staff (2021) Correction: Twenty years of gender equality research: A scoping review based on a new semantic indicator. PLOS ONE 16(11): e0259930. https://doi.org/10.1371/journal.pone.0259930 View correction

Gender equality is a major problem that places women at a disadvantage thereby stymieing economic growth and societal advancement. In the last two decades, extensive research has been conducted on gender related issues, studying both their antecedents and consequences. However, existing literature reviews fail to provide a comprehensive and clear picture of what has been studied so far, which could guide scholars in their future research. Our paper offers a scoping review of a large portion of the research that has been published over the last 22 years, on gender equality and related issues, with a specific focus on business and economics studies. Combining innovative methods drawn from both network analysis and text mining, we provide a synthesis of 15,465 scientific articles. We identify 27 main research topics, we measure their relevance from a semantic point of view and the relationships among them, highlighting the importance of each topic in the overall gender discourse. We find that prominent research topics mostly relate to women in the workforce–e.g., concerning compensation, role, education, decision-making and career progression. However, some of them are losing momentum, and some other research trends–for example related to female entrepreneurship, leadership and participation in the board of directors–are on the rise. Besides introducing a novel methodology to review broad literature streams, our paper offers a map of the main gender-research trends and presents the most popular and the emerging themes, as well as their intersections, outlining important avenues for future research.

Citation: Belingheri P, Chiarello F, Fronzetti Colladon A, Rovelli P (2021) Twenty years of gender equality research: A scoping review based on a new semantic indicator. PLoS ONE 16(9): e0256474. https://doi.org/10.1371/journal.pone.0256474

Editor: Elisa Ughetto, Politecnico di Torino, ITALY

Received: June 25, 2021; Accepted: August 6, 2021; Published: September 21, 2021

Copyright: © 2021 Belingheri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its supporting information files. The only exception is the text of the abstracts (over 15,000) that we have downloaded from Scopus. These abstracts can be retrieved from Scopus, but we do not have permission to redistribute them.

Funding: P.B and F.C.: Grant of the Department of Energy, Systems, Territory and Construction of the University of Pisa (DESTEC) for the project “Measuring Gender Bias with Semantic Analysis: The Development of an Assessment Tool and its Application in the European Space Industry. P.B., F.C., A.F.C., P.R.: Grant of the Italian Association of Management Engineering (AiIG), “Misure di sostegno ai soci giovani AiIG” 2020, for the project “Gender Equality Through Data Intelligence (GEDI)”. F.C.: EU project ASSETs+ Project (Alliance for Strategic Skills addressing Emerging Technologies in Defence) EAC/A03/2018 - Erasmus+ programme, Sector Skills Alliances, Lot 3: Sector Skills Alliance for implementing a new strategic approach (Blueprint) to sectoral cooperation on skills G.A. NUMBER: 612678-EPP-1-2019-1-IT-EPPKA2-SSA-B.

Competing interests: The authors have declared that no competing interests exist.

Introduction

The persistent gender inequalities that currently exist across the developed and developing world are receiving increasing attention from economists, policymakers, and the general public [e.g., 1 – 3 ]. Economic studies have indicated that women’s education and entry into the workforce contributes to social and economic well-being [e.g., 4 , 5 ], while their exclusion from the labor market and from managerial positions has an impact on overall labor productivity and income per capita [ 6 , 7 ]. The United Nations selected gender equality, with an emphasis on female education, as part of the Millennium Development Goals [ 8 ], and gender equality at-large as one of the 17 Sustainable Development Goals (SDGs) to be achieved by 2030 [ 9 ]. These latter objectives involve not only developing nations, but rather all countries, to achieve economic, social and environmental well-being.

As is the case with many SDGs, gender equality is still far from being achieved and persists across education, access to opportunities, or presence in decision-making positions [ 7 , 10 , 11 ]. As we enter the last decade for the SDGs’ implementation, and while we are battling a global health pandemic, effective and efficient action becomes paramount to reach this ambitious goal.

Scholars have dedicated a massive effort towards understanding gender equality, its determinants, its consequences for women and society, and the appropriate actions and policies to advance women’s equality. Many topics have been covered, ranging from women’s education and human capital [ 12 , 13 ] and their role in society [e.g., 14 , 15 ], to their appointment in firms’ top ranked positions [e.g., 16 , 17 ] and performance implications [e.g., 18 , 19 ]. Despite some attempts, extant literature reviews provide a narrow view on these issues, restricted to specific topics–e.g., female students’ presence in STEM fields [ 20 ], educational gender inequality [ 5 ], the gender pay gap [ 21 ], the glass ceiling effect [ 22 ], leadership [ 23 ], entrepreneurship [ 24 ], women’s presence on the board of directors [ 25 , 26 ], diversity management [ 27 ], gender stereotypes in advertisement [ 28 ], or specific professions [ 29 ]. A comprehensive view on gender-related research, taking stock of key findings and under-studied topics is thus lacking.

Extant literature has also highlighted that gender issues, and their economic and social ramifications, are complex topics that involve a large number of possible antecedents and outcomes [ 7 ]. Indeed, gender equality actions are most effective when implemented in unison with other SDGs (e.g., with SDG 8, see [ 30 ]) in a synergetic perspective [ 10 ]. Many bodies of literature (e.g., business, economics, development studies, sociology and psychology) approach the problem of achieving gender equality from different perspectives–often addressing specific and narrow aspects. This sometimes leads to a lack of clarity about how different issues, circumstances, and solutions may be related in precipitating or mitigating gender inequality or its effects. As the number of papers grows at an increasing pace, this issue is exacerbated and there is a need to step back and survey the body of gender equality literature as a whole. There is also a need to examine synergies between different topics and approaches, as well as gaps in our understanding of how different problems and solutions work together. Considering the important topic of women’s economic and social empowerment, this paper aims to fill this gap by answering the following research question: what are the most relevant findings in the literature on gender equality and how do they relate to each other ?

To do so, we conduct a scoping review [ 31 ], providing a synthesis of 15,465 articles dealing with gender equity related issues published in the last twenty-two years, covering both the periods of the MDGs and the SDGs (i.e., 2000 to mid 2021) in all the journals indexed in the Academic Journal Guide’s 2018 ranking of business and economics journals. Given the huge amount of research conducted on the topic, we adopt an innovative methodology, which relies on social network analysis and text mining. These techniques are increasingly adopted when surveying large bodies of text. Recently, they were applied to perform analysis of online gender communication differences [ 32 ] and gender behaviors in online technology communities [ 33 ], to identify and classify sexual harassment instances in academia [ 34 ], and to evaluate the gender inclusivity of disaster management policies [ 35 ].

Applied to the title, abstracts and keywords of the articles in our sample, this methodology allows us to identify a set of 27 recurrent topics within which we automatically classify the papers. Introducing additional novelty, by means of the Semantic Brand Score (SBS) indicator [ 36 ] and the SBS BI app [ 37 ], we assess the importance of each topic in the overall gender equality discourse and its relationships with the other topics, as well as trends over time, with a more accurate description than that offered by traditional literature reviews relying solely on the number of papers presented in each topic.

This methodology, applied to gender equality research spanning the past twenty-two years, enables two key contributions. First, we extract the main message that each document is conveying and how this is connected to other themes in literature, providing a rich picture of the topics that are at the center of the discourse, as well as of the emerging topics. Second, by examining the semantic relationship between topics and how tightly their discourses are linked, we can identify the key relationships and connections between different topics. This semi-automatic methodology is also highly reproducible with minimum effort.

This literature review is organized as follows. In the next section, we present how we selected relevant papers and how we analyzed them through text mining and social network analysis. We then illustrate the importance of 27 selected research topics, measured by means of the SBS indicator. In the results section, we present an overview of the literature based on the SBS results–followed by an in-depth narrative analysis of the top 10 topics (i.e., those with the highest SBS) and their connections. Subsequently, we highlight a series of under-studied connections between the topics where there is potential for future research. Through this analysis, we build a map of the main gender-research trends in the last twenty-two years–presenting the most popular themes. We conclude by highlighting key areas on which research should focused in the future.

Our aim is to map a broad topic, gender equality research, that has been approached through a host of different angles and through different disciplines. Scoping reviews are the most appropriate as they provide the freedom to map different themes and identify literature gaps, thereby guiding the recommendation of new research agendas [ 38 ].

Several practical approaches have been proposed to identify and assess the underlying topics of a specific field using big data [ 39 – 41 ], but many of them fail without proper paper retrieval and text preprocessing. This is specifically true for a research field such as the gender-related one, which comprises the work of scholars from different backgrounds. In this section, we illustrate a novel approach for the analysis of scientific (gender-related) papers that relies on methods and tools of social network analysis and text mining. Our procedure has four main steps: (1) data collection, (2) text preprocessing, (3) keywords extraction and classification, and (4) evaluation of semantic importance and image.

Data collection

In this study, we analyze 22 years of literature on gender-related research. Following established practice for scoping reviews [ 42 ], our data collection consisted of two main steps, which we summarize here below.

Firstly, we retrieved from the Scopus database all the articles written in English that contained the term “gender” in their title, abstract or keywords and were published in a journal listed in the Academic Journal Guide 2018 ranking of the Chartered Association of Business Schools (CABS) ( https://charteredabs.org/wp-content/uploads/2018/03/AJG2018-Methodology.pdf ), considering the time period from Jan 2000 to May 2021. We used this information considering that abstracts, titles and keywords represent the most informative part of a paper, while using the full-text would increase the signal-to-noise ratio for information extraction. Indeed, these textual elements already demonstrated to be reliable sources of information for the task of domain lexicon extraction [ 43 , 44 ]. We chose Scopus as source of literature because of its popularity, its update rate, and because it offers an API to ease the querying process. Indeed, while it does not allow to retrieve the full text of scientific articles, the Scopus API offers access to titles, abstracts, citation information and metadata for all its indexed scholarly journals. Moreover, we decided to focus on the journals listed in the AJG 2018 ranking because we were interested in reviewing business and economics related gender studies only. The AJG is indeed widely used by universities and business schools as a reference point for journal and research rigor and quality. This first step, executed in June 2021, returned more than 55,000 papers.

In the second step–because a look at the papers showed very sparse results, many of which were not in line with the topic of this literature review (e.g., papers dealing with health care or medical issues, where the word gender indicates the gender of the patients)–we applied further inclusion criteria to make the sample more focused on the topic of this literature review (i.e., women’s gender equality issues). Specifically, we only retained those papers mentioning, in their title and/or abstract, both gender-related keywords (e.g., daughter, female, mother) and keywords referring to bias and equality issues (e.g., equality, bias, diversity, inclusion). After text pre-processing (see next section), keywords were first identified from a frequency-weighted list of words found in the titles, abstracts and keywords in the initial list of papers, extracted through text mining (following the same approach as [ 43 ]). They were selected by two of the co-authors independently, following respectively a bottom up and a top-down approach. The bottom-up approach consisted of examining the words found in the frequency-weighted list and classifying those related to gender and equality. The top-down approach consisted in searching in the word list for notable gender and equality-related words. Table 1 reports the sets of keywords we considered, together with some examples of words that were used to search for their presence in the dataset (a full list is provided in the S1 Text ). At end of this second step, we obtained a final sample of 15,465 relevant papers.

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https://doi.org/10.1371/journal.pone.0256474.t001

Text processing and keyword extraction

Text preprocessing aims at structuring text into a form that can be analyzed by statistical models. In the present section, we describe the preprocessing steps we applied to paper titles and abstracts, which, as explained below, partially follow a standard text preprocessing pipeline [ 45 ]. These activities have been performed using the R package udpipe [ 46 ].

The first step is n-gram extraction (i.e., a sequence of words from a given text sample) to identify which n-grams are important in the analysis, since domain-specific lexicons are often composed by bi-grams and tri-grams [ 47 ]. Multi-word extraction is usually implemented with statistics and linguistic rules, thus using the statistical properties of n-grams or machine learning approaches [ 48 ]. However, for the present paper, we used Scopus metadata in order to have a more effective and efficient n-grams collection approach [ 49 ]. We used the keywords of each paper in order to tag n-grams with their associated keywords automatically. Using this greedy approach, it was possible to collect all the keywords listed by the authors of the papers. From this list, we extracted only keywords composed by two, three and four words, we removed all the acronyms and rare keywords (i.e., appearing in less than 1% of papers), and we clustered keywords showing a high orthographic similarity–measured using a Levenshtein distance [ 50 ] lower than 2, considering these groups of keywords as representing same concepts, but expressed with different spelling. After tagging the n-grams in the abstracts, we followed a common data preparation pipeline that consists of the following steps: (i) tokenization, that splits the text into tokens (i.e., single words and previously tagged multi-words); (ii) removal of stop-words (i.e. those words that add little meaning to the text, usually being very common and short functional words–such as “and”, “or”, or “of”); (iii) parts-of-speech tagging, that is providing information concerning the morphological role of a word and its morphosyntactic context (e.g., if the token is a determiner, the next token is a noun or an adjective with very high confidence, [ 51 ]); and (iv) lemmatization, which consists in substituting each word with its dictionary form (or lemma). The output of the latter step allows grouping together the inflected forms of a word. For example, the verbs “am”, “are”, and “is” have the shared lemma “be”, or the nouns “cat” and “cats” both share the lemma “cat”. We preferred lemmatization over stemming [ 52 ] in order to obtain more interpretable results.

In addition, we identified a further set of keywords (with respect to those listed in the “keywords” field) by applying a series of automatic words unification and removal steps, as suggested in past research [ 53 , 54 ]. We removed: sparse terms (i.e., occurring in less than 0.1% of all documents), common terms (i.e., occurring in more than 10% of all documents) and retained only nouns and adjectives. It is relevant to notice that no document was lost due to these steps. We then used the TF-IDF function [ 55 ] to produce a new list of keywords. We additionally tested other approaches for the identification and clustering of keywords–such as TextRank [ 56 ] or Latent Dirichlet Allocation [ 57 ]–without obtaining more informative results.

