Gender inequity remains a challenge in the health workforce, with too few women making critical decisions and leading the work. The World Health Organisation (WHO), the Global Health Workforce Network, and Women in Global Health have launched a report at the Commission on the Status of Women to describe the social and economic factors that determine why few women lead in global health, and make a call for action to urgently address gender inequity.
These are the 10 key points to emerge from the report.
1. Women make up 70% of the health workforce but only 25% hold senior roles – this means that in reality, women deliver global health and men lead it. These gaps in gender leadership are driven by stereotypes, discrimination, and power imbalances. Some women are further disadvantaged on the basis of their race or class.
2. Gender inequity in the health workforce is indicative of a wider problem in global health – global health is predominantly led by men: 69% of global health organisations are headed by men, and 80% of board chairs are men. Only 20% of global health organisations were found to have gender parity on their boards, and only 25% had gender parity at senior management level.
3. Often, gender norms and stereotypes of jobs can affect the roles that women occupy – cultural labelling as either ‘men’s’ or ‘women’s’ roles prevent women from reaching leadership levels.
4. This stereotyping is a significant contributor to the gender pay gap – female health workers also face a gender pay gap that is around 25% higher on average in global health than in other sectors. Female health workers are clustered into lower-status and lower-paid (often unpaid) roles.
5. Women often face bias and discrimination, as well as sexual harassment – this can affect their careers and lead to extreme stress and a loss of morale. Many countries lack laws and social protection that are the foundation for gender equality at work – moreover, male health workers are more likely to be organized in trade unions that defend their rights than female health workers.
6. Gender inequity is threatening the delivery of health – an estimated 40m new jobs will be needed by 2030 in the global health and social sector. Yet there is an estimated shortfall of 18m health workers, primarily in low- and middle-income countries.
7. Leaving the gender balance to equalize on its own is not an option – unless specific, targeted measures are taken, workplace gender equality is estimated to take 202 years.
8. Addressing gender inequities in the health and social workforce as one of the biggest employment sectors of women could have enormous impact towards achieving the Sustainable Development Goals (SDGs) – there is a health dividend in filling the millions of new jobs that must be created to meet growing demand and reach universal health coverage and the health-related SDGs by 2030. There is a gender equality dividend, since investing in women and the education of girls to enter formal, paid work will increase gender equality and women’s empowerment as women gain income, education and autonomy. In turn, this is likely to improve family education, nutrition, women’s and children’s health, and other aspects of development. Finally, there is a development dividend as new jobs are created, fuelling economic growth.
9. Countries need to adopt policies that address the underlying causes of gender inequities – this is what is called gender-transformative change. For example, adding jobs to the health workforce under current conditions will not solve the gender inequities that exacerbate the health worker shortage. Policies to date have attempted to fix women to fit into inequitable systems; now we need to fix the system and work environment to create decent work for women and close gender gaps in leadership and pay.
10. The focus of research in the global health and social workforce should be shifted – research must prioritise low- and middle-income countries; apply a gender and intersectionality lens; include sex- and gender-disaggregated data; and include the social care workforce. Research must go beyond describing the gender inequities to also evaluate the impact of gender-transformative interventions.
[link url="https://www.who.int/news-room/feature-stories/detail/10-key-issues-in-ensuring-gender-equity-in-the-global-health-workforce"]World Health Organisation material[/link]
[link url="https://apps.who.int/iris/bitstream/handle/10665/311314/WHO-HIS-HWF-Gender-WP1-2019.1-eng.pdf"]WHO report[/link]