The farmer-producer organisation (FPO) is an umbrella term used to describe modes of farmer collectivisation in India, i.e. co-operatives and companies. While women cultivators play a central role in agriculture, their continued marginalisation is reflected in a lack of engagement in FPO activities and governance structures, with only 3% of existing FPOs being female-led ventures. This paper examines the nature of tensions around social inequities-and how such tensions might be addressed in the collective spaces offered by FPOs-using a gender lens, specifically in balancing conflicting pressures of economic performance versus inclusion and meeting specific members\' needs. Using a participatory research approach, a conceptual framework is developed and applied in three FPOs operating at various stages of development. With a specific focus on gender equity and social inclusion, selected cases involved FPOs with > 75% female membership and scheduled caste/tribe participation. Qualitative data on societal needs, based on the expectations and experiences of FPO participants, are then analysed to better understand (1) what might promote FPO participation and (2) how equity and inclusion may be enabled from the \'bottom-up\'. This exploratory study informs the collective action debate with its new and intersectional approach to gender equity and inclusivity. Empirical observations and within-case analyses involving FPOs provide new insights into the functioning of these institutions and nuanced interactions involving their members. Findings suggest that informal micro-producer arrangements or vyavastha, in the FPO pre-registration phase, are well positioned to act as spatial agents for establishing ethical norms as FPOs collectivise and grow. In terms of promoting social objectives and evaluating FPOs operating in different stages, a set of guiding principles are proposed with follow-on implications for policy.

BACKGROUND: In 2020, almost 100 million people were blind or visually impaired from cataract. Cataract surgery is a cost-effective treatment for cataracts. In Nigeria, twice as many women are cataract blind as men. Cataract surgical rate (CSR, the number of cataract operations per million population per year in a defined geographical location) is an output indicator of cataract surgical services. The recommended target CSR for sub-Saharan Africa is 1000/year. The aim of this study was to assess the CSR in men and women in Imo state, Nigeria.
METHODS: A retrospective review of cataract surgery undertaken in all eye health facilities in Imo State in 2019. Data collected included the type and location of facilities, patient demographics and the number and type of cataract operations performed in each facility. The CSR was calculated overall, in men and women, and in younger and older women.
RESULTS: The CSR overall was 330/million and was slightly higher in women (347/million) than in men (315/million) (p<0.001). More elderly women (≥65 years) accessed cataract surgery through outreach than men and younger women (OR 1.5 (95% CI 1.03 to 2.22, p=0.03) and 1.6 (95% CI 1.07 to 2.44, p=0.02)), respectively.
CONCLUSIONS: The overall CSR in Imo state was approximately one-third of that recommended for sub-Saharan Africa. Although the CSR was higher in women than in men, considerably higher CSRs are needed in women to address their higher burden of cataract blindness. Operational and intervention science research are needed, to identify and evaluate interventions which address demand and supply barriers to accessing cataract surgery, particularly for elderly women.

BACKGROUND: Existing evidence suggests that organisation-level policies are important in enabling gender equality and equity in the workplace. However, there is little research exploring the knowledge of health sector employees on whether policies and practices to advance women\'s career progression exist in their organisations. In this qualitative study, we explored the knowledge and perspectives of health managers on which of their organisations\' workplace policies and practices contribute to the career advancement of women and their knowledge of how such policies and practices are implemented and monitored.
METHODS: We employed a purposive sampling method to select the study participants. The study adopted qualitative approaches to gain nuanced insights from the 21 in-depth interviews and key informant interviews that we conducted with health managers working in public and private health sector organisations. We conducted a thematic analysis to extract emerging themes relevant to advancing women\'s career progression in Kenya\'s health sector.
RESULTS: During the interviews, only a few managers cited the policies and practices that contribute to women\'s career advancement. Policies and practices relating to promotion and flexible work schedules were mentioned most often by these managers as key to advancing women\'s career progression. For instance, flexible work schedules were thought to enable women to pursue further education which led to promotion. Some female managers felt that women were promoted to leadership positions only when running women-focused programs. There was little mention of capacity-building policies like training and mentorship. The health managers reported how policies and practices are implemented and monitored in general, however, they did not state how this is done for specific policies and practices. For the private sector, the health managers stated that implementation and monitoring of these policies and practices is conducted at the institutional level while for the public sector, this is done at the national or county level.
CONCLUSIONS: We call upon health-sector organisations in Kenya to offer continuous policy sensitisation sessions to their staff and be deliberate in having supportive policies and other pragmatic interventions beyond policies such as training and mentorship that can enable women\'s career progression.