Classification of research topics

To guide the literature analysis, two experts met regularly to examine the sample of collected papers and to identify the main topics and trends in gender research. Initially, they conducted brainstorming sessions on the topics they expected to find, due to their knowledge of the literature. This led to an initial list of topics. Subsequently, the experts worked independently, also supported by the keywords in paper titles and abstracts extracted with the procedure described above.

Considering all this information, each expert identified and clustered relevant keywords into topics. At the end of the process, the two assignments were compared and exhibited a 92% agreement. Another meeting was held to discuss discordant cases and reach a consensus. This resulted in a list of 27 topics, briefly introduced in Table 2 and subsequently detailed in the following sections.

https://doi.org/10.1371/journal.pone.0256474.t002

Evaluation of semantic importance

Working on the lemmatized corpus of the 15,465 papers included in our sample, we proceeded with the evaluation of semantic importance trends for each topic and with the analysis of their connections and prevalent textual associations. To this aim, we used the Semantic Brand Score indicator [ 36 ], calculated through the SBS BI webapp [ 37 ] that also produced a brand image report for each topic. For this study we relied on the computing resources of the ENEA/CRESCO infrastructure [ 58 ].

The Semantic Brand Score (SBS) is a measure of semantic importance that combines methods of social network analysis and text mining. It is usually applied for the analysis of (big) textual data to evaluate the importance of one or more brands, names, words, or sets of keywords [ 36 ]. Indeed, the concept of “brand” is intended in a flexible way and goes beyond products or commercial brands. In this study, we evaluate the SBS time-trends of the keywords defining the research topics discussed in the previous section. Semantic importance comprises the three dimensions of topic prevalence, diversity and connectivity. Prevalence measures how frequently a research topic is used in the discourse. The more a topic is mentioned by scientific articles, the more the research community will be aware of it, with possible increase of future studies; this construct is partly related to that of brand awareness [ 59 ]. This effect is even stronger, considering that we are analyzing the title, abstract and keywords of the papers, i.e. the parts that have the highest visibility. A very important characteristic of the SBS is that it considers the relationships among words in a text. Topic importance is not just a matter of how frequently a topic is mentioned, but also of the associations a topic has in the text. Specifically, texts are transformed into networks of co-occurring words, and relationships are studied through social network analysis [ 60 ]. This step is necessary to calculate the other two dimensions of our semantic importance indicator. Accordingly, a social network of words is generated for each time period considered in the analysis–i.e., a graph made of n nodes (words) and E edges weighted by co-occurrence frequency, with W being the set of edge weights. The keywords representing each topic were clustered into single nodes.

The construct of diversity relates to that of brand image [ 59 ], in the sense that it considers the richness and distinctiveness of textual (topic) associations. Considering the above-mentioned networks, we calculated diversity using the distinctiveness centrality metric–as in the formula presented by Fronzetti Colladon and Naldi [ 61 ].

Lastly, connectivity was measured as the weighted betweenness centrality [ 62 , 63 ] of each research topic node. We used the formula presented by Wasserman and Faust [ 60 ]. The dimension of connectivity represents the “brokerage power” of each research topic–i.e., how much it can serve as a bridge to connect other terms (and ultimately topics) in the discourse [ 36 ].

The SBS is the final composite indicator obtained by summing the standardized scores of prevalence, diversity and connectivity. Standardization was carried out considering all the words in the corpus, for each specific timeframe.

This methodology, applied to a large and heterogeneous body of text, enables to automatically identify two important sets of information that add value to the literature review. Firstly, the relevance of each topic in literature is measured through a composite indicator of semantic importance, rather than simply looking at word frequencies. This provides a much richer picture of the topics that are at the center of the discourse, as well as of the topics that are emerging in the literature. Secondly, it enables to examine the extent of the semantic relationship between topics, looking at how tightly their discourses are linked. In a field such as gender equality, where many topics are closely linked to each other and present overlaps in issues and solutions, this methodology offers a novel perspective with respect to traditional literature reviews. In addition, it ensures reproducibility over time and the possibility to semi-automatically update the analysis, as new papers become available.

Overview of main topics

In terms of descriptive textual statistics, our corpus is made of 15,465 text documents, consisting of a total of 2,685,893 lemmatized tokens (words) and 32,279 types. As a result, the type-token ratio is 1.2%. The number of hapaxes is 12,141, with a hapax-token ratio of 37.61%.

Fig 1 shows the list of 27 topics by decreasing SBS. The most researched topic is compensation , exceeding all others in prevalence, diversity, and connectivity. This means it is not only mentioned more often than other topics, but it is also connected to a greater number of other topics and is central to the discourse on gender equality. The next four topics are, in order of SBS, role , education , decision-making , and career progression . These topics, except for education , all concern women in the workforce. Between these first five topics and the following ones there is a clear drop in SBS scores. In particular, the topics that follow have a lower connectivity than the first five. They are hiring , performance , behavior , organization , and human capital . Again, except for behavior and human capital , the other three topics are purely related to women in the workforce. After another drop-off, the following topics deal prevalently with women in society. This trend highlights that research on gender in business journals has so far mainly paid attention to the conditions that women experience in business contexts, while also devoting some attention to women in society.

https://doi.org/10.1371/journal.pone.0256474.g001

Fig 2 shows the SBS time series of the top 10 topics. While there has been a general increase in the number of Scopus-indexed publications in the last decade, we notice that some SBS trends remain steady, or even decrease. In particular, we observe that the main topic of the last twenty-two years, compensation , is losing momentum. Since 2016, it has been surpassed by decision-making , education and role , which may indicate that literature is increasingly attempting to identify root causes of compensation inequalities. Moreover, in the last two years, the topics of hiring , performance , and organization are experiencing the largest importance increase.

https://doi.org/10.1371/journal.pone.0256474.g002

Fig 3 shows the SBS time trends of the remaining 17 topics (i.e., those not in the top 10). As we can see from the graph, there are some that maintain a steady trend–such as reputation , management , networks and governance , which also seem to have little importance. More relevant topics with average stationary trends (except for the last two years) are culture , family , and parenting . The feminine topic is among the most important here, and one of those that exhibit the larger variations over time (similarly to leadership ). On the other hand, the are some topics that, even if not among the most important, show increasing SBS trends; therefore, they could be considered as emerging topics and could become popular in the near future. These are entrepreneurship , leadership , board of directors , and sustainability . These emerging topics are also interesting to anticipate future trends in gender equality research that are conducive to overall equality in society.

https://doi.org/10.1371/journal.pone.0256474.g003

In addition to the SBS score of the different topics, the network of terms they are associated to enables to gauge the extent to which their images (textual associations) overlap or differ ( Fig 4 ).

https://doi.org/10.1371/journal.pone.0256474.g004

There is a central cluster of topics with high similarity, which are all connected with women in the workforce. The cluster includes topics such as organization , decision-making , performance , hiring , human capital , education and compensation . In addition, the topic of well-being is found within this cluster, suggesting that women’s equality in the workforce is associated to well-being considerations. The emerging topics of entrepreneurship and leadership are also closely connected with each other, possibly implying that leadership is a much-researched quality in female entrepreneurship. Topics that are relatively more distant include personality , politics , feminine , empowerment , management , board of directors , reputation , governance , parenting , masculine and network .

The following sections describe the top 10 topics and their main associations in literature (see Table 3 ), while providing a brief overview of the emerging topics.

https://doi.org/10.1371/journal.pone.0256474.t003

Compensation.

The topic of compensation is related to the topics of role , hiring , education and career progression , however, also sees a very high association with the words gap and inequality . Indeed, a well-known debate in degrowth economics centers around whether and how to adequately compensate women for their childbearing, childrearing, caregiver and household work [e.g., 30 ].

Even in paid work, women continue being offered lower compensations than their male counterparts who have the same job or cover the same role [ 64 – 67 ]. This severe inequality has been widely studied by scholars over the last twenty-two years. Dealing with this topic, some specific roles have been addressed. Specifically, research highlighted differences in compensation between female and male CEOs [e.g., 68 ], top executives [e.g., 69 ], and boards’ directors [e.g., 70 ]. Scholars investigated the determinants of these gaps, such as the gender composition of the board [e.g., 71 – 73 ] or women’s individual characteristics [e.g., 71 , 74 ].

Among these individual characteristics, education plays a relevant role [ 75 ]. Education is indeed presented as the solution for women, not only to achieve top executive roles, but also to reduce wage inequality [e.g., 76 , 77 ]. Past research has highlighted education influences on gender wage gaps, specifically referring to gender differences in skills [e.g., 78 ], college majors [e.g., 79 ], and college selectivity [e.g., 80 ].

Finally, the wage gap issue is strictly interrelated with hiring –e.g., looking at whether being a mother affects hiring and compensation [e.g., 65 , 81 ] or relating compensation to unemployment [e.g., 82 ]–and career progression –for instance looking at meritocracy [ 83 , 84 ] or the characteristics of the boss for whom women work [e.g., 85 ].

The roles covered by women have been deeply investigated. Scholars have focused on the role of women in their families and the society as a whole [e.g., 14 , 15 ], and, more widely, in business contexts [e.g., 18 , 81 ]. Indeed, despite still lagging behind their male counterparts [e.g., 86 , 87 ], in the last decade there has been an increase in top ranked positions achieved by women [e.g., 88 , 89 ]. Following this phenomenon, scholars have posed greater attention towards the presence of women in the board of directors [e.g., 16 , 18 , 90 , 91 ], given the increasing pressure to appoint female directors that firms, especially listed ones, have experienced. Other scholars have focused on the presence of women covering the role of CEO [e.g., 17 , 92 ] or being part of the top management team [e.g., 93 ]. Irrespectively of the level of analysis, all these studies tried to uncover the antecedents of women’s presence among top managers [e.g., 92 , 94 ] and the consequences of having a them involved in the firm’s decision-making –e.g., on performance [e.g., 19 , 95 , 96 ], risk [e.g., 97 , 98 ], and corporate social responsibility [e.g., 99 , 100 ].

Besides studying the difficulties and discriminations faced by women in getting a job [ 81 , 101 ], and, more specifically in the hiring , appointment, or career progression to these apical roles [e.g., 70 , 83 ], the majority of research of women’s roles dealt with compensation issues. Specifically, scholars highlight the pay-gap that still exists between women and men, both in general [e.g., 64 , 65 ], as well as referring to boards’ directors [e.g., 70 , 102 ], CEOs and executives [e.g., 69 , 103 , 104 ].

Finally, other scholars focused on the behavior of women when dealing with business. In this sense, particular attention has been paid to leadership and entrepreneurial behaviors. The former quite overlaps with dealing with the roles mentioned above, but also includes aspects such as leaders being stereotyped as masculine [e.g., 105 ], the need for greater exposure to female leaders to reduce biases [e.g., 106 ], or female leaders acting as queen bees [e.g., 107 ]. Regarding entrepreneurship , scholars mainly investigated women’s entrepreneurial entry [e.g., 108 , 109 ], differences between female and male entrepreneurs in the evaluations and funding received from investors [e.g., 110 , 111 ], and their performance gap [e.g., 112 , 113 ].

Education has long been recognized as key to social advancement and economic stability [ 114 ], for job progression and also a barrier to gender equality, especially in STEM-related fields. Research on education and gender equality is mostly linked with the topics of compensation , human capital , career progression , hiring , parenting and decision-making .

Education contributes to a higher human capital [ 115 ] and constitutes an investment on the part of women towards their future. In this context, literature points to the gender gap in educational attainment, and the consequences for women from a social, economic, personal and professional standpoint. Women are found to have less access to formal education and information, especially in emerging countries, which in turn may cause them to lose social and economic opportunities [e.g., 12 , 116 – 119 ]. Education in local and rural communities is also paramount to communicate the benefits of female empowerment , contributing to overall societal well-being [e.g., 120 ].

Once women access education, the image they have of the world and their place in society (i.e., habitus) affects their education performance [ 13 ] and is passed on to their children. These situations reinforce gender stereotypes, which become self-fulfilling prophecies that may negatively affect female students’ performance by lowering their confidence and heightening their anxiety [ 121 , 122 ]. Besides formal education, also the information that women are exposed to on a daily basis contributes to their human capital . Digital inequalities, for instance, stems from men spending more time online and acquiring higher digital skills than women [ 123 ].

Education is also a factor that should boost employability of candidates and thus hiring , career progression and compensation , however the relationship between these factors is not straightforward [ 115 ]. First, educational choices ( decision-making ) are influenced by variables such as self-efficacy and the presence of barriers, irrespectively of the career opportunities they offer, especially in STEM [ 124 ]. This brings additional difficulties to women’s enrollment and persistence in scientific and technical fields of study due to stereotypes and biases [ 125 , 126 ]. Moreover, access to education does not automatically translate into job opportunities for women and minority groups [ 127 , 128 ] or into female access to managerial positions [ 129 ].

Finally, parenting is reported as an antecedent of education [e.g., 130 ], with much of the literature focusing on the role of parents’ education on the opportunities afforded to children to enroll in education [ 131 – 134 ] and the role of parenting in their offspring’s perception of study fields and attitudes towards learning [ 135 – 138 ]. Parental education is also a predictor of the other related topics, namely human capital and compensation [ 139 ].

Decision-making.

This literature mainly points to the fact that women are thought to make decisions differently than men. Women have indeed different priorities, such as they care more about people’s well-being, working with people or helping others, rather than maximizing their personal (or their firm’s) gain [ 140 ]. In other words, women typically present more communal than agentic behaviors, which are instead more frequent among men [ 141 ]. These different attitude, behavior and preferences in turn affect the decisions they make [e.g., 142 ] and the decision-making of the firm in which they work [e.g., 143 ].

At the individual level, gender affects, for instance, career aspirations [e.g., 144 ] and choices [e.g., 142 , 145 ], or the decision of creating a venture [e.g., 108 , 109 , 146 ]. Moreover, in everyday life, women and men make different decisions regarding partners [e.g., 147 ], childcare [e.g., 148 ], education [e.g., 149 ], attention to the environment [e.g., 150 ] and politics [e.g., 151 ].

