The Italian Health and Gender Group (GISeG)
Anna Maria Moretti
GISeG President and Pneumologist, Bari
The Italian Health and Gender Group (GISeG) was established in Bari on 3 August 2009 to implement strategies that foster a culture of health and gender medicine through prevention, training and information programmes shared with hospital and local health facilities, primary healthcare, institutions, professional boards, non-medical health specialties, and patient associations.
GISeG participates in the activities of the Center for Gender-Specific Medicine (MEGE) of the Italian National Institute of Health (ISS), which for many years now has established an interregional technical panel for the dissemination of gender medicine and currently plays a coordinating role nationwide, as provided for in article 3 of Italian Decree Law no. 3 of 2018. Dr Anna Maria Moretti is a member of the panel, also as an expert appointed by the Puglia Region. The group of experts is currently working on drafting the implementation plan of article 3 of Decree Law no. 3 of 11 January 2018 and is collaborating, together with the MEGE, with the ‘Research and Innovation’, ‘Prevention’ and ‘Communication and European and International Relations’ Directorates of the Italian Ministry of Health, called by this decree to implement a plan to disseminate gender medicine.
In the awareness of the need to carry out organised and controlled activity nationwide, the ISS, GISeG and the National Center for Health and Gender Medicine Studies have set up a national network and have invited players operating in the sector to join in promoting research, training and information programmes. In order to improve the dissemination of useful information, they have activated the publication of a quarterly newsletter on gender medicine with the aim of informing general practitioners and health professionals on current events in the field.
Since 2015, when The Italian Journal of Gender Specific Medicine was founded, the network’s members contributed and continue to contribute its dissemination.
The Central Committee of FNOMCeO in 2013 proposed disseminating gender medicine in the medical profession by entrusting a group of experts, including the GISeG President, with the task of developing training programmes and encouraging the Boards of Italian Doctors to join the project.
Since 2015, GISeG has been participating in the activities of the ministerial project GARD-Italy (alliance against chronic respiratory diseases). The President of the Association coordinated the drafting of the document “Surveillance in the field of respiratory diseases”; the document stressed the need to include gender as an indicator in charting out pathways and in evaluating the outcomes of diseases.
In 2016, the Ministry of Health published in its Quaderni (no. 26, April 2016) “Gender as a determinant of health: the development of gender medicine to ensure equity and appropriateness of care,” aimed at general practitioners and those who monitor health and promote medicine based on the appropriateness of diagnosis and treatment. The document was written with the collaboration of a panel of experts, including the GISeG President, who also reported the data collected as part of the group’s activities.
Since 2017, the Department of Health Sciences (Careggi University Hospital) of the University of Florence has been organizing an annual master’s degree in Health and Gender Medicine, open to graduates of the main postgraduate degree courses (Medicine, Pharmacy, Dentistry, Biology, Psychology, Biotechnology, Nursing and Obstetric Sciences, Physiotherapy, and Dietetics) with the aim of developing skills in the field of health and gender medicine. The GISeG President participates annually in the event as a lecturer.
GISeG’s activities also include the association’s participation in numerous conferences in Italy and abroad. GISeG organizes an annual national conference on gender medicine to evaluate significant gender differences in diagnostic pathways and outcomes of therapies, with experts in the field, according to specific health determinants.
Since 2012, the association’s President has participated in the gender medicine session of all conferences organised by FADOI, with presentations on issues related to the management and treatment of diseases with obvious gender differences.
The President also participated, as a speaker and faculty member, in the VII Conference of the International Society of Gender Medicine (IGM) held in Berlin in September 2015, and, as a member of the Scientific Committee, in the VIII Conference of the International Society of Gender Medicine (IGM), held in Sendai in September 2017.
Many scientific societies have joined the GISeG’s activities, signing memoranda of understanding aimed at formulating shared programmes.
GISeG has formalized protocols of understanding with national scientific societies such as AIDM (Italian Association of Women Physicians), ENGHEA (ENGendering HEAlth), SIEDP/ISPED (Italian Society of Endocrinology and Paediatric Diabetology), SIN-Nephrology, etc.
