Background and objective:
According to the World Health Organization (WHO), sex and gender interact in complex ways to affect health outcomes. In Italy, the most important document regarding planning of prevention strategies is the “Regional Prevention Plan” (RPP), developed by each region according to the national recommendations. All RPPs have 10 mandatory programs that focus on specific Public Health areas. The study aimed to develop a Gender Equity assessment tool for the 10 RPPs programs, to evaluate how gender is included in the plans and raise awareness for future implementations.

Methods:
The WHO “Checklist for assessing the gender responsiveness of sexual and reproductive health policies” was identified as the main reference after a narrative synthesis of literature. The adapted Gender equality assessment tool is composed of 5 domains, analyzing the dimension of gender in the context, the objectives, the actions, the expected impact, and the monitoring indicators of each program contained in the plans.

Results:
Five RPPs, representative of Northern (Lombardia, Emilia-Romagna), Central (Lazio, Marche) and Southern (Puglia) Italy, were analyzed. In the context analysis, gender was included in 7 programs in Emilia-Romagna, 10 in Lombardia, 6 in Lazio, 5 in Marche and 4 in Puglia. When considering the objectives, the actions, and the expected impact, no plan had a score higher then 2/10, 5/10 and 1/10, respectively. In Puglia, Marche and Lazio, gender was never detected as having influence on the access to care and on chosen monitoring indicators.

Conclusion:
In the RPPs investigated, there was never a clear distinction between sex and gender; they were considered mainly in the context analysis, but this did not translate in their consideration in other parts of the plans. These findings underline the need for policymakers to give greater attention to gender and account for its potential impact on health policy outcomes.