Ana Lorena Ruano is a researcher at the Center for International Health at the University of Bergen, Norway, and the new Editor-in-Chief of the International Journal for Equity in Health. Her work focuses on Primary Health Care, particularly on how social participation leads to stronger and more equitable health systems, and on strengthening research environments to improve capacity for health policy and systems research in low and middle-income countries, particularly in Latin America.
How does your work relate to SDG3?
My research focuses on social participation and on how this right can make health systems more inclusive and accountable to the vulnerable populations it should be there to serve. In this way, my work is closely related to SDG3: Good Health and Well-being. Improving the quality of care through participation and good governance helps countries, and their health systems, on their path to achieving Universal Health Coverage (UHC) (target 3.8). Working with rights awareness, social accountability, and legal empowerment leads to action on health-related issues that directly affect women every day, including maternal and child health, and sexual and reproductive health rights more broadly (targets 3.1, 3.2, & 3.7).
You recently joined the senior board of the International Journal for Equity in Health as the new Editor-in-Chief. How do you see this moment in your career and what do you envisage for the journal?
I have served on the board of the International Journal for Equity in Health for fifteen years, fourteen of those as the journal’s Managing Editor. When I first started, we were a small journal and equity in health was a relatively small field that focused on the use of quantitative methods, epidemiology, and on health, economics to measure and understand what inequities and inequalities in health were. Today, we have a much wider scope, both thanks to the global focus on equity and its pivotal role in achieving UHC and SDG3, and to our efforts to open spaces for new voices, methods, and approaches to how we think about, and understand, health equity.
For me, this new role is a renewed opportunity for inclusion. Editors-in-Chief play a unique gatekeeping role within journals and in the research community overall. We have the power to open the door to new voices, and more importantly, to new ways of thinking about equity, not just in health but in terms of access, methodologies, and publication. I will use my tenure to work towards more inclusive publication practices, ones that consider other ways of communicating science while also ensuring the quality and uniqueness of the articles we publish.
Which changes are needed in this field to be more attractive to women in science and what were the main challenges you’ve had to overcome in your career?
As a woman from a very gender-unequal country, I am aware that the issue of the underrepresentation of women in science is deeply rooted and complex. When I was an undergraduate student, looking to start my research career, educational spaces in my country were unsafe for women. Even today, more than twenty years later, many universities around the globe continue to foster a toxic, and gendered, work culture where science is seen as a male space.
I was lucky to have always had mentors that played key roles in the opportunities I was offered, and in the ones I was able to pursue. They provided me with safe spaces where my gender was not a weakness, and my curiosity and vocal interest in what we researched were seen as positive traits. The biggest challenge most women face, for me, is that gatekeepers are there to exclude them, instead of empowering them to have a voice in the research community, be it as authors, reviewers, or as editors.
The changes we need to make are structural and require many years of sustained work from everyone in the research community… but mostly from those of us that have the privilege to be in a position of power. We need to make the process of publishing an article transparent and to level the power differentials between authors and editors. This is something I am committed to doing, and something that has been a hallmark of my career as an editor.
What advice would you give a young girl considering a scientific career?
I am aware of the societal expectations that are placed on women, and how these can exclude us from leadership spaces in academia and in society at large, and so, I have thought much about what to say on this topic. Not everything can be overcome with hard work, and not everything happens out of sheer luck. I would tell young women and early-career researchers to take the opportunities that come to them if they can, and to ask for help and guidance when they need it. To remember that academics do not work alone, and that they do not have to carry the burden all by themselves. Alongside this advice, I wish that the mentors they seek are able to provide them with the support and guidance they need.
For this International Women’s Day, what message would you like to share?
That the underrepresentation of women in science will not be solved through networking opportunities alone. Overcoming the systemic, structural, and gender inequities in science requires those of us that are gatekeepers to be inclusive, to foster new voices, and give opportunities to those that have found their path closed off in the past. Science must, and will, change as a result of our participation in it, and we must be clear about how we want to put the value of inclusion into practice. Just as we need different methodologies for understanding inequity in health, we need to foster new voices and approaches to deal with inequities in science.