Gender equality in decision-making positions is crucial to achieving the goals of good governance, peace, democracy, and inclusive/sustainable development. The major aim of this research article is to investigate the representation trend of women in higher decision-making positions over the last thirty years, since 1991. The federal three organs of government (law formulating, law enforcing, and law interpreting bodies) were the focus of this research. This research is a mixed type of research that inculcates both qualitative and quantitative data types. Secondary data sources from relevant government institutions were mostly used. The data was analyzed through content analysis of documents and presented via descriptive data presenting techniques. The research findings reveal that although women\'s representation in positions of decision-making has advanced considerably in recent years, the empirical data throughout the previous thirty years demonstrated the underrepresentation of women in higher leadership positions within the Ethiopian federal government. Furthermore, Women never held certain higher-level government leadership positions, such as the Prime Minister position, which seems to be forbidden for women. Women made up 23%, 19%, 19%, and 24% of the House of Peoples Representatives (HPR), the House of Federation (HoF), ministerial posts, and judicial bodies, respectively over the last three decades. Women are visibly underrepresented in the executive positions as compared to others. Thus, substantial policy and practical initiatives are needed to remove institutional, social, and economic barriers to boost women\'s advanced visibility in senior leadership roles.

Women represent 70% of the global health workforce but only occupy 25% of health and social care leadership positions. Gender-based stereotypes, discrimination, family responsibilities, and self-perceived deficiencies in efficacy and confidence inhibit the seniority and leadership of women. The leadership inequality is often compounded by the intersection of race and socio-economic identities. Resolving gender inequalities in healthcare leadership brings women\'s expertise to healthcare decision making, which can lead to equity of healthcare access and improve healthcare services. With the aim of enhancing women\'s advancement to leadership positions, a rapid realist review (RRR) was conducted to identify the leadership and career advancement interventions that work for women in healthcare, why these interventions are effective, for whom they are effective, and within which contexts these interventions work. A RRR ultimately articulates this knowledge through a theory describing an intervention\'s generative causation. The Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) for conducting a realist synthesis guided the methodology. Preliminary theories on leadership and career advancement interventions for women in healthcare were constructed based on an appraisal of key reviews and consultation with an expert panel, which guided the systematic searching and initial theory refinement. Following the literature search, 22 studies met inclusion criteria and underwent data extraction. The review process and consultation with the expert panel yielded nine final programme theories. Theories on programmes which enhanced leadership outcomes among women in health services or professional associations centred on organisational and management involvement; mentorship of women; delivering leadership education; and development of key leadership skills. The success of these strategies was facilitated by accommodating programme environments, adequacy and relevance of support provided and programme accessibility. The relationship between underlying intervention entities, stakeholder responses, contexts and leadership outcomes, provides a basis for underpinning the design for leadership and career advancement interventions for women in healthcare.

