A Systematic Review of Gendered Medical Practices and Health Outcomes in North Africa,

Gender is a critical social determinant of health, shaping access to care, treatment received, and health outcomes. In North Africa, gendered norms are deeply embedded within sociocultural and medical systems. A comprehensive synthesis of how these factors specifically influence clinical practice in the region is lacking. This systematic review aims to synthesise evidence on how gender influences medical practices and health outcomes in North Africa. Its primary objective is to identify and analyse gendered patterns in healthcare provision, access, and patient experiences across medical specialities. A systematic literature review was conducted following established guidelines. Multiple electronic databases were searched for relevant peer-reviewed studies. Included studies reported on gendered aspects of medical practice in North African countries. Study screening, data extraction, and quality assessment were performed independently by two reviewers. The analysis identified a predominant theme of gender bias in pain management and the diagnosis of cardiovascular conditions, frequently leading to the underestimation of women's symptoms. Women were significantly less likely than men to be referred for specialised cardiac interventions despite similar clinical presentations. The review also found consistent gendered disparities in access to reproductive and mental health services. Gendered biases are pervasive in medical practice across North Africa, systematically disadvantaging women in several key clinical areas. These practices contribute to inequitable health outcomes and underscore the necessity for gender-sensitive healthcare approaches. Medical curricula in the region should integrate mandatory gender-sensitive training. Clinical guidelines should be developed to mitigate identified biases, particularly in cardiology and pain management. Further research should explore the intersection of gender with other social determinants of health. Gender, Medical Practice, Health Equity, North Africa, Systematic Review, Women's Health This review provides a consolidated evidence base on gendered medical practices in North Africa, highlighting specific clinical areas where bias occurs. It offers clear directions for education, policy, and future research to advance gender equity in healthcare.