THE CASE FOR COLLECTING, ANALYSING AND UTILISING SEXDISAGGREGATED DATA AND GENDERED DATA TO INFORM OUTBREAK RESPONSES, A SYSTEMATIC REVIEW OF THE LITERATURE FROM 2012-2022

Intro: Understanding sex-related differences and gendered roles in outbreak dynamics is critical to deliver an effective response. Despite existing recommendations and minimum requirements, collection, analysis, and use of sex-disaggregated data and gendered data, including operational analytics, is seldom included in outbreak response. Methods: A systematic literature review was conducted to examine the extent to which sex-disaggregated data and gendered data for outbreak analytics and responses are collected, analyzed, and utilized in low-and middle-income countries (LMIC). Five databases were searched for peer-reviewed literature examining sex- and gender-specific outcomes for communicable disease outbreaks, published in English between January 1, 2012, and April 12, 2022. Results were independently screened, and all articles meeting the inclusion criteria were included in the review. Findings: A total of 77 out of 15,601 screened articles were included in the analysis. Literature describes sex- and gender-related differences in outbreak susceptibility, risk of exposure, symptoms, and severity of illness, healthcare seeking behavior, and access to treatment and support services. Findings varied by disease, setting, and population. Gaps in the analysis and use of sex disaggregated data and gendered data in outbreak response were identified. The analysis showed that identified sex and gender-related differences were not systematically utilized to address sex and gender-related barriers to health, implement sex and gender specific prevention messaging, and adapt disease detection and treatment across all aspects of outbreak response. Conclusion: While sex data is often collected during outbreaks in LMIC, few publications disaggregated outcomes by sex or discussed gendered roles in outbreak dynamics, and even fewer examined the implications of the differential outcomes that were observed. Mounting evidence calls for an approach to outbreak prevention, detection, response, and recovery that includes sex and gender specificities. Systematic and context specific guidance for the collection, analysis, and utilization of sex-disaggregated data and gendered data is urgently needed.