At the firm level, scholars highlighted, for example, how the presence of women in the board affects corporate decisions [e.g., 152 , 153 ], that female CEOs are more conservative in accounting decisions [e.g., 154 ], or that female CFOs tend to make more conservative decisions regarding the firm’s financial reporting [e.g., 155 ]. Nevertheless, firm level research also investigated decisions that, influenced by gender bias, affect women, such as those pertaining hiring [e.g., 156 , 157 ], compensation [e.g., 73 , 158 ], or the empowerment of women once appointed [ 159 ].

Career progression.

Once women have entered the workforce, the key aspect to achieve gender equality becomes career progression , including efforts toward overcoming the glass ceiling. Indeed, according to the SBS analysis, career progression is highly related to words such as work, social issues and equality. The topic with which it has the highest semantic overlap is role , followed by decision-making , hiring , education , compensation , leadership , human capital , and family .

Career progression implies an advancement in the hierarchical ladder of the firm, assigning managerial roles to women. Coherently, much of the literature has focused on identifying rationales for a greater female participation in the top management team and board of directors [e.g., 95 ] as well as the best criteria to ensure that the decision-makers promote the most valuable employees irrespectively of their individual characteristics, such as gender [e.g., 84 ]. The link between career progression , role and compensation is often provided in practice by performance appraisal exercises, frequently rooted in a culture of meritocracy that guides bonuses, salary increases and promotions. However, performance appraisals can actually mask gender-biased decisions where women are held to higher standards than their male colleagues [e.g., 83 , 84 , 95 , 160 , 161 ]. Women often have less opportunities to gain leadership experience and are less visible than their male colleagues, which constitute barriers to career advancement [e.g., 162 ]. Therefore, transparency and accountability, together with procedures that discourage discretionary choices, are paramount to achieve a fair career progression [e.g., 84 ], together with the relaxation of strict job boundaries in favor of cross-functional and self-directed tasks [e.g., 163 ].

In addition, a series of stereotypes about the type of leadership characteristics that are required for top management positions, which fit better with typical male and agentic attributes, are another key barrier to career advancement for women [e.g., 92 , 160 ].

Hiring is the entrance gateway for women into the workforce. Therefore, it is related to other workforce topics such as compensation , role , career progression , decision-making , human capital , performance , organization and education .

A first stream of literature focuses on the process leading up to candidates’ job applications, demonstrating that bias exists before positions are even opened, and it is perpetuated both by men and women through networking and gatekeeping practices [e.g., 164 , 165 ].

The hiring process itself is also subject to biases [ 166 ], for example gender-congruity bias that leads to men being preferred candidates in male-dominated sectors [e.g., 167 ], women being hired in positions with higher risk of failure [e.g., 168 ] and limited transparency and accountability afforded by written processes and procedures [e.g., 164 ] that all contribute to ascriptive inequality. In addition, providing incentives for evaluators to hire women may actually work to this end; however, this is not the case when supporting female candidates endangers higher-ranking male ones [ 169 ].

Another interesting perspective, instead, looks at top management teams’ composition and the effects on hiring practices, indicating that firms with more women in top management are less likely to lay off staff [e.g., 152 ].

Performance.

Several scholars posed their attention towards women’s performance, its consequences [e.g., 170 , 171 ] and the implications of having women in decision-making positions [e.g., 18 , 19 ].

At the individual level, research focused on differences in educational and academic performance between women and men, especially referring to the gender gap in STEM fields [e.g., 171 ]. The presence of stereotype threats–that is the expectation that the members of a social group (e.g., women) “must deal with the possibility of being judged or treated stereotypically, or of doing something that would confirm the stereotype” [ 172 ]–affects women’s interested in STEM [e.g., 173 ], as well as their cognitive ability tests, penalizing them [e.g., 174 ]. A stronger gender identification enhances this gap [e.g., 175 ], whereas mentoring and role models can be used as solutions to this problem [e.g., 121 ]. Despite the negative effect of stereotype threats on girls’ performance [ 176 ], female and male students perform equally in mathematics and related subjects [e.g., 177 ]. Moreover, while individuals’ performance at school and university generally affects their achievements and the field in which they end up working, evidence reveals that performance in math or other scientific subjects does not explain why fewer women enter STEM working fields; rather this gap depends on other aspects, such as culture, past working experiences, or self-efficacy [e.g., 170 ]. Finally, scholars have highlighted the penalization that women face for their positive performance, for instance when they succeed in traditionally male areas [e.g., 178 ]. This penalization is explained by the violation of gender-stereotypic prescriptions [e.g., 179 , 180 ], that is having women well performing in agentic areas, which are typical associated to men. Performance penalization can thus be overcome by clearly conveying communal characteristics and behaviors [ 178 ].

Evidence has been provided on how the involvement of women in boards of directors and decision-making positions affects firms’ performance. Nevertheless, results are mixed, with some studies showing positive effects on financial [ 19 , 181 , 182 ] and corporate social performance [ 99 , 182 , 183 ]. Other studies maintain a negative association [e.g., 18 ], and other again mixed [e.g., 184 ] or non-significant association [e.g., 185 ]. Also with respect to the presence of a female CEO, mixed results emerged so far, with some researches demonstrating a positive effect on firm’s performance [e.g., 96 , 186 ], while other obtaining only a limited evidence of this relationship [e.g., 103 ] or a negative one [e.g., 187 ].

Finally, some studies have investigated whether and how women’s performance affects their hiring [e.g., 101 ] and career progression [e.g., 83 , 160 ]. For instance, academic performance leads to different returns in hiring for women and men. Specifically, high-achieving men are called back significantly more often than high-achieving women, which are penalized when they have a major in mathematics; this result depends on employers’ gendered standards for applicants [e.g., 101 ]. Once appointed, performance ratings are more strongly related to promotions for women than men, and promoted women typically show higher past performance ratings than those of promoted men. This suggesting that women are subject to stricter standards for promotion [e.g., 160 ].

Behavioral aspects related to gender follow two main streams of literature. The first examines female personality and behavior in the workplace, and their alignment with cultural expectations or stereotypes [e.g., 188 ] as well as their impacts on equality. There is a common bias that depicts women as less agentic than males. Certain characteristics, such as those more congruent with male behaviors–e.g., self-promotion [e.g., 189 ], negotiation skills [e.g., 190 ] and general agentic behavior [e.g., 191 ]–, are less accepted in women. However, characteristics such as individualism in women have been found to promote greater gender equality in society [ 192 ]. In addition, behaviors such as display of emotions [e.g., 193 ], which are stereotypically female, work against women’s acceptance in the workplace, requiring women to carefully moderate their behavior to avoid exclusion. A counter-intuitive result is that women and minorities, which are more marginalized in the workplace, tend to be better problem-solvers in innovation competitions due to their different knowledge bases [ 194 ].

The other side of the coin is examined in a parallel literature stream on behavior towards women in the workplace. As a result of biases, prejudices and stereotypes, women may experience adverse behavior from their colleagues, such as incivility and harassment, which undermine their well-being [e.g., 195 , 196 ]. Biases that go beyond gender, such as for overweight people, are also more strongly applied to women [ 197 ].

Organization.

The role of women and gender bias in organizations has been studied from different perspectives, which mirror those presented in detail in the following sections. Specifically, most research highlighted the stereotypical view of leaders [e.g., 105 ] and the roles played by women within firms, for instance referring to presence in the board of directors [e.g., 18 , 90 , 91 ], appointment as CEOs [e.g., 16 ], or top executives [e.g., 93 ].

Scholars have investigated antecedents and consequences of the presence of women in these apical roles. On the one side they looked at hiring and career progression [e.g., 83 , 92 , 160 , 168 , 198 ], finding women typically disadvantaged with respect to their male counterparts. On the other side, they studied women’s leadership styles and influence on the firm’s decision-making [e.g., 152 , 154 , 155 , 199 ], with implications for performance [e.g., 18 , 19 , 96 ].

Human capital.

Human capital is a transverse topic that touches upon many different aspects of female gender equality. As such, it has the most associations with other topics, starting with education as mentioned above, with career-related topics such as role , decision-making , hiring , career progression , performance , compensation , leadership and organization . Another topic with which there is a close connection is behavior . In general, human capital is approached both from the education standpoint but also from the perspective of social capital.

The behavioral aspect in human capital comprises research related to gender differences for example in cultural and religious beliefs that influence women’s attitudes and perceptions towards STEM subjects [ 142 , 200 – 202 ], towards employment [ 203 ] or towards environmental issues [ 150 , 204 ]. These cultural differences also emerge in the context of globalization which may accelerate gender equality in the workforce [ 205 , 206 ]. Gender differences also appear in behaviors such as motivation [ 207 ], and in negotiation [ 190 ], and have repercussions on women’s decision-making related to their careers. The so-called gender equality paradox sees women in countries with lower gender equality more likely to pursue studies and careers in STEM fields, whereas the gap in STEM enrollment widens as countries achieve greater equality in society [ 171 ].

Career progression is modeled by literature as a choice-process where personal preferences, culture and decision-making affect the chosen path and the outcomes. Some literature highlights how women tend to self-select into different professions than men, often due to stereotypes rather than actual ability to perform in these professions [ 142 , 144 ]. These stereotypes also affect the perceptions of female performance or the amount of human capital required to equal male performance [ 110 , 193 , 208 ], particularly for mothers [ 81 ]. It is therefore often assumed that women are better suited to less visible and less leadership -oriented roles [ 209 ]. Women also express differing preferences towards work-family balance, which affect whether and how they pursue human capital gains [ 210 ], and ultimately their career progression and salary .

On the other hand, men are often unaware of gendered processes and behaviors that they carry forward in their interactions and decision-making [ 211 , 212 ]. Therefore, initiatives aimed at increasing managers’ human capital –by raising awareness of gender disparities in their organizations and engaging them in diversity promotion–are essential steps to counter gender bias and segregation [ 213 ].

Emerging topics: Leadership and entrepreneurship

Among the emerging topics, the most pervasive one is women reaching leadership positions in the workforce and in society. This is still a rare occurrence for two main types of factors, on the one hand, bias and discrimination make it harder for women to access leadership positions [e.g., 214 – 216 ], on the other hand, the competitive nature and high pressure associated with leadership positions, coupled with the lack of women currently represented, reduce women’s desire to achieve them [e.g., 209 , 217 ]. Women are more effective leaders when they have access to education, resources and a diverse environment with representation [e.g., 218 , 219 ].

One sector where there is potential for women to carve out a leadership role is entrepreneurship . Although at the start of the millennium the discourse on entrepreneurship was found to be “discriminatory, gender-biased, ethnocentrically determined and ideologically controlled” [ 220 ], an increasing body of literature is studying how to stimulate female entrepreneurship as an alternative pathway to wealth, leadership and empowerment [e.g., 221 ]. Many barriers exist for women to access entrepreneurship, including the institutional and legal environment, social and cultural factors, access to knowledge and resources, and individual behavior [e.g., 222 , 223 ]. Education has been found to raise women’s entrepreneurial intentions [e.g., 224 ], although this effect is smaller than for men [e.g., 109 ]. In addition, increasing self-efficacy and risk-taking behavior constitute important success factors [e.g., 225 ].

Finally, the topic of sustainability is worth mentioning, as it is the primary objective of the SDGs and is closely associated with societal well-being. As society grapples with the effects of climate change and increasing depletion of natural resources, a narrative has emerged on women and their greater link to the environment [ 226 ]. Studies in developed countries have found some support for women leaders’ attention to sustainability issues in firms [e.g., 227 – 229 ], and smaller resource consumption by women [ 230 ]. At the same time, women will likely be more affected by the consequences of climate change [e.g., 230 ] but often lack the decision-making power to influence local decision-making on resource management and environmental policies [e.g., 231 ].

Research gaps and conclusions

Research on gender equality has advanced rapidly in the past decades, with a steady increase in publications, both in mainstream topics related to women in education and the workforce, and in emerging topics. Through a novel approach combining methods of text mining and social network analysis, we examined a comprehensive body of literature comprising 15,465 papers published between 2000 and mid 2021 on topics related to gender equality. We identified a set of 27 topics addressed by the literature and examined their connections.

At the highest level of abstraction, it is worth noting that papers abound on the identification of issues related to gender inequalities and imbalances in the workforce and in society. Literature has thoroughly examined the (unconscious) biases, barriers, stereotypes, and discriminatory behaviors that women are facing as a result of their gender. Instead, there are much fewer papers that discuss or demonstrate effective solutions to overcome gender bias [e.g., 121 , 143 , 145 , 163 , 194 , 213 , 232 ]. This is partly due to the relative ease in studying the status quo, as opposed to studying changes in the status quo. However, we observed a shift in the more recent years towards solution seeking in this domain, which we strongly encourage future researchers to focus on. In the future, we may focus on collecting and mapping pro-active contributions to gender studies, using additional Natural Language Processing techniques, able to measure the sentiment of scientific papers [ 43 ].

All of the mainstream topics identified in our literature review are closely related, and there is a wealth of insights looking at the intersection between issues such as education and career progression or human capital and role . However, emerging topics are worthy of being furtherly explored. It would be interesting to see more work on the topic of female entrepreneurship , exploring aspects such as education , personality , governance , management and leadership . For instance, how can education support female entrepreneurship? How can self-efficacy and risk-taking behaviors be taught or enhanced? What are the differences in managerial and governance styles of female entrepreneurs? Which personality traits are associated with successful entrepreneurs? Which traits are preferred by venture capitalists and funding bodies?

The emerging topic of sustainability also deserves further attention, as our society struggles with climate change and its consequences. It would be interesting to see more research on the intersection between sustainability and entrepreneurship , looking at how female entrepreneurs are tackling sustainability issues, examining both their business models and their company governance . In addition, scholars are suggested to dig deeper into the relationship between family values and behaviors.

Moreover, it would be relevant to understand how women’s networks (social capital), or the composition and structure of social networks involving both women and men, enable them to increase their remuneration and reach top corporate positions, participate in key decision-making bodies, and have a voice in communities. Furthermore, the achievement of gender equality might significantly change firm networks and ecosystems, with important implications for their performance and survival.

Similarly, research at the nexus of (corporate) governance , career progression , compensation and female empowerment could yield useful insights–for example discussing how enterprises, institutions and countries are managed and the impact for women and other minorities. Are there specific governance structures that favor diversity and inclusion?