The Italian Association of Doctors’ Wives (AMMI) has included health and gender medicine among its institutional objectives for many years, and each year awards a scholarship with the aim of rewarding the most innovative and significant research project in the field of gender medicine and pharmacology. The prize is awarded by a jury composed of experts in the field and includes a GISeG representative.
In June 2011, the Puglia Region set up a technical panel on gender medicine and entrusted GISeG with planning and monitoring the scientific activities.
Puglia was one of the first Regions in Italy to include gender medicine in the Regional Health Plan, providing permanent professional training and establishing a Regional Commission for Health and Gender Medicine.
Thanks to the collaboration with the Regional Epidemiological Observatory (OER-Puglia), GISeG has published documents on the impact of hospitalization for chronic obstructive pulmonary disease (COPD) and pulmonary embolism in the Puglia Region according to gender indicators. It has promoted and sponsored numerous training events throughout the Region. It has also set up a Centre for Gender Medicine Studies at the University Hospital of Bari, which has provided training courses for the hospital’s medical and healthcare personnel.
The Medical Board of the Province of Bari, in collaboration with GISeG, has set up an Observatory on Gender Medicine, which includes specialists in many disciplines, to improve the training of doctors and health professionals by organizing numerous training events. The teaching of gender medicine in research audits in primary healthcare was also established and a master’s degree dedicated to the knowledge of the different clinical, radiological and functional manifestations in both sexes in certain specific diseases (pulmonary embolism, ALS, thyroid diseases) was organised. A banner has been created on the Board’s website, consisting of a specific logo, to convey in real time information useful to all members of the Medical Board.
The new challenge for the Medical Board of Bari and GISeG is to establish a network among all the medical boards of the Puglia Region to share projects and training courses in order to offer these programmes to other medical boards and healthcare professions around Italy.
On 26 September 2018, GISeG signed a memorandum of understanding with the Chair of the Regional Council of Puglia to establish a multimedia library, with the aim of building an efficient cultural and information centre that will serve as a qualified reference point for research and the collection of scientific documentation. The multimedia library aims at collecting and cataloguing the literature available on health and gender medicine, making useful material available online to users involved in various ways in the related issues. This structure will be a centre at the forefront of experimentation and use of new technologies for the dissemination of knowledge and will be able to develop projects in collaboration with other institutions in the area.
On 7 December 2018, a Framework Agreement was signed between the ‘Aldo Moro’ University of Bari and the National Association ‘Gruppo italiano Salute e Genere – GISeG’ of gender medicine for the following objectives:
■ ensure the appropriateness of research, prevention, diagnosis and treatment, implementing an interdisciplinary approach between the different medical areas and human sciences according to gender indicators;
■ promote actions in support of biomedical, pharmacological and psychosocial research based on gender differences;
■ promote studies to investigate the regulatory and pharmacological aspects of gender medicine;
■ promote the prevention of risks to health and safety at work through their evaluation and management from a gender perspective;
■ encourage the creation of collaborative networks at local, national and international level between entities interested in gender medicine;
■ promote actions to prevent and combat gender-based violence (women, children, the elderly, vulnerable people, migrants);
■ promote the development and dissemination of SAGER (Sex and Gender Equity in Research) editorial guidelines for authors and publishers for the adoption of a gender approach in publications in the biomedical area (ISS);
■ promote the inclusion in their projects and activities of the thematic area ‘gender medicine’ among scientific societies through the programming of training and research activities;
■ promote and implement interventions for the ongoing training of doctors and healthcare professionals useful to favour the sharing of the latest scientific findings, the appropriate prescription of drugs and the correct approach to a patient according to gender indicators (master’s degree, distance learning, workshops, etc.).
A problem of great interest, which the Puglia Region (OER-Puglia and GISeG) is following with particular attention, is the collection and correct use of health data according to gender indicators: currently information in this area is insufficient. In order to have correct data, it is necessary to collect information through computerised systems including specific indicators for gender differences. OER-Puglia and GISeG have proposed to other Regions to share common protocols aimed at collecting homogeneous data.
Therefore, GISeG has carried out many activities to date, but the hope is that they will be increasingly numerous and interesting and will contribute to improving knowledge on gender issues.