UNASSIGNED: Under-representation of women in high academic and medical positions is reported in many countries. This study aims to compare degrees and careers between men and women tenured as Full Professors of Medicine in recent years in France.
UNASSIGNED: We identified all new tenured French Full Professors between 2017 and 2021 and collected the publicly available data (gender, year of birth, curriculum) from the Bibliographic Agency for Higher Education, a public institution under the aegis of the Ministry for Higher Education Research and Innovation. The primary outcome was the gender difference in age appointment of Full Professors. Secondary outcomes were gender differences in career development.
UNASSIGNED: Among 820 Full Professors, only 266 (32.4%) were women. They were tenured at a later age than men (43.7 vs 42.4 years, p<0.001), while they graduated for the MD (29.5 vs 29.9 years, p<0.005) or PhD (35.3 vs 36.0 years, p<0.05) several months earlier. Women were also more often Associate Professors than men before becoming Full Professors (67.3% vs 59.2%, p<0.05).  Before achieving Full professor tenure, the average delay is longer for women from MD graduation (14.6 vs 12.5 years), PhD graduation (8.7 vs 6.4 years), or Associate Professor nomination (7.5 vs 5.5 years), with a difference of 2.2, 2.4 and 2.0 years respectively (p<0.001 for all comparisons).
UNASSIGNED: Gender inequalities remain in regards to access to Full Professor status, the highest position in the medical fields.

BACKGROUND: Women remain underrepresented in leadership roles, faculty roles, and among residents in orthopaedic surgery. It has been suggested that having women in leadership positions in orthopaedic surgery may help to increase the gender diversity of residency programs. However, to our knowledge, no study has explored the relationship, if any, between the gender of the residency program director and the percentage of women in the residency program.
OBJECTIVE: (1) Is the program director\'s gender associated with differences in the percentage of women orthopaedic surgery residents? (2) Do women and men differ in the time to appointment of program director?
METHODS: A list of 207 orthopaedic surgery residencies was obtained from the Accreditation Council for Graduate Medical Education (ACGME) website for the academic year 2021 to 2022. The study excluded 6% (13) of programs; 4% (8) were those without ACGME accreditation and those with initial accreditation, and 2% (5) did not have updated 2021 to 2022 resident lists. Descriptive information on 194 programs was obtained from publicly accessible resources from July 2021 through July 2022. The institution\'s website and the American Medical Association\'s (AMA) Fellowship and Residency Electronic Interactive Database (FREIDA) was used to collect residency program characteristics and resident demographics [ 2 ]. Doximity, Healthgrades, and LinkedIn were used to further collect current orthopaedic surgery residency program director demographics, including gender, age, and education/training history. To determine gender, photographs and pronouns (she/her/hers or he/him/hers) used in their biographies were used first. To confirm this, secondary sources were used including their NPI profile, which lists gender; Doximity; and their LinkedIn profile. Scopus was used to analyze research output by the program directors-using the Hirsch index (h-index) as the primary bibliometric metric. A total of 194 program directors were identified, of whom of 12% (23) were women and 88% (171) were men. Of the 4421 total residents among these programs, 20% (887) were women and 80% (3534) were men. A univariate analysis comparing program directors was conducted, with continuous variables analyzed using an independent-sample t-test and categorical variables analyzed using a Pearson chi-square test. With the numbers available, a post hoc statistical power calculation indicated that we could detect an 32% difference in the percentage of women in a program as significant with 80% power at the p < 0.05 level, whereas we might have been underpowered to discern smaller differences than that.
RESULTS: With the numbers available, we found no difference in the percentage of women in residency programs run by women program directors than in programs in which the program director was a man (22% [125 of 558] versus 20% [762 of 3863], mean difference 2% [95% CI -1.24% to 7.58%]; p = 0.08). Comparing women to men program directors, women had fewer years between residency completion and appointment to the position of program director (8 ± 2 years versus 12 ± 7 years, mean difference 4 years [95% CI 2.01 to 7.93 years]; p = 0.02) and had a lower mean h-index (7 ± 4 versus 11 ± 11, mean difference 4 [95% CI 1.70 to 6.56]; p = 0.03) and number of publications (24 ± 23 versus 41 ± 62, mean difference 17 [95% CI 3.98 to 31.05]; p = 0.01), although they did not differ in terms of their advanced degrees, duration of training, or likelihood of having taken a fellowship.
CONCLUSIONS: Orthopaedic residency programs that were run by women did not contain a higher percentage of women residents, suggesting that the gender of the individual in that role may not be as important as has been speculated by others. Future studies should investigate the intersectionality of gender, race, and ethnicity of residents, program directors, and current faculty.
CONCLUSIONS: The fact that women were placed in program director roles earlier in career may also carry special jeopardy for them. Those roles are difficult and can impair a faculty member\'s ability to conduct individual research, which often is key to further academic promotions. Given that and the fact that the gender of the program director was not associated with differences in gender composition of residency programs, we believe that increasing mentorship and access to pipeline programs will help promote diversity in residency programs.