Lastly, we foresee an emerging stream of research pertaining how the spread of the COVID-19 pandemic challenged women, especially in the workforce, by making gender biases more evident.

For our analysis, we considered a set of 15,465 articles downloaded from the Scopus database (which is the largest abstract and citation database of peer-reviewed literature). As we were interested in reviewing business and economics related gender studies, we only considered those papers published in journals listed in the Academic Journal Guide (AJG) 2018 ranking of the Chartered Association of Business Schools (CABS). All the journals listed in this ranking are also indexed by Scopus. Therefore, looking at a single database (i.e., Scopus) should not be considered a limitation of our study. However, future research could consider different databases and inclusion criteria.

With our literature review, we offer researchers a comprehensive map of major gender-related research trends over the past twenty-two years. This can serve as a lens to look to the future, contributing to the achievement of SDG5. Researchers may use our study as a starting point to identify key themes addressed in the literature. In addition, our methodological approach–based on the use of the Semantic Brand Score and its webapp–could support scholars interested in reviewing other areas of research.

Supporting information

S1 text. keywords used for paper selection..

https://doi.org/10.1371/journal.pone.0256474.s001

Acknowledgments

The computing resources and the related technical support used for this work have been provided by CRESCO/ENEAGRID High Performance Computing infrastructure and its staff. CRESCO/ENEAGRID High Performance Computing infrastructure is funded by ENEA, the Italian National Agency for New Technologies, Energy and Sustainable Economic Development and by Italian and European research programmes (see http://www.cresco.enea.it/english for information).

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Social Protection and Its Effects on Gender Equality

Publication date: 2020-16

Publication series: Innocenti Working Papers

No. of pages: 58

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Globally, progress has been made in the fight against both poverty and gender inequality, including through the expansion of social protection programmes. Yet significant gaps remain. Many women and girls remain in poverty and often face different structural constraints and risks across their life course, related to their biological sex as well as entrenched gender norms that discriminate against them in many aspects of their lives. As poverty, risks and vulnerabilities – which social protection aims to minimize, reduce or tackle – are gendered, if the root causes of gender inequality are not investigated in evidence generation and addressed in policy and practice, poverty will not be sustainably eradicated, nor gender equality achieved.

This paper provides an overview of the latest evidence on the effects of social protection on gender equality. It starts by considering how risks and vulnerabilities are gendered, and the implications of their gendered nature for boys’ and girls’, and men’s and women’s well-being throughout the life course. It then reviews and discusses the evidence on the design features of four types of social protection programmes – non-contributory programmes, contributory programmes, labour market programmes, and social care services – and their effects on gender equality, unpacking which design features matter the most to achieve gender equality. Finally, the paper concludes with implications for a future research agenda on gender and social protection.

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Systematic literature review of digital resources to educate on gender equality

• Published: 02 February 2023
• Volume 28 , pages 10639–10664, ( 2023 )

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• Alma Gloria Barrera Yañez   ORCID: orcid.org/0000-0001-9879-2111 1 ,
• Cristina Alonso-Fernández 2 &
• Baltasar Fernández-Manjón 1  

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Violence and discrimination against women are serious problems that affect today's society regardless of culture or social environment. Educational and government programs addressing these gender issues are difficult to scale up, insufficient or, in some cases, nonexistent. Digital resources can contribute to address discrimination against women and different technological initiatives are being carried out around the world. Videogames and digital resources have proven their effectiveness as tools to educate, prevent and raise awareness about social problems. This article presents a systematic literature review of digital resources such as videogames, apps and simulations that address gender issues including violence and stereotypes. Throughout the review, we analyze multiple characteristics of the resources found (development tools, platforms, location, target audience) to classify the studies found. The main goal of this review is to present the status of gender-focused digital resources, their evaluation studies, including the metrics used and samples, as well as the acceptance and impact of their application. Most of the studies reviewed aimed to raise awareness about gender-based violence using serious games targeted at teenagers. For the resources evaluated, pre-post questionnaires were commonly used. However, many of the projects reviewed did not have evaluation studies or the resources were not openly available, thus limiting their massive application and their potential impact on society. We consider that our results provide a starting point to better understand the role of digital resources in raising awareness about gender issues, highlighting their current limitations, and providing recommendations for future research in gender-based digital resources.

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1 Introduction

Gender stereotypes, gender violence and discrimination against women are serious societal problems frequently ignored or not adequately addressed nowadays. Among the different types of discrimination that exist (United Nations, 2022 ), this work focuses on discrimination against women, due to its social relevance and prevalence among different countries and cultures. This is a type of discrimination of large reach, as women roughly represent half of the world’s population, and time span, as it is not of recent appearance. These sexist behaviors are present in all cultures and social environments. These issues are especially serious in educational institutions, which commonly lack effective protocols to address them (Bailey & Graves, 2016 ).

Gender stereotypes are social and cultural constructs that assign specific characteristics to individuals, based on their sex and the attitudes historically associated with it. For females, stereotypes generally reduce social value and attack the individual's self-esteem. The so-called gender roles refer to the roles assigned by society and establish the norm of how an individual should act, depending on his or her sex. These roles depend on stereotypes and aim to regulate the associated or expected behaviors of an individual, as well as the interactions with other members of society (Heilman, 2012 ).

Among the many gender issues that women face, violence is one of the most alarming. In its multiple forms (sexual, economic, physical, labor, institutional, etc.), it attacks different aspects of the victims, including their physical and mental health, economy, dignity, ability to make decisions for themselves, and self-esteem. According to WHO figures in its 2002 World Report on Violence and Health, with surveys conducted in 48 countries, up to 69% of the women interviewed had been physically assaulted by an intimate partner at some point in their lives (Krug et al., 2002 ). UN Women, the United Nations organization dedicated to promoting gender equality and women's empowerment, estimates that 736 million women globally (nearly one in three) have been subjected to intimate partner violence, non-partner sexual violence, or both at least once in their lifetime and less than 40 percent of women who experience violence seek help (UN Women, 2021 ). Gender-based violence can also escalate due to external circumstances; for example, because of the quarantine measures taken during the COVID-19 pandemic, cases of gender-based violence rose considerably (Pastor-Moreno & Ruíz Pérez, 2021 ).

Gender-related discrimination and violence additionally have a serious impact on children’s development, mainly on those of primary school age, whose formative years define and ingrain the individual's future values, beliefs, and behaviours in society. Gender stereotypes and violence faced daily especially by girls in environments such as school can have detrimental effects including school dropout, depression, low performance, or substance abuse, and even permanent effects on their psychosocial and learning development (OHCHR, 2021 ). Constant exposure to the media (music, television, social networks) and its hypersexualization only aggravate this problem (Trekels et al., 2018 ). Regardless of women’s age and circumstances, gender-based issues are prevalent and widespread, and need to be made visible and effectively addressed.

Digital resources such as serious games, virtual reality simulations or mobile apps can contribute to address these gender issues, mainly for prevention and awareness. For instance, the mobile application "Girl Rising Footnote 1 " addresses the difficulties girls face when attending school in India, while the app "Sheboard Footnote 2 " uses the predictive text of mobile keyboards to educate on the use of inclusive and gender-neutral language. Both initiatives have proven to have a positive impact among their users (Vyas et al., 2020 ).

Serious games are designed with a formative and educational purpose beyond the playful purposes typically associated with videogames (Djaouti et al., 2011 ; Zhonggen, 2019 ). A wide range of serious games have been effectively used in education, scientific (biotechnology, STEM), medical (health professionals, CPR training), political, or historical domains. Videogames provide an interactive environment that allows serious messages to be conveyed through platforms commonly used by children and teenagers, enriching opportunities for interaction, engagement, and active learning (Horban & Maletska, 2019 ). NGO examples such as Project Tomorrow Footnote 3 reported that in the USA, during 2021, 67% of primary and secondary school principals considered the use of serious videogames and digital tools as an indispensable part of their curricula. Footnote 4 Considering their multiple benefits, once validated, serious games can be effectively used in educational settings (e.g., schools) and can be easily scaled up to obtain a bigger impact than traditional non-digital resources (Boyle et al., 2016 ).

This article presents a systematic literature review of studies presenting serious games and other digital resources addressing gender issues (including stereotypes, violence, etc.). The review studies the educational resources to analyze their characteristics and assess their impact on players. The main goals of this review are:

To present a compilation of existing works on games and interactive digital resources that address gender issues, describing their main characteristics and, if applicable, the evidence on their effectiveness.

To present the current state of research to set an academic and informative precedent for those who are developing or researching games and digital resources to address gender issues.

The rest of the article is structured as follows: Section  2 reviews some related works and the background of the review; Section  3 describes the methodology used for the systematic literature review; Section  4 presents the results obtained which are discussed in Section  5 ; Section  6 states the limitations; and finally, Section  7 summarizes the main conclusions of the literature review.

2 Related work

Multiple types of serious games have been used to address different educational or social problems. There are many examples of serious games created to train or educate in various domains (e.g., STEM, business, health) (Eid et al., 2014 ). Other kinds of serious games are used to address complex scientific problems by transforming the problem into a game, so users contribute to solve the problem simply by playing (e.g., Foldit to find new medicines) (Kleffner et al., 2017 ). Serious games have also been used to increase students' awareness of various social problems (e.g., cyberbullying) (Calvo-Morata et al., 2019 ) or even to change complex behaviors such as prejudice or bias (Gertner et al., 2016 ). However, despite the great variety of existent serious games, we have identified an important gap concerning gender education and we have not found any specific review on the topic.

Regarding gender issues, technology has been used mainly for informative purposes, while there are few interactive or playful approaches that could foster connection or increase participants' interest in these topics. There are mainly awareness campaigns and other actions to combat sexism, counteract gender stereotypes or make women's rights more visible (Sabri et al., 2022 ). Those campaigns are usually funded or supported by NGO or non-profits organizations. For example, "Alerta Machitroll" by the Karisma Foundation (Naranjo Ruiz & Ospina Álvarez, 2021 ) in Spain to visibilize the digital gender-based violence suffered by women, or the "Centro Especializado de Atención a la Violencia" of the DIARQ Foundation in Mexico (Weinstein, 2020 ) aims at the prevention, detection and care of family and gender-based violence. Another example of a non-profit company is John Snow Inc. (JSI) that provides governments around the world with technical and management assistance for different initiatives, including the prevention and awareness of gender violence. Footnote 5

Recently some serious games and other digital resources have started to be used to address gender-based violence and gender-related issues. A relevant initiative is the one of "Jennifer Ann's Group" a non-profit specialized in educating and preventing dating violence (Crecente, 2014 ). They have created and promoted many digital resources (mainly serious games) to raise awareness about dating violence, including titles like Honey Moon, Footnote 6 Another Chance Footnote 7 and Grace's Diary. Footnote 8 Other initiatives addressing gender issues are "Ni más ni menos Footnote 9 (Spain)" or "Spotlight Footnote 10 (worldwide)" that use different approaches, such as trivia to test the user's knowledge on gender issues, usually combined with more traditional approaches, such as community work, fostering independent associations and civil society, or providing support services to victims of gender violence. Another relevant initiative is "Afroes games", a project developed in Africa that uses digital tools to address violence and inequality (Fisher, 2016 ). For instance, they created the videogame "Moraba", Footnote 11 a digital tool that aims to raise awareness about gender violence on the continent (Fisher, 2017 ).

Games to address gender issues may incorporate all features, techniques, and mechanics of serious games in general, to increase empathy, or raise awareness about gender differences like other social issues covered in serious games. While a priori, gender issues can be addressed through serious games like any other, some factors may need to be considered. A potential difference when addressing gender issues may appear from the perspective followed in the game: first-person games may rely on the identification of the player with the game’s character (Dillon, 2013 ) and, if the gender of the game character is different to that of the player, it may cause a lack of identification that affects the game’s purpose. The same may occur if all members of one gender are oversimplified in the game (e.g., women depicted as victims, men as villains), potentially drifting those players away from the game by causing an initial rejection, instead of engaging both male and female players (Sadati & Mitchell, 2021 ). While there also may be potential differences in the preferences between male and female regarding videogame genres, the stereotype that females do not play videogames is not valid (Rugelj & Lapina, 2019 ), therefore, a well-designed game-based approach could be equally effective for both male and female players.

An important issue regarding gender-related serious games and digital resources is that in most cases these resources have not been scientifically validated, and there are no related scientific articles presenting these resources or providing evidence on their effectiveness. To cope with this problem and find such resources, in a previous study a search of general gaming websites was conducted to locate serious games that aimed to educate on a variety of gender topics (Barrera et al., 2020 ). Some of the example games and applications mentioned in this paper come from that general search. Even though multiple resources were found in that study, we still confirmed that most of them did not have related publications validating the resources and/or providing evidence of their effectiveness. Therefore, we decided to carry out this systematic literature review, to find such validated and tested games and digital resources addressing gender issues.

3 Methodology

This article presents a systematic review of the literature on serious games and digital resources that address gender issues, with goals such as awareness, visibility, or support for a more egalitarian gender education, describing their effectiveness and validity. This methodology is based on the PRISMA 2020 protocol (Page et al., 2021 ). The review was performed independently by the authors of this review to try to minimize any possible bias (every result was reviewed by at least 2 researchers).

In this review, we aim to determine the described benefits and identified challenges of using digital resources (e.g., serious games, mobile apps) to raise awareness of gender-related issues (e.g., gender stereotypes, gender inequality, gender-based violence). For that, we analyze the type of resources and mechanics used to address these gender issues, as well as their target audience (e.g., age, socio-cultural context). Regarding the studies concerning their validation or effectiveness, we further analyze the characteristics of such studies including the number of users with whom these games are evaluated, and the accessibility of these tools and their social impact.

3.1 Research questions

To obtain that information, we propose the following research questions:

RQ1. What gender issues are addressed in existing digital resources?

RQ2. What are the target audience and platform of the digital resources?

RQ3. What are the types of digital resources and their characteristics (e.g., mechanics) used to identify and counteract the issues addressed?

RQ4. What instruments are used to conduct the impact analysis of the digital resources Footnote 12 ?

