Gender, Health, and Healthcare Access: An Original Research Analysis of Gynaecological and Obstetric Medicine in Guinea-Bissau

Gender is a critical social determinant of health. Its specific operation within obstetric and gynaecological healthcare in low-resource settings such as Guinea-Bissau requires detailed contextual understanding to improve maternal and reproductive health outcomes. This study analysed the gender dimensions influencing access to and utilisation of obstetric and gynaecological healthcare services in Guinea-Bissau. It aimed to explore patient and provider perspectives on gender roles in healthcare decision-making and to identify gender-related barriers to accessing services. An exploratory qualitative study was conducted using semi-structured interviews and focus group discussions. Participants included women of reproductive age, male partners, community health workers, and clinical staff from urban and rural health facilities. Data were analysed using thematic analysis. Patriarchal norms strongly dictated healthcare access, with male authorisation frequently required for women seeking care. A prominent theme was the prioritisation of male children, which influenced decisions around antenatal care and facility-based delivery. Women also reported experiencing judgement from healthcare providers regarding their fertility choices. Gender power dynamics, rooted in sociocultural norms, present a significant barrier to equitable access to obstetric and gynaecological care in Guinea-Bissau. These dynamics operate at household, community, and health system levels, often compromising women's autonomy and timely care-seeking. Recommendations include implementing gender-sensitivity training for all healthcare staff, developing community engagement programmes to address harmful gender norms, and designing health promotion materials that target men as key stakeholders in maternal health. Gender, Maternal Health, Healthcare Access, Guinea-Bissau, Qualitative Research, Obstetrics, Gynaecology This original research provides contextual evidence on how gender norms shape obstetric and gynaecological healthcare access in Guinea-Bissau, highlighting specific points for intervention within the health system and wider community.