Research to improve people's health

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Gemma Falguera: “The IDIAPJGol is one of the research centers that takes the gender perspective more into account”

In this interview, the coordinator of the Institute’s sexual and reproductive health research group explains the projects they are carrying out, the situation of sexist violence and the gender perspective in research

Gemma Falguera

Until our society abandons patriarchal culture, we will not stop having cases of gender violence. This is what the midwife Gemma Falguera, coordinator of the sexual and reproductive health research group at IDIAPJGol (GRASSIR), believes. Falguera coordinates studies on sexist violence that highlight the importance of Primary Care and its sexual and its reproductive care services in its detection. However, almost half of the cases go undetected. In addition to these works, her group studies other issues related to women's health.

What are the main projects you are currently carrying out at GRASSIR?

We are conducting a study on the impact of breastfeeding on the carbon footprint and water consumption. We are seeing that, indeed, the impact on the environment of exclusive breastfeeding is less than that of artificial or mixed breastfeeding. Furthermore, we are seeing that, if the partner takes leave after the birth of the baby, the impact also decreases, and the mother’s diet improves. Another of the investigations we are currently carrying out is studying the prevalence of cytomegalovirus infections among the population of the northern metropolitan area of Barcelona. We have the hypothesis that the percentage of infections is higher than what we are registering in Primary Care. On the other hand, we are carrying out two clinical trials, one on vulvovaginitis and another to validate a vaginal ring as a contraceptive method.

One of your lines of research is addressing sexist violence. What are the most notable results that you are obtaining in the studies you carry out on this issue?

We are working with the Autonomous University of Barcelona to detect cases of gender violence that are not reported or detected, through a mathematical tool that they have developed, which allows us to predict this hidden gender violence. With this instrument, we have been able to see that almost half of the cases are not detected in Primary Care, because the women are ashamed to explain it, they fear suffering retaliation, they maintain economic dependence on the aggressor, or they blame themselves for the situation. We are carrying out the research in the northern metropolitan area of Barcelona, where one and a half million people live and which has a great diversity of population, with very heterogeneous sociodemographic and socioeconomic characteristics. This allows the research results to be extrapolated to the rest of Spain and also to other countries that have public health systems and primary care models similar to ours.

Now we have published an article about the importance of primary health care in detecting cases of gender violence. One of the results that has surprised us is that the age of victims of gender violence is becoming younger. We found a very high percentage of girls between 16 and 25 years old who have suffered attacks. Many of these cases are not detected in primary care centres. Therefore, it is essential to design specific actions to facilitate the access of younger victims of gender violence to primary care.

There is increasing social awareness about sexist violence, but it does not seem that the numbers of attacks have decreased, quite the contrary. What do you think is the cause of this situation?

Although there is more and more talk about it, the model we have in our society has not changed. We are still in a very sexist society, characterized by a patriarchal culture. Until this changes, it will be difficult to fix the problem. We should ask what model of men and women we want for our society in schools and in the family environment.

What is the role of social conditions and gender inequalities in women’s health? What measures do you consider necessary to address these problems effectively?

An important issue is that there are still many women who are not financially independent, which makes them vulnerable to dangerous and toxic relationships. Another is sexual autonomy. It is necessary that women be empowered to use methods to avoid sexually transmitted infections and unwanted pregnancies.

How do you evaluate the measure of the Department of Equality and Feminisms of the Autonomous Government of Catalonia to offer menstrual products free of charge in pharmacies?

It is a good idea that allows you to reduce the financial expense of menstruation and the environmental impact of disposable pads and tampons. However, this measure should be expanded. Now there is a choice between a menstrual cup, menstrual panties or a pack of cloth pads, and the entire package should be offered, and, in addition, the measure should be extended to other age groups.

How do GRASSIR incorporate the gender perspective into their studies on sexual and reproductive health?

We, by dedicating ourselves to researching sexual and reproductive health, have always been very clear about this. To begin with, one of the difficulties we have in studies with a feminist vision is that, on many occasions, when they give us health data, they do not come to us differentiated by sex. For example, at the beginning of the pandemic, the Catalan Ministry of Health sent us data segmented only by age and not by gender. After requesting it several times, they began to provide differentiated data, as well as data on pregnant women. The gender vision is also present in other issues, not only strictly health issues, but also related to emotional or social aspects that are associated with women, which are not considered.

How do you see the role of IDIAPJGol in strengthening research with a gender perspective and promoting women’s health?

Currently, IDIAPJGol is one of the research institutes that is working the most with a gender perspective and takes this approach into account in all the studies it is carrying out.