RQ5. What are the characteristics of the samples used in the studies (sample size, ages, geographic location, social context, etc.)?

RQ6. What results have been obtained in the studies?

RQ7. What are the limitations of the studies?

3.2 Data collection

We followed a standard systematic literature review methodology, using a fixed set of queries in a previously identified list of bibliographic databases and clear inclusion/exclusion criteria.

3.2.1 Databases used

We identified and consulted 16 different databases, including some of the main research-oriented databases and specific databases chosen based on their relevance, academic validation, and number of results. The databases consulted are Association for Computing Machinery (ACM), Cambridge Journals Online, CIEG UNAM, Dialnet, Education Resources Information Center (ERIC), Frontiers, IEEE Computer Society Digital Library (CDSL), IEEE Xplore, JSTOR, Oxford University Press (journals), Science Direct, Scopus, Springer, Taylor & Francis, Web of Science and Wiley Online Library. The databases CIEG UNAM and Dialnet were included to consider possible relevant results in Spanish, which is pertinent due to the high rate of gender issues present in Spanish-speaking countries, especially in Latin America (Pérez-de-Guzmán et al., 2019 ). In the specific case of CIEG we considered it relevant since it is a database focused on gender issues. Footnote 13

3.2.2 Search terms

Our search scope is articles written in English or Spanish, so we initially proposed two alternative searches with terms in both languages. The queries include terms related to the digital resource (serious game, and alternative terms for digital resources) combined with terms related to gender-related issues. All searches, when allowed by the database search, are limited to the title, abstract and keywords. In databases that did not allow this filtering automatically, it was performed manually by the authors. All searches were conducted in May 2021.

English search terms:

(“videogame” OR “serious game” OR “educational game” OR “video game” OR “mobile app” OR “educational app” OR “simulation” OR “virtual environment” OR “m-learning” OR “mobile learning” OR “e-learning” OR “game-based learning” OR “digital resource”)

(“gender equality” OR “gender education” OR “gender stereotypes” OR “gender violence” OR “gender roles” OR “gender inequality” OR “gender gap” OR “gender discrimination” OR “gender issues”)

Spanish search terms:

(“videojuego” O “juego serio” O “juego educativo” O “video juego” O “aplicación móvil” O “app educativa” O “simulación” O “realidad virtual” O “aprendizaje móvil” O”aprendizaje electrónico” O “aprendizaje basado en juegos”)

("igualdad de género" O "educación de género" O "estereotipos de género" O "violencia de género" O "roles de género" O "desigualdad de género" O "brecha de género" O “discriminación de género”)

3.2.3 Selection of studies

While several games and digital resources may exist that address gender issues, this review focuses only on those resources described in scientific publications or with some type of academic or formative validation, to ensure that they provide sufficient evidence for analysis. To this end, we established the following inclusion and exclusion criteria.

Inclusion criteria:

Articles published in scientific journals or at research conferences.

Articles that include empirical evidence from studies that evaluate serious games or digital resources on gender-related issues (even if the resource is not available).

Exclusion criteria:

Publications whose full text is not available.

Publications whose language is not English or Spanish.

Publications that focus on gender differences in videogame use (e.g., gender differences playing non-serious videogames).

All searches and study selection were conducted by at least two of the authors independently, and the results were compared to ensure both an adequate search of the different databases and an adequate selection of relevant studies.

3.2.4 Data analysis and extraction

For each of the articles included in the review, we collected the specific data to address each of the proposed research questions, and then conducted a mapping study to categorize the results obtained. Any additional information provided in the studies and considered relevant to the literature review was also collected. We classified the data from the selected studies according to the following measures:

Focus and approach to the gender issue (addressing RQ1)

Target audience and platform (addressing RQ2)

Type of digital resources and features/mechanics (addressing RQ3)

Instruments used to study the impact of the resources, such as pre-post questionnaires (addressing RQ4)

Sampling used in the studies, including sample size, ages, geographic location, social context (addressing RQ5)

Results obtained from the studies (addressing RQ6)

Limitations of the studies (addressing RQ7)

4.1 Studies identified by search terms

The studies were retrieved in May 2021 using the search queries. Some of the selected databases (e.g., Dialnet, JSTOR) did not support the full query, so it was necessary to split it into separate searches and then combine the results. Other databases did not work correctly with the AND and OR operators, so we had to double-check the presence of the terms in the studies.

The total number of studies obtained in the searches performed in the different databases was 6669 articles. Some databases did not provide any results (IEEE Xplore and CIEG UNAM).

4.2 Studies identified by inclusion criteria

The selection of studies was carried out by reviewing the obtained 6669 articles. Although the search yielded many articles, most of them did not meet the inclusion criteria. One of the reasons was the confusion between "gender" and "genre" (referring to videogame genres like shooters, sports, role-playing games / RPGs, etc.) in the results. This was solved (in the absence of adequate filters in the databases) by reviewing each result individually and discarding those with topics unrelated to this research. Another issue was the high number of articles that studied gender differences when using videogames. These articles appeared in the search results as they included terms such as "videogame" and "gender roles” but were discarded because the games did not address any aspect of gender; instead, the gender perspective was only included to measure differences between female and male users when playing the games.

After reading the titles and abstracts of the articles obtained, 188 were selected as possible candidates. Removing the articles that were duplicated in different databases, we obtained 119 unique articles that were subjected to scrutiny to determine their full relevance (or lack thereof). After reading the full text of these articles, the final set of articles included in our literature review contains 36 studies (Fig.  1 ).

Systematic literature review search process

The 36 studies included in the final set were reread and analyzed according to the criteria established in Section  3.2.4 Data analysis. The following section presents the results obtained from that analysis, answering the research questions.

4.3 Analysis results

All selected studies were recent (publication years ranged from 2014 to 2021). The selected articles had been published in journals (22 studies), conferences (12) and workshops (2) and were written in English, except for one that was written in Spanish.

Serious games and digital resources addressing gender issues are primarily aimed at raising awareness (13 studies, including (Fonseca et al., 2018 )), changing player behavior (13, including (Jouriles et al., 2016a )), and teaching or training skills (10, including (Potter et al., 2021 )).

Gender-specific issues addressed by digital resources can be broadly categorized within the theme of gender-based violence (28 studies) and gender stereotypes (8). Gender-based violence aspects considered in the studies included domestic violence (Smith et al., 2017 ), gender violence (Aguilar et al., 2019 ) or sexual violence (Gilliam et al., 2016 ). Gender stereotypes are considered in studies like (Muller et al., 2017 ) or (Hagerer et al., 2020 ). In particular, the specific gender-related issues addressed by the resources are shown in Fig.  2 , along with the number of tools that mention each issue. Some resources cover more than one gender-related topic.

Specific gender-related issues addressed in the games

The target audience of the games and resources reviewed are mainly adolescents (18 studies, such as (Gilliam et al., 2016 )), followed by youth and university students (8 studies, such as (Do et al., 2021 )). Only 3 studies targeted younger participants in elementary school (Andrade et al., 2019 ; Boduszek et al., 2019 ; Scholes et al., 2014 ). 5 studies targeted participants of any age, and 2 did not specify any age, but a specific profession (health care providers and professionals), thus targeting adults in those fields (Almeida et al., 2018 ; Mason & Turner, 2018 ). Notice that the resources in some studies targeted multiple age ranges (e.g., high school and college students).

Regarding the platform of use of the games (Fig.  3 ), most can be played online on websites (13), while others mention specific platforms or operating systems: Android (7), iOS (4), Windows (4), MAC (1), and headsets/virtual reality goggles (4). The remaining 3 studies do not mention platform of use.

Platforms and operating systems used in the games

RQ3. What are the types of digital resources and their characteristics (e.g., mechanics) used to identify and counteract the problems addressed?

The tools included in the studies are mainly videogames and serious games (25 studies), followed by virtual reality environments (6) and apps (5).

The mechanisms used to identify and counteract the gender-related issues addressed are varied. Most games and tools (17 studies) expose players to different situations to promote reflection and learning. Through this "situation exposure", players can learn by observing the actions and experiences of other people (indirect learning): both the player's avatar and other NPCs. To further promote these reflections, games include different mechanics, such as allowing interactions with some characters in the game (Pabón-Guerrero et al., 2019 ), conversations, challenges and multiple-choice options to act in response to the story (Navarro-Pérez et al., 2019 ), observing actions and their consequences (Sygel et al., 2014 ). With these mechanics, games aim to make players question socially accepted beliefs, identify negative messages or problematic scenarios, or explore gender stereotypes.

Some of these studies (3) specify that players are exposed to a story that follows the life of a woman: one story involves a mother and her child, who live with the mother's partner who has violent tendencies (Boduszek et al., 2019 ); another story features a woman recalling a past experience of sexual assault (Gilliam et al., 2016 ); and the third story follows a female character and her experiences of intimate partner violence in her relationships (Pearson et al., 2020 ).

Another large group of games and tools (11 studies) uses perspective-taking to address gender issues. In most cases, players take the perspective of the victim of one of the gender issues (dating violence, domestic violence, sexual harassment, discrimination in the workplace) (Ugolotti et al., 2020 ). In some of those situations, players can respond to change the story or observe the consequences. Some tools allowed players to take different points of view in the story (a friend of the main female character (Cabrera-González & Florido, 2020 ), female or male avatar to compare stereotypes (Beltran et al., 2021 ), or both first and third person perspectives (Muller et al., 2017 )). This perspective-taking approach appears in studies using virtual reality environments, 4 of which included an actor to play the role of the male avatar in the simulation. Some studies mention that instructors can use supplemental teaching materials to then discuss in small groups in class the gender issues covered in the resources (Lee et al., 2019 ).

RQ4. What instruments are used to conduct the impact analysis of the digital resources?

27 of the 36 selected studies (75%) present assessment of the games, but not all studies used similar instruments to analyze the impact of their respective games. Most studies used pre-post questionnaires (13 studies, like (Jozkowski & Ekbia, 2015 )), while some authors choose to apply only post-game questionnaires (e.g., (Sygel et al., 2014 )). Some studies included control groups (e.g., (Rowe et al., 2015 )), focus groups (e.g., (Debnam & Kumodzi, 2021 )) or follow-ups (e.g., (Ugolotti et al., 2020 )). All methods contained in the evaluation studies are shown in Fig.  4 .

Tools and methods used in evaluation studies

Of the total of 36 studies, only 26 provided information on the population used in the evaluation studies. One additional study described the use of pre- and post-questionnaires, but did not detail validation samples (Lee et al., 2019 ). Of the 26 studies that did present information on the population used, the mean sample size used was 443 participants (SD = 1735). This result is altered by an outlier of one study with almost 9000 participants (Mason & Turner, 2018 ). Without this outlier, for the remaining 25 studies the mean sample size falls to 103 participants (SD = 103, median = 71 and mode = 32), with a minimum value of 7 participants (Pearson et al., 2020) and a maximum of 369 participants (Navarro-Pérez et al., 2019 ). Figure  5 provides the boxplot of the sample size of the studies.

Sample size of the studies

Regarding the age of participants, most of the 26 studies presenting population information (19), were applied with adolescents and college-aged participants (aligning with the target ages of the resources), while only 4 were tested with adults. 3 studies did not provide information on the age of the participants.

Of the 22 studies that reported the location of participants, most studies were conducted in the American continent, followed by Europe (Fig.  6 ).

Studies found by continent

Figure  7 presents the studies by country that provide information on the samples. It is important to note that although the American continent yielded the most studies, it is the United States that contributed most of these articles and digital tools (11), with studies like (Potter et al., 2019 ) or (Sargent et al., 2020 ). The remaining studies were conducted in Spain (Aguilar et al., 2019 ; Navarro-Pérez et al., 2019 , 2020 ), United Kingdom (Bowen et al., 2014 ; Pearson et al., 2020 ), Barbados (Boduszek et al., 2019 ), Canada (Mason & Turner, 2018 ), Netherlands (Muller et al., 2017 ), Sweden (Sygel et al., 2014 ), two of Brazil (Fonseca et al., 2018 ), one of them in collaboration with Portugal (Andrade et al., 2019 ).

Studies by country that include sample information

Some studies mentioned additional characteristics about the participants. In most studies, participants were university or college students (8) or primary and secondary school students (4). Health professionals were the subject of 2 studies (Almeida et al., 2018 ; Mason and Turner, 2018 ). Other studies included additional eligibility criteria. For example, one study included public school students with a substance abuse or intimate partner violence risk criterion (criteria included being pregnant, being a parent, or having failed two or more core classes) (Elias-Lambert et al., 2015 ). Other studies indicated that participants were recruited through local community service organizations (Debnam & Kumodzi, 2021 ) or reception centers (Navarro-Pérez et al., 2020 ). One study was tested with a group of male offenders and a control group of non-offender males (Sygel et al., 2014 ).

Of the 27 studies analyzed that contained an evaluation of the games, 18 reported positive results, while 5 obtained mixed results and 4 stated that were still in the analysis process at the publication time.

The positive results obtained included measures of effectiveness and impact of the tools applied. The game "Behind Every Great One" effectively conveyed benevolent sexism and increased empathy toward victims (Ugolotti et al., 2020 ). The game "Pandora's Caixa" positively impacted players, with 80% of participants increasing their awareness about domestic violence against women after the game (Almeida et al., 2018 ). The initial application of the game "Ines & Us" indicates that it can influence adolescents and adults to combat critical social scenarios in their region regarding, among others, violence against women (Andrade et al., 2019 ). With the "Choices & Consequences" game, participants increased their learning about gender violence and believed that the game can help prevent violence in relationships (Elias-Lambert et al., 2015 ). The use of the "Campus Craft" game increased students' learning about different prevention concepts related to sexual consent and rape culture, while participants also enjoyed various aspects of the game (Jozkowski & Ekbia, 2015 ).

