The COVID-19 pandemic appears to have exacerbated the inequalities that already existed between men and women across the globe, a review of data showed.

Analyses of gender-specific datasets from 193 countries found that women were more likely than men to report employment loss from March 2020 to September 2021 (26% vs 20.4%, respectively), and were 1.8 to 2.4 times more likely to give up paid employment to care for others, reported Luisa Flor, PhD, of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, and colleagues.

Women and girls were also 1.21 times more likely to report dropping out of school for reasons other than school closures compared with men and boys, and were 1.23 times more likely to see increases in gender-based violence than their male counterparts, they noted in The Lancet.

Most of the existing research on the pandemic’s gender disparities has been focused on the direct effects of COVID-19, including case numbers, hospitalizations, and deaths. These data tend to show that men have higher rates of hospitalization and death, Flor’s group pointed out, but given their findings, women have had to bear the brunt of COVID-19’s indirect reverberations.

Obtaining data from almost 200 countries also made it clear that these gender gaps vary significantly from region to region. For example, women in all regions except North Africa and the Middle East were more likely to report an increase in domestic responsibilities and caring for family members. The largest gaps between men and women on this front were seen in high-income regions like Central Europe, Eastern Europe, and Central Asia.

“These data reinforce what gender scholars have known and stated for years: that the ways in which gender power relations manifest as inequities are context-specific,” wrote Rosemary Morgan, PhD, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues in an accompanying editorial. “Any action and policy should not be replicated without local adaptations, and considerations of local contexts, resources, systems, demographics, and social-cultural dynamics and spaces should always be made.”

Based on one multinational source, the largest gender gaps in schooling — wherein girls were more likely than boys to drop out of school for reasons other than school closures — were seen in Central Europe, Eastern Europe, Central Asia, and South Asia.

Women were also more likely to report disruptions in healthcare overall, with increased disruptions in all regions, except South Asia, Southeast Asia, East Asia, Oceania, and sub-Saharan Africa.

Breaking down violence regionally, the highest increases in perceived gender-based violence were observed among women in Latin America and the Caribbean (61.2%), in high-income countries (59.9%), and in sub-Saharan Africa (56.7%). On a global scale, women and men were equally likely to report feeling unsafe at home, but broken down by region, women had higher rates of feeling unsafe in Latin America, the Caribbean, Central Europe, Central Asia, Southeast Asia, East Asia, and Oceania.

“Even though there are multiple indications that the COVID-19 pandemic has potentially exacerbated gender-based violence and complicated service provision for those experiencing violence, it is worth emphasizing that challenges in addressing gender-based violence and inadequate service provision long predate the pandemic,” Flor’s group wrote. “The crucial need for better evidence and sufficient resources allocated to this important health, societal, and humanitarian problem has always been urgent, and has now become even more so.”

The researchers noted that the modes of data collection presented a major limitation to their study’s findings. Most available information was gathered through self-report surveys distributed via apps or online platforms, thereby favoring populations with high smartphone ownership and internet access. The self-report nature of the surveys also added another limitation, as responses may be subject to desirability bias.

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