OBJECTIVE: This paper examines the availability of legal provisions, or the lack thereof, that support women to progress equitably into leadership positions within the health workforce in India and Kenya.
METHODS: We adapted the World Bank\'s Women, Business and Law framework of legal domains relevant to gender equality in the workplace and applied a \'law cube\' to analyse the comprehensiveness, accountability and equity and human rights considerations of 27 relevant statutes in India and 11 in Kenya that apply to people in formal employment within the health sector. We assessed those laws against 30 research-validated good practice measures across five legal domains: (1) pay; (2) workplace protections; (3) pensions; (4) care, family life and work-life balance; and (5) reproductive rights. In India, the pension domain and related measures were not assessed because the pension laws do not apply to the public and private sector equally.
RESULTS: Several legal domains are addressed inadequately or not at all, including pay in India, reproductive rights in Kenya and the care, family life and the work-life balance domain in both countries. Additionally, we found that among the Kenyan laws reviewed, few specify accountability mechanisms, and equity and human rights measures are mainly absent from the laws assessed in both countries. Our findings highlight inadequacies in the legal environments in India and Kenya may contribute to women\'s under-representation in leadership in the health sector. The absence of specified accountability mechanisms may impact the effective implementation of legislation, undermining their potential to promote equal opportunities.
CONCLUSIONS: Government action is needed in both countries to ensure that legislation addresses best practice provisions, equity and human rights considerations, and provides for independent review mechanisms to ensure accountability for implementation of existing and future laws. This would contribute to ensuring that legal environments uphold the equality of opportunity necessary for realising gender justice in the workplace for the health workforce.
UNASSIGNED: Bill & Melinda Gates Foundation (INV-031372).

International concern for the human rights of Afghan women has spiked since the Taliban consolidated power in Afghanistan in fall 2021. Yet little is known about how to effectively advocate for women\'s human rights under this new context. We present findings from a random sample of all adult Afghan internet users\' attitudes toward peace, security, gender, and human rights and find significant support for women\'s human rights as a national priority within Afghanistan, even when controlling for other priorities and even among many men and women aligned with the Taliban. Given that men now have much more political power in Afghan society to protect women\'s rights, we paid particular attention to men\'s attitudes toward women\'s human rights. Our evidence from an embedded survey experiment, building on earlier literature from other countries, demonstrates that fathers of eldest daughters are particularly likely to favor prioritizing women\'s rights when primed to think about the gender of their eldest children. Thus, the human rights and humanitarian community should spend more time and attention engaging with this demographic, and specifically creating marketing and advocacy strategies that encourage men to think about or act on behalf of their eldest daughters.

The Gender Inequality Index is a country-level measure of gender inequality based on women\'s levels of reproductive health, social and political empowerment, and labor-market representation. In two studies, we tested the validity of the GII-S, a state-level measure of gender inequality in the USA. In Study 1, the GII-S was associated with objective and subjective measures of wellness among women, including life satisfaction, financial well-being, and perceptions of safety. GII-S was not associated with the Gini coefficient, a well-established measure of economic inequality, suggesting that gender and economic disparities represent distinct aspects of social inequality. Study 2 tested the link between GII-S scores and collective action-specifically, participation in the #MeToo movement promoting awareness of sexual harassment and violence against women. Analysis of geo-localized messages on the Twitter social media platform reveals that higher GII-S scores were associated with fewer tweets containing the #MeToo hashtag. Moreover, GII-S was associated with state-level political orientation: the more conservative a state, the higher its level of gender inequality. Results are discussed in terms of possible socio-cognitive processes underpinning the association between gender inequality and sensitivity to violence against women.