Several studies also reported positive outcomes of the resources compared to control groups. The mobile app "Liad@s" had two studies that showed that the application of the app reduced adolescent sexism significantly by 6% to 12% (Navarro-Pérez et al., 2019 ) and that the reduction in all dimensions (sexism, prejudice towards men, romantic love myths) was linked to the prevention of teen dating violence. In that second study, the experimental group had a greater effect than the control group, and no differences were found by sex of the participants (Navarro-Pérez et al., 2019 ). The results of the application of the videogame "Jesse" showed that participants in the experimental condition, but not in the control condition, increased affective responsiveness toward victims of intimate partner violence (IPV) at the end of the intervention (Boduszek et al., 2019 ). Users of a conversational interface also reported feeling more engaged with the situation and more comfortable discussing the topic of sexual harassment than those in the control group who read the same vignette online (Do et al., 2021 ).

Virtual reality (VR) environments also elicited positive effects on players. The virtual reality "Through Pink and Blue Glasses" had a positive effect, with more than half of the participants feeling moved, involved in the character's feelings, and with new insights after seeing things from another perspective (Muller et al., 2017 ). Another VR obtained scores on four simulations that correlated, as expected, with self-report measures of dating violence perpetration, among other issues (Sargent et al., 2020 ). The VR environment presented by Jouriles had two studies, the results of which showed that bystander behavior in simulations correlated with all measures of responsibility to intervene, effectiveness to intervene, intention to intervene, and self-reported bystander behavior (Jouriles et al., 2016a ), and that effectiveness to intervene correlated with observed bystander behavior in dating violence situations at 1-week and 6-month assessments (Jouriles et al., 2016b ). In a virtual work environment, comparing positive and negative work scenarios, and female and male avatars, the largest effect was found for participants with a female avatar in the negative environment, who significantly reduced their implicit gender bias (Beltran et al., 2021 ).

In health applications, the "Responding to Domestic Violence in Clinical Settings" program to increase knowledge and competence in assisting victims of intimate partner violence was positively received by both health professionals and students, and was perceived as engaging and clear (Mason & Turner, 2018 ). Also, the "Reactions to Display/Intimate Partner Violence (RoD/IPV)" computer simulation was well received and understood by both offender and non-offender male groups. Results showed that offenders who had not undergone the Integrated Domestic Abuse Program showed a tendency to make more violent decisions in the simulation (Sygel et al., 2014 ).

Some of the analyzed articles also obtained positive results in follow-up studies. The games "Mindflock" and "Ship Happens" had two studies. In the first, both the question-and-answer game (Mindflock) and the interactive scenario game (Ship Happens) had a positive impact, while the interactive scenario game was especially effective in increasing male attitudes towards bystander intervention. This increased effect was obtained in the posttest and in the follow-up study (Potter et al., 2019 ). The second study with these games found an increase in bystander efficacy (confidence in knowledge about the intervention) and bystander attitude (perceived intention to intervene) in both the trivia and adventure game conditions, but not in the control group (Potter et al., 2021 ). The game “Lucidity” was first tested with a focus group in which participants gained new knowledge and approved the game. In follow-up interviews, nearly all participants had initiated a conversation with a parent, peer, or teacher about sexual violence, and reported that the game increased their knowledge and awareness of a variety of health and sexual violence issues (Gilliam et al., 2016 ).

Some studies presented mixed results in their findings. Basically, these results included some possible improvements discovered during the evaluation studies and some limitations found in the resources. Two studies reported limitations and frustrations with functionality (Bowen et al., 2014 ), and the need to simplify the instructions and clarify the language to make it more familiar to the young target audience (Aguilar et al., 2019 ). Two studies had poor results in follow-up interventions: one reported an effect in only 12 participants (Rowe et al., 2015 ), while the other reported changes that only held for females in one of the game conditions (Potter et al., 2021 ). Participants in one study had positive attitudes but still reiterated gender stereotypes (Fonseca et al., 2018 ).

Other studies reported work in progress: a study with preliminary evaluation results yet to be analyzed of a game to increase awareness of gender-based violence (Pabón-Guerrero et al., 2019 ); a discussion between game designers and participants about the characteristics (characters, environments, story, etc.) of a game to increase awareness of intimate partner violence (Pearson et al., 2020 ); a preliminary evaluation with a focus group to provide feedback (e.g., should clarify signs of abusive relationships, provide resources for immediate help) on an app for safety planning and teen dating violence (Debnam & Kumodzi, 2021 ); and a theoretical framework that uses empathy and creativity to design serious games, illustrated with an example of a serious game to raise awareness of domestic violence (Marda et al., 2018 ).

Additionally, the 9 studies that did not contain game evaluation described different phases of the life cycle of the games: the background that led to the creation of the game (e.g., interviews with victims of teen dating violence), the design, development, and implementation of the games, and/or general description of the games (Alonso-Garcia et al., 2020 ; Cabrera-González & Florido, 2020 ; Crecente, 2014 ; Fisher, 2017 ; Hagerer et al., 2020 ; Hosse et al., 2015 ; Lee et al., 2019 ; Scholes et al., 2014 ; Smith et al., 2017 ).

Some additional findings were presented in the studies. Positive features of the games were highlighted, including the possibility of being able to change gender, which helped in identification (Muller et al., 2017 ) and the use of first person, which made the narrative realistic and relatable (Do et al., 2021 ). Interactivity was also a major strength of the tools (Mason & Turner, 2018 ). The virtual reality simulations yielded high-impact results and provided an additional method relevant to self-reports for assessing responses in different situations (Sargent et al., 2020 ). Finally, young participants stated that they preferred games to traditional learning methods, as they are more engaging, interactive, and combine learning in formal and informal settings (Elias-Lambert et al., 2015 ).

The limitations found in the studies included small sample size (9 studies), other limitations in the sample (6 studies), technical problems (8) and other limitations in the game (8), the lack of follow-up studies (6), and the lack of results (5).

Regarding the sample size, it was a limitation of several studies for replicability and generalizability of the results (Aguilar et al., 2019 ). Some other limitations in the samples used are that are not representative of the users, either not belonging to the target population, being from a single school or not being sufficiently diverse (e.g., the game “Papo Reto” was tested in just one school, during a short period of time (Fonseca et al., 2018 )). In the experiments conducted in presence of members of the design team, a possible positive bias may arise from participants trying to behave in a socially desirable manner (Jouriles et al., 2016a ) or when expressing their opinion in front of the developers (Elias-Lambert et al., 2015 ).

Technical problems and other game limitations were also present in several studies. Technical limitations included requirements for Internet connectivity in schools, games were too slow, or the screen would freeze. Some of these technical problems occurred when the studies were conducted with prototypes, while their final versions were still being developed at the time of the studies. Other limitations found in the games included unclear instructions, resulting in players needing help to navigate the game, some buttons (e.g., the help button) not being clearly visible, a limited range of interactions, and other improvements found in playability and user experience. For instance, “Green Acres High” had issues with frozen screens and non-visible parts of the game, along with unclear instructions (Bowen et al., 2014 ). An additional limitation in the studies that applied VR environments was the requirement of specific personnel (players and observers/coders) that increased costs, time, and labor, even more than traditional self-diagnostic questionnaires, so the use of such resources may not be feasible in large-scale evaluations.

Another limitation noted in some studies was the lack of follow-up studies to measure the long-term effects of the resources or to compare their efficacy with more traditional methods (Cabrera-González & Florido, 2020 ). A final limitation was that some studies did not include results of the validation of the games, but only a simple description of their characteristics (Pabón-Guerrero et al., 2019 ). The latter happens with different games that, although they have significant investments, seem to have neglected the studies or simply decided not to make them public.

5 Discussion

Gender-themed digital resources were scarce and difficult to locate. Most of the results found are written in English, and we only located one in Spanish (Cabrera-González & Florido, 2020 ). Although there may be more results in other languages, those results should be not very relevant, as most databases automatically translate search terms and article titles delivering results in different languages. This led us to find less than a dozen results in languages such as Chinese, Portuguese and German, most of which were translated versions of articles already found.

Aligning with their development in English, most resources found in the review came from the USA. This may be related to the significant budget of the Office of Gender Equality and Women's Empowerment, Footnote 14 the office in charge of gender issues in the USA, which through US AID, has access to some percentage (not specified) of the $19.6 billion dollars that this agency receives on average annually (US AID, 2021 ). Footnote 15 Considering Europe some games developed in this continent are used as a support tool in other less developed countries. A relevant example is Jesse, a 3D game developed by "None in Three", a project led by the University of Huddersfield (UK), in conjunction with the Global Challenges Research Fund (UK). This game is primarily oriented to young people living in the Caribbean region (Barbados) to educate and raise awareness about domestic violence (Smith et al., 2017 ).

Regarding evaluation methodologies, results show a strong tendency towards pre- and post-game questionnaires. This may be since, compared to post-questionnaire interviews, or the applicator's annotations of each of the digital resources, the conjunction of pre- and post- questionnaires makes it possible to quantify the impact of the tools. Unlike these pre-post questionnaires, the tools that only use post-game questionnaires have nothing to contrast the results with and could lose valuable information on the change in participants’ perception of the topics addressed. In this regard, a very relevant option for future research is the use of Learning Analytics (Papamitsiou & Economides, 2014 ) collected from players’ interactions, even combined with the data previously obtained (questionnaires, annotations), to obtain more detailed information about players. At the same time, the collection of data about players' actions would allow researchers to detect areas of opportunity regarding the development and playability of digital resources (Alonso-Fernández et al., 2019 ).

The results obtained clearly show the need for more research on tools for gender issues, as the results of our search were scarce. The lack of scientific validation studies, follow-up studies, funding, the disappearance of companies or individuals sponsoring the initiatives, and even public health issues (such as the COVID-19 pandemic) result in the loss of important tools for education and awareness about gender violence and stereotypes. Such is the case of Chuka, Footnote 16 a serious game designed and developed to teach children in Mexico to address child sexual abuse with 5.4 million cases per year (OECD Footnote 17 , 2017 ). The game, developed in Mexico in collaboration with OHCHR, has reached more than 200,000 users since its public release, and yet it does not have any type of related scientific study, which does not allow us to know the impact it has had on its users. Although the tool may be functional within its own scope, it lacks impact, for instance, to help in the implementation of other similar digital tools, as they do not inform of the methodology used to reach that many users. Another relevant aspect to consider is distribution. Even when digital tools can be very useful in different contexts, many of them remain within their local application (provinces, states, and even educational campuses, such as Campus Craft), depriving people in other socio-cultural contexts of their contribution.

The significant gap found between the high relevance of the social problem and the scarcity of resources for its treatment is also present in other fields: such is the case of cyberbullying, a relatively recent problem but of great impact on both the physical and emotional health of the victims (Kim & Leventhal, 2008 ) for which there are also very few digital resources that address the issue. In particular, a literature review on games to prevent and detect bullying and cyberbullying found only 33 relevant resources (Calvo-Morata et al., 2020 ).

While a certain level of satisfaction can be noted in the discussions and conclusions of the studies, it is not clear whether the resources used were as effective as expected. An in-depth analysis of which digital resource better promotes learning would be required. Although it is difficult to determine which kind of digital resource is the most effective, we perceive an inclination of the authors of these resources towards videogames. By playing a videogame, users’ interest and motivation increases and learning becomes active and abiding (Cóndor-Herrera et al., 2021 ). Creating attractive tools like videogames, they can be used as playful applications and be well accepted for their entertainment, without neglecting the educational part or being considered a mandatory activity (Jozkowski & Ekbia, 2015 ).

6 Limitations

As in any other literature review, our work is limited by the selected search terms. We tried to minimize the limitations, regarding the databases, by including a wide range of alternative terms (for both gender issues and digital resources) and modifying the query according to the needs of each database. The choice of languages is an additional limitation: our results are restricted only to works published in English or Spanish.

Additionally, some of the resources found were not scientifically validated. It would be worthwhile to perform a further review of these games without validation, to try to determine whether they serve their purpose, even without a solid scientific basis. A possible reason to explain the lack of associated scientific studies is the need for more economic support, since this situation occurs more frequently in resources developed in countries that are not considered to be of high or very high human development, according to the United Nations Development Program. Footnote 18

As a final limitation, the diversity and variety of the tools and results of the studies included in our review limits the possibility to issue definitive general conclusions. Even if comparing different tools merely related to the gender issues addressed by them is complicated, we have drawn some general conclusions that allow us to provide an overview of the (already scarce) resources that focus on gender-related issues.

7 Conclusions

The results obtained in the review are heterogeneous but can open a relevant analysis, as gender issues are increasingly visible and new tools are being developed to address them, particularly, digital resources like serious games. As previously mentioned, we found no other systematic literature reviews regarding games and digital resources to address gender issues. Therefore, as few studies have addressed this topic, we considered it particularly important to recover what has been advanced on the subject, as well as to create a baseline for future research. It is noteworthy the acceptance of digital resources over other types of learning scenarios (classroom, workshops, courses, etc.), due to their popularity among the young adult population (Jozkowski & Ekbia, 2015 ).

Most of the studies found aimed to raise awareness or change players’ behaviors about gender-based violence by using serious games targeted at teenagers or young adults. The use of digital tools has multiple advantages over face-to-face courses on gender issues, which are taught in some higher education institutions. School-based courses require a lot of time and resources and, if made mandatory to reach a broad number of students, it would only increase the use of resources, which in many cases are severely limited. To reach a broader student body, it is suggested that Sexual Assault Prevention Education Programs appeal to the target population (Jozkowski & Ekbia, 2015 ). We consider that the popularity of videogames and digital resources among teenagers and young adults may be key to address this factor.

The evaluation studies carried out with the digital resources were varied, including the use of pre- and post-game questionnaires to provide a means to measure the effect of each intervention. Control groups were also applied in many of the studies; we recommend the use of a control group together with the application of pre-post questionnaires, which will allow us to perform an in-depth analysis of both the immediate effect of the digital tool as well as its impact compared to more traditional approaches (e.g., lectures). To obtain resources with long-term impact, we also recommend adding a follow-up sometime after the application of the tool to ensure that the immediate effects of its application are sustained over time. Finally, it is also necessary to promote that the developed resources are openly available to increase their reach and impact in the society, together with the information and tools to adequately measure their effectiveness and impact on players. The availability of open code validated projects could help other researchers and developers to produce better games or to adapt those games according to cultural differences to be used in other parts of the world (e.g., Playmint.) (Hagerer et al., 2020 ).

While the number of articles found may be limited, this is not unexpected. The limitations encountered in our review, including the lack of initiatives with scientific/academic validations and follow-ups, or the lack of budget, restrict the possible impact of the few developed resources. Further research is needed regarding digital resources for gender education, validating the resources developed and establishing clear means to assess the impact they may have on their target players. These requirements would ensure that the benefits of games and digital resources for learning and awareness are adequately translated into their application in the field of gender equality education.

Data availability

Authors can confirm that all relevant data are included in the article and/or its supplementary information files.

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• There are multiple digital tools (serious games, apps, etc.) to educate in equality.

• The found digital tools come from all over the world.

• Most gender education initiatives belong to private organizations and NGOs.

• Not all digital tools for educating in equality have related studies or follow-up.

• The reviewed digital resources can be used in different contexts (socioeconomic, geographic, etc.).

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Yañez, A.G.B., Alonso-Fernández, C. & Fernández-Manjón, B. Systematic literature review of digital resources to educate on gender equality. Educ Inf Technol 28 , 10639–10664 (2023). https://doi.org/10.1007/s10639-022-11574-8

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How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps

Miriam hartmann.

1 Women’s Global Health Imperative, RTI International, San Francisco, CA, United States of America

Rajat Khosla

2 World Health Organization, Geneva, Switzerland

Suneeta Krishnan

3 Research Triangle Institute Global India Private Limited, New Delhi, India

Asha George

4 School of Public Health, University of the Western Cape, Cape Town, South Africa

Sofia Gruskin

5 Program on Global Health and Human Rights, University of Southern California, Los Angeles, CA, United States of America

• Conceptualization: RK AA SK.
• Data curation: MH.
• Formal analysis: MH SK.
• Funding acquisition: RK AA.
• Investigation: MH.
• Methodology: MH SK RK AA SG AG.
• Project administration: RK.
• Visualization: MH RK.
• Writing – original draft: MH RK.
• Writing – review & editing: MH SK RK AA SG AG.

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The importance of promoting gender equality and human rights in sexual and reproductive health (SRH) programmes and policies has been affirmed in numerous international and regional agreements, most recently the 2030 Agenda for Sustainable Development. Given the critical role of research to determine what works, we aimed to identify research gaps as part of a broader priority setting exercise on integrating gender equality and human rights approaches in SRH programmes and policies. A systematic literature review of reviews was conducted to examine the question: what do we know about how research in the context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research. We searched three databases for reviews that addressed the research question, were published between 1994–2014, and met methodological standards for systematic reviews, qualitative meta-syntheses and other reviews of relevance to the research question. Additional grey literature was identified based on expert input. Articles were appraised by the primary author and examined by an expert panel. An abstraction and thematic analysis process was used to synthesize findings. Of the 3,073 abstracts identified, 56 articles were reviewed in full and 23 were included along with 10 from the grey literature. The majority focused on interventions addressing gender inequalities; very few reviews explicitly included human rights based interventions. Across both topics, weak study designs and use of intermediate outcome measures limited evidence quality. Further, there was limited evidence on interventions that addressed marginalized groups. Better quality studies, longer-term indicators, and measurement of unintended consequences are needed to better understand the impact of these types of interventions on SRH outcomes. Further efforts are needed to cover research on gender equality and human rights issues as they pertain to a broader set of SRH topics and populations.

Introduction

Sexual and reproductive health (SRH) affects, and is affected by the intersectionality of people’s personal experiences and relationships and by the broader structural context of their lives which shapes their overall health and well-being. This context includes gender inequality as a determinant on its own and in combination with other social and economic inequalities including: unequal power dynamics in interpersonal relationships, harmful gender and other socio-cultural norms and practices, limited economic circumstances, lack of access to education, limited employment opportunities, poor living conditions, disability, ethnicity, as well as the challenging political and legal environments where they live[ 1 ]. Studies have shown that harmful gender norms that promote male dominance over women prevent women from practicing safer sex, limit their use of contraceptives, and increase their risk of STIs, including HIV[ 2 ]. Similarly, research has also shown a relationship between violation and neglect of human rights and negative health outcomes and emphasizes the need to better integrate human rights approaches into interventions, particularly with attention to provider training, service delivery, raising awareness and capacity building[ 3 , 4 ].

In the past two decades, great strides have been made in the development of norms and standards related to gender equality and human rights pertaining to SRH and the interpretation and application of existing standards to different areas of SRH programming and policy making. This is true at the level of international policy, as well as at policy and programmatic levels within countries. The centrality of addressing interconnections between gender equality, human rights, and SRH, was recognized in the Cairo and Beijing agreements, the World Health Organization’s Reproductive Health Strategy[ 5 ], and most recently the 2030 Agenda for Sustainable Development and the accompanying Sustainable Development Goals (SDGs). Not only is the achievement of gender equality a goal in itself (i.e. Goal 5), but there is a specific target within that goal on universal access to SRH and rights (i.e. target 5.6), in addition to the target(i.e. target 3.7) on sexual and reproductive health in the health goal (i.e. Goal 3).[ 6 ]

The achievement of the highest attainable standard of SRH is thus closely linked with the extent to which gender equality and people’s human rights–such as the rights to non-discrimination, to privacy and confidentiality, to life, liberty, and security, as well as the rights to education, information and health–are respected, protected and fulfilled. In its recently adopted General Comment on the right to sexual and reproductive health, the UN Committee on Economic, Social and Cultural Rights, emphasizes that this includes, a “set of freedoms and entitlements”. The freedoms, according to the Committee, include the right to make free and responsible decisions and choices, free of violence, coercion and discrimination, over matters concerning one’s body and sexual and reproductive health. The entitlements, the Committee explains, include unhindered access to a whole range of health facilities, goods, services and information, which ensure all people full enjoyment of sexual and reproductive health.[ 6 ]

While progress has been made in understanding how some dimensions of gender inequalities and violations of human rights shape SRH outcomes, as well as in developing and evaluating interventions that promote gender equality in the context of some SRH programmes and policies, much remains to be done to address these issues systematically. Research has a critical role to play in effectively identifying and addressing gender inequalities and human rights by developing an understanding of what’s been done and what remains to be done. As a first step to determine what is known, a systematic literature review of reviews was conducted to address the following question: what do we know about how research in context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research? This review was conducted to inform a larger research priority setting exercise that is being undertaken to identify what research should be prioritized to strengthen the integration of effective gender equality interventions and human rights approaches in SRH programmes and policies. This paper summarizes the results of the review.

The systematic literature review of reviews was guided by a protocol (See S1 Protocol ) that identified the search strategy including search terms, inclusion and exclusion criteria, and a data abstraction process. The choice of conducting a review of reviews rather than primary intervention studies was guided by the necessity of including the broad scope of topics covered within the field of SRH.

Search strategy

An automated search strategy was undertaken in 2014 to identify literature reviews, systematic reviews and meta-analyses. Three priority databases that typically index most systematic and other types of literature reviews were searched—Scopus, PubMed, and Cochrane—using a list of preliminary search terms related to gender equality, human rights, and SRH that included terms such as gender, gender norms, equality, equity, and sexual health. The preliminary search yielded a very large number of review articles). Therefore, some of the search terms were revised to minimize/remove duplicate terms (e.g., empowerment vs. women’s empowerment). Key words capturing important human rights concepts such as human rights, reproductive rights, and accountability were retained. Table 1 , below, lists the initial terms used, as well as the revised terms.

Finally, in addition to database searches, we consulted participants of an expert meeting that was convened in January 2015 to identify additional reviews from the grey literature that may have been missed in the databases[ 7 ].

Inclusion and exclusion criteria

Articles, both peer reviewed and from the grey literature, that met the following criteria were included: (i) addressed the primary research question: what do we know about how research in context of SRH programmes and policies has addressed gender equality and human rights and what are the current gaps in research; (ii) published between 1994 and 2014 –the period between when ICPD raised global attention to the role of gender equality and human rights in SRH and when the search was conducted; and (iii) classified as reviews and met methodological standards (i.e. followed PRISMA guidelines) for systematic reviews, or qualitative meta-syntheses, or other reviews of relevance to the research question. For the purpose of this review, interventions were defined as actions seeking to promote change in a directed manner. For example, a human rights intervention may be an intervention aimed at empowering women and girls to know and claim their rights in context of sexual and reproductive health. Articles were selected if the role of gender or human rights was explicitly stated as the focus of an intervention or if a gender equality or human rights component was explicitly included within a broader SRH intervention. SRH outcomes of interest were limited to those included within the WHO Reproductive Health (RH) strategy. These include family planning (FP), unsafe abortion, sexually transmitted infections (STI) HIV, reproductive tract infections (RTIs), gender-based violence (GBV), menstrual conditions, urinary and fecal incontinence due to obstetric fistula, uterine prolapse, pregnancy loss, sexual dysfunction, female genital mutilation (FGM), antenatal, perinatal, postpartum and newborn care, cervical cancer, and infertility.[ 5 ]

Articles that were considered secondary analyses, discussions of literature, editorial discussions, or which did not provide sufficient detail regarding their review methodology were excluded. Articles were also excluded if: (i) they were published in a language other than English or Spanish (the languages accessible by the primary authors), or (ii) human rights, gender equality, or SRH outcomes were not explicitly discussed.

Title, abstract, and article screening

Search results from each of the three priority databases were exported into Excel and titles and abstracts were reviewed by the primary author (MH) to identify articles that merited full text review. Articles were delineated into those that met review criteria based on the abstract (Y), may meet review criteria (M), or did not meet review criteria (N). Those articles identified as meeting (Y) or may meet (M) the review criteria were reviewed in full text. Findings were reviewed with other authors (SK, AA, RK) and decisions discussed.

Study appraisal and synthesis

Selected reviews that still met the inclusion criteria, after full text evaluation, were abstracted for the following information: authors, year, title, journal, type of review, population focus, geographic focus, gender/human rights interventions covered, SRH topics covered, outcomes assessed, and research gaps/limitations. Reviews identified in the grey literature by the expert meeting participants in January 2015 were subjected to the same abstraction process.

Literature Review and Search Process

In total, we reviewed 3,073 abstracts from our peer-review literature search. We shortlisted 42 abstracts as either meeting (Y) or possibly meeting (M) the inclusion criteria for the review. These articles were retrieved for a full text review. Following a full text review 19 of the 42 articles were excluded as they did not meet the inclusion criteria. The 23 remaining articles were abstracted as per the process outlined above. In addition, ten reviews from the grey literature were reviewed and abstracted. Fig 1 , below, outlines the search and screening process and reasons for article exclusion.

Characteristics of Included Reviews

Ten out of the thirty-three publications (i.e. 23 peer reviewed articles and 10 reports from grey literature) were classified as systematic reviews, all the peer-reviewed articles were published in health-related journals, and the majority of articles either took a global perspective or focused on low and middle-income countries. Despite the wide time range specified for inclusion (1994–2014), the oldest gender focused review selected was published in 2003 and the oldest human rights focused review article was published in 2011. More specific characteristics of the included review articles are presented below and outlined in tables that are available as supporting information to this manuscript ( S1 and S2 Tables).

What’s the state of the research?

Based on the findings of the review the following section identifies research foci and gaps in order to inform research priority setting in relation to developing effective interventions and approaches to address gender equality and human rights within sexual and reproductive health programmes and policies. Results are broken down by key themes, such as research topic, location, target population, outcomes, and other methodological issues.

Research Topics

Human Rights: Only five review articles specifically assessed the impact of human rights interventions on SRH outcomes. These included interventions targeted at the health facility[ 8 – 10 ], community[ 10 , 11 ], and policy[ 12 ] levels. Given this dearth of information, the primary topical gap is a lack of explicit focus on human rights interventions in SRH research. Furthermore, the reviews that did exist tended to focus on one or two human rights principles (e.g. participation, empowerment) as against a comprehensive inclusion of human rights interventions in relation to SRH. Furthermore, the review highlights the need to look beyond traditional ‘outcomes’ and to focus more on processes and staggered effects over time. [ 8 ]

Gender equality: The majority of articles (N = 29) represented reviews of gender-equality focused interventions. These reviews most frequently assessed impact of gender equality or human rights on HIV outcomes (N = 18), followed by other SRH outcomes such as FP (N = 7), gender-based violence (N = 8), and maternal health (N = 6). The gender equality interventions focused on male involvement, women’s empowerment, addressing gender roles—such as those relating to communication and decision-making, and biomedical interventions addressing gender-based barriers to SRH (e.g. female-controlled HIV prevention methods). Several reviews examined whether strategies reinforced (i.e. perpetuated unequal gender relations), accommodated (i.e. took into account men and women’s unequal roles and power but did not change them) or were transformative (i.e. attempted to change unequal gender power relations and norms)[ 13 – 15 ]. Reviews also indicated that gender-equality interventions in this area have ranged from those that focused on structural factors such as community gender norms to others that focused on interpersonal gender power relations reflected in couple’s communication.

Intersection of Gender and Human Rights: While it is assumed that implicitly, interventions that address gender inequalities de facto are addressing some human rights concerns and vice versa, few reviews explicitly addressed both gender inequalities and human rights. One of the five human rights focused reviews examined interventions specifically designed to promote FP demand and access using rights-based approaches, and also included an intervention to address inequitable gender norms[ 10 ]. Similarly, three reviews of gender-equality focused interventions were explicitly stated to be addressing human rights by framing interventions to address gender-based violence (GBV) or gender-barriers to FP as human rights issues[ 16 – 18 ].

SRH: Across both gender equality and human rights reviews, a comparison between the SRH topics addressed in the reviews and those included in the WHO RH strategy identified several gaps. The primary SRH topics covered by reviews of human rights interventions have been GBV and FP. Gender equality interventions included in the reviews have looked at a broader range of SRH topics (e.g., maternal health, FP/contraception, HIV/STIs). However, even within maternal health and FP, specific topics such as safe motherhood, healthy timing and spacing of pregnancy, and neonatal, child health and nutrition have received less attention. Other topics such as menstrual conditions, urinary and fecal incontinence due to obstetric fistula, uterine prolapse, infertility, and cervical cancer were relatively limited in their inclusion in the reviews. Similarly abortion and FGM, both topics that have clear gender equality and human rights associations, were rarely covered.

Laws and Policies: The reviews did not include many studies or interventions that examined the potential positive impacts of laws and policies promoting gender equality or human rights on SRH. One review focused on the negative impact of discriminatory laws around sex work, including their impact on voluntariness of medical care and access to health services; yet the review itself found limited data regarding the positive impact of changes in policies on SRH outcomes (e.g. how law influences sex workers ability to avoid STIs or to access SRH services as opposed to measuring levels of HIV infection)[ 12 ]. Another included some review of how changes in policies positively impact human rights related outcomes such as access to FP, participation of diverse stakeholders, or equity, nondiscrimination, and quality of SRH care. This latter review found that most policy level intervention studies were not true evaluations, but rather documentation of FP policy implementation and subsequent changes in FP access and uptake. It also found that while policies exist to support FP access and uptake, a human rights perspective to doing so is often not included. Some identification of factors necessary to ensure the fulfillment of individuals’ rights to FP, defined as availability, accessibility, acceptability and quality of contraceptives, and participation in decision-making, were found in this literature. However a need to better understand the association between human rights and SRH was acknowledged in many of the reviews, as was the need for better tools to monitor both health and human rights concerns.[ 10 , 19 ] This was particularly noted for topic areas that are difficult to measure (e.g. abortion)[ 20 ].

Geographical Focus

Although several reviews attempted to include data on either global level or low- and middle-income country interventions, they found gaps in the geographical focus of the research studies they identified. For instance, within low- and middle-income countries there was a dearth of evidence from the Middle East and North Africa with more research occurring in sub-Saharan Africa[ 21 ]. Humanitarian or conflict-affected countries were often cited as missing from the evidence-base as well, particularly in relation to violence against women, an issue that can be exacerbated in these settings[ 17 , 22 ]. When interventions have been conducted in these settings, the reviews noted they are often not rigorously evaluated and thus their effectiveness is unclear[ 17 ]. Finally, one review found that within South Asia, the majority of gender equality interventions across several SRH topics (i.e. RMNCH, HIV, GBV, and universal health care) took place in India[ 23 ].

Target Populations

The ways in which population of focus were defined in gender equality and human rights reviews differed. Gender equality reviews often included generic categories of women and/or men whereas reviews of human rights interventions tended to focus more on people who were marginalized such as female sex workers or women living with HIV. For example, two reviews of human rights interventions focused on sex workers, one of which reviewed policy and advocacy interventions to promote female sex workers’ rights and the other reviewed community empowerment initiatives designed to overcome barriers to female sex workers’ health and human rights[ 11 , 12 ]. A third review focused on the pregnancy-related rights of HIV-positive women[ 9 ]. The final two, which focused on women and children and women and men broadly speaking–reviewed elements of healthcare according to human rights principles such as availability, accessibility, acceptability, and quality of care[ 8 , 10 ]. Despite the more clear focus on marginalized populations within human rights reviews, reviews with a focus on lesbian, gay, bi-sexual, or transgender individuals were not found suggesting both a heteronormative lens to the existing research base and the invisibility of gender expressions that differ from the cultural norm. Additionally, while four reviews addressed adolescents, two of which focused exclusively on this population (one on African American youth and another on Latino youth in the US and Mexico)[ 14 , 15 , 17 , 24 ], concentration on this population, which often faces stigma and discrimination in SRH service provision, was still relatively rare.

Gender, Human Rights, and SRH outcomes: Reflective of the range of topics and foci addressed across the reviews, outcome measures ranged accordingly. Gender related measures often included gender norms, partner communication, male involvement levels, decision-making or power dynamics, but also measurement of harmful outcomes, such as incidence of FGM, violence, or early marriage. The use of longer term outcomes like female life expectancy were rare, but were used on occasion, such as in one review examining outcomes of gender equitable policies[ 19 ]. While harmful SRH outcomes that were the intended focus of interventions were at times included, such as incidence of FGM, it was not common for interventions to measure unintended harm resulting from intervention efforts[ 22 , 25 , 26 ]. Furthermore, some reviews noted that male engagement approaches, in particular, suffer from greater inconsistences in measurement and in impact on SRH behaviours and health outcomes and thus, in understanding how male engagement might help or possibly hinder women’s empowerment.[ 21 , 27 , 28 ]

The framing of human rights measures similarly varied according to intervention goals. These ranged from exposure to empowerment interventions, to access to care, to longer term impacts, such as decriminalization of sex work. Accessibility and quality of services were commonly measured in areas such as FP to sex work[ 8 – 10 , 12 ], whereas measures of stigma or voluntariness were used less consistently[ 9 , 12 ]. This was the case even when the review included studies that explicitly included interventions promoting voluntary rights-based FP[ 10 ].

Across the reviews, the majority of SRH outcomes were related to changes in knowledge, attitude, or behaviors, and not clinical outcomes (e.g. STI or HIV prevalence). Related to this, self-report was commonly used to measure outcomes such as STI symptoms or male perpetration of VAW highlighting the methodological limitations of studies in the reviews.[ 22 ]

Cost, replicability, and scale: A majority of the studies or interventions covered in the reviews point to research on new innovations or small-scale interventions addressing gender equality in single settings. Only one review focused on examining the implementation of an intervention found to be effective in one setting, ‘Stepping Stones’, across multiple settings[ 29 ]. Therefore, more research is needed on replicability of pilot gender equality (and human rights) interventions across different settings and their scale up. In addition, only two of the reviews provided information on the costs, cost-effectiveness, and sustainability of gender equality and human rights-based interventions in SRH programmes and policies[ 15 , 30 ]. One review, which focused exclusively on cost and cost-effectiveness, found as well that most cost-related data comes from pilot and single-site studies, again pointing towards a research gap around intervention scale[ 30 ].

Other Methodological Gaps

A number of methodological limitations of existing research on gender equality and human rights-based interventions and SRH emerged. The majority of identified reviews included studies using either qualitative or quantitative methods but not both, and none of the reviews undertook a qualitative meta-ethnographic or meta-synthesis/analysis process. Methodological rigor may also vary according to intervention approach and region of implementation. One review, which examined research design according to gender accommodating versus transformative interventions, found that accommodating interventions less commonly used a mixed methods approach and those attempting to transform gender norms tended to use qualitative only designs. The review also identified less use of randomized controlled trials in South Asia as compared to other regions of the world.[ 23 ] Reviews also identified studies with poor quality design highlighting the need for better quality research studies that not only rely on randomized controlled trials, but also case series, cohort studies and use qualitative research methodologies that are well recognized in order to instill reasonable confidence in the findings. Diversity in outcome measures (as reported in the section on outcomes) highlight the need for a validated and consistent range of outcome measures of gender equality and human rights interventions[ 11 , 21 , 22 , 25 – 27 , 31 – 36 ]. Consideration for a longer timeframe of measurement in order to assess whether positive outcomes are sustained over time was often highlighted[ 15 , 17 , 21 , 23 , 25 , 26 , 29 , 33 , 34 ]. The reviews of gender equality interventions (e.g. social norm change) tended to have limited time frames making it difficult to measure behavior change or the impact on health outcomes.

Nearly 20 years after ICPD Programme of Action (1994) and the Beijing Platform for Action (1995) highlighted the importance of addressing gender equality and human rights in health and specifically SRH programmes, there has been an accumulation of interventions, programming and evaluations that have enabled researchers to review bodies of evidence. This review of reviews provides an overview of that body of evidence, highlighting what the focus and subsequent gaps have been across topics, population and geographic focus, and methodological approaches.

While interventions addressing gender equality and human rights were recognized as important more than a decade ago, our review found that research on gender equality has received more attention than human rights. This is reflected in the relative paucity of peer reviewed reviews on human rights, particularly in the public health literature. A myriad of factors, including limited funding and limited understanding of human rights, may contribute to this finding. As a result, this body of evidence suffers from additional challenges including selective or ad hoc application of some elements (e.g. non-discrimination, participation) of a human rights based approach as against a comprehensive application; data considerations; and lastly implicit integration of what are called human rights considerations, instead of explicit and comprehensive integration of human rights as internationally understood which impairs study design and evaluations.[ 1 , 8 ]

Although the reviews on gender equality provide a much wider body of evidence than human rights, it’s still challenged by gaps that impede our ability to understand the effectiveness of these interventions. Not surprisingly, given women’s often socially prescribed lower status in communities worldwide, the interventions included in the reviews primarily focused on women and women’s SRH outcomes. While interventions have clearly targeted gender equality for women from multiple levels ranging from the interpersonal to the structural, understanding and measuring change from both women and men’s perspectives is still inadequately done. Specifically, in line with recent ethical and safety recommendations on VAW intervention research[ 37 ], evaluations of interventions should measure potential harms or unintended consequences, as well as outcomes in terms of the individual and in relation to social norms. Moreover, there is a need to better understand whether and what types of interventions lead to resistance to prevailing inequitable gender norms among men and how resistance to norms impacts men for the sake of their own SRH (as partners, fathers, and community members). The latter is of particular importance given both, the challenge of engaging men in these issues and the need to engage them to address their contribution to maintaining existing gender inequalities that inhibit women’s health. While much remains to be learned on effective male engagement, motivating men based on the contributions they can make, as well as their own benefits has been highlighted as an important approach and as such, reliable and valid measurement of these outcomes needs to be incorporated.[ 21 , 28 , 32 ]

Finally, several gaps identified by this review, including the short timeframes of research studies, the limited geographical spread of research, the minimal inclusion of a wider variety of populations, and the missing focus on policy research and on cost, replicability and scale of interventions hinder the field’s ability to progress in integrating gender equality and equal human rights in SRH programmes and policies. For example, shorter timeframes for measuring research outcomes inhibit our ability to understand longer term change–a challenge of great importance for issues such as these, where interventions must support intensive changes in social norms and sustain changes in SRH behaviours. Without longer term research frameworks and funding support to measure and evaluate impact of gender equality and human rights interventions in SRH programmes and policies, we will continue to rely on shorter term outcome measures that can only capture shifts in more proximate knowledge and attitudes, rather than truly understanding what is required to change social, cultural and other norms and behaviours. As another example, the limited attention to replicability of interventions included in the reviews prevent us from understanding how different socio-cultural and economic context would affect whether or not a particular gender equality intervention or human rights approach would work across settings. Similarly, the pilot nature of interventions or studies included in the reviews makes it difficult to know and understand whether these would work or not if implemented on a larger scale. Funding agencies have an important role to play in shaping where, how, and for how long research projects occur in order to allow for measuring longer term, community-wide and larger scale impacts across different settings

This review of reviews has several limitations. One limitation was the search focused on databases that primarily capture the public health literature. Although we did identify articles from disciplines other than public health (e.g. legal, policy), all articles meeting review criteria ultimately came from public health journals. This may have somewhat limited the scope of which gender and human rights interventions were considered. However, given the need to identify articles measuring SRH outcomes, we expect that this limitation should be minimized. Another limitation was the restriction of inclusion criteria of reviews published in English and Spanish. This was due to the language capabilities of the authors; yet, given that the inclusion of Spanish reviews identified no additional reviews meeting criteria, it’s likely that the addition of other languages would have yielded similarly low returns. Additionally, although a large number of potential search terms (key words) were initially identified, we were compelled to revise the search strategy due to the volume of results. This, in addition to our focus on review of reviews, contributed to the varied nature of interventions captured under the broad categories of gender equality and human rights and as such, our inability to make nuanced observations about the research gaps within specific gender equality or human rights intervention approaches. For example, among human rights interventions, we were unable to review interventions at the individual, community, health care, or national level or across identified principles such as non-discrimination, availability, accessibility, acceptability, quality of care, decision-making, or participation[ 4 ]. Without explicit search terms reflecting the many levels of intervention, we cannot be certain that the exclusion of certain topics is reflective of an actual lack of research across these many areas. On the other hand, the broad search terms used should have captured research framed as gender equality or human rights, thus pointing again to a lack of conceptualization of principles of non-discrimination, availability, participation etc., as part of a human rights framework.

This review highlights that progress has been made over the last fifteen years on research related to inclusion of gender equality and human rights interventions in SRH policies and programming, but fundamental gaps remain. Much more has been published on gender equality interventions than human rights-based interventions in the SRH literature. Research relating to both gender equality and human rights based interventions has been published on topics such as HIV/AIDS, SRH, more broadly, and to a limited extent on FP. There is a need to strengthen research methods and measurement of outcomes to capture long-term sustained changes in SRH behaviours and biological health outcomes[ 21 , 22 ]. Attention to human rights in intervention research although limited and ad hoc in nature is increasing, although here too publication has been greatest in relation to HIV and FP. Further investment, documentation, research and development of methodologies is needed in order to capture a) the pathways by which gender equality and human rights interventions can improve SRH outcomes; and b) how we address intersecting forms of inequalities and discrimination along with gender and human rights concerns faced by specific sub-populations and marginalized groups in relation to their SRH. Increased coordination between gender and human rights focused actors could improve their ability to more holistically incorporate human rights and gender into intervention design, implementation, and evaluation thereby strengthening the evidence base.

Supporting Information

S1 protocol, acknowledgments.

The authors would like to acknowledge participants of the expert review meeting who provided feedback on the initial results of the review search and who aided in the identification of relevant grey literature. The review was conceptualized by RK, AA, and SK. All authors (MH, SK, RK, AA, SG, AG) provided inputs into the scope of the review and the search strategy. MH conducted the search, screened citations, read and appraised the literature, and summarized findings. MH and SK led the content analysis and wrote the first draft of the manuscript. MH constructed the figures and tables. All authors participated in revision, including the present manuscript version. All authors read and approved the final manuscript.

Funding Statement

This review was supported by the Human Reproduction Programme, World Health Organization. The content is solely the responsibility of the authors and does not necessarily represent the official views of the authors’ employers or funders. Asha George is supported by the South African Research Chair's Initiative of the Department of Science and Technology and National Research Foundation of South Africa (Grant No 82769). Any opinion, finding and conclusion or recommendation expressed in this material is that of the author and the NRF does not accept any liability in this regard.

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