This blog post was written by Dr. Kelly Thompson (kelly.thompson@womeningh.org), Dr. Roopa Dhatt (roopa.dhatt@womeningh.org) and Mehr Manzoor (research@womeningh.org).
Despite women making up the vast majority of those working in the field of global health, there is a persistent lack of female representation in the highest management and leadership positions. Our recent article explores the current situation in Cambodia, Kenya and Zimbabwe, to gain a better understanding of the barriers and successes women face in obtaining leadership roles.
In many countries, more than 75% of the health workforce is women [1], with women contributing around three trillion US dollars to global health care, with nearly half of this unpaid [2]. However, women’s huge contribution to the global health system is not represented at the highest levels of management and leadership. In Cambodia, for example, women constitute only 20% of those in senior roles in the Ministry of Health. In 2015, only 27% of Ministers of Health were women [3]; and in 2017, at the 70th World Health Assembly only 30% of member state delegations were led by a woman [4]. The gender gap is also evident in top leadership positions in global-health funding and development agencies.
In all three country cases studies (Cambodia, Kenya and Zimbabwe), women felt a bigger burden of the gendered role of women as the primary caretaker of children. This in turn led to delays in achieving necessary educational qualifications, or being encouraged to take time away from work or to leave positions impacting their career progression when compared to men. In Zimbabwe and Kenya, other intersecting norms inhibited women’s career progression and advancement to leadership positions. In Zimbabwe, men were often more likely to be offered rural positions, which in turn provided them with access to greater levels of training, international workshop invitations and promotions. In Kenya, the hierarchal nature of the system meant that doctors were often promoted to leadership roles, and since women were less likely to become doctors they were also less likely to become leaders. Positive changes have been seen in Cambodia, where national and provincial governments have recognized the need for greater gender sensitivity with the aim of improving female representation at all levels.
Achieving gender parity at all levels of health systems is critical to harnessing the full potential of the global health community and creating solutions, which are both gender responsive and effective. Women’s leadership is particularly critical in addressing issues that directly affect their own lives, and in addressing areas with increasing inequality [5]. While a rights-based approach should be sufficient for achieving gender parity in both global health and non-health fields, the economic benefits also provide a strong argument. It is estimated that achieving gender parity would be worth around US$28 trillion to the global economy, an increase of 26% from levels projected given conditions of continued gender inequity [6]. The limited evidence available, which evaluates the impact of gender on policy decision-making and health outcomes, suggests clear links between women’s leadership and more equitable health outcomes. In India, for example, women in leadership positions within governmental organisations tended to implement policies which were more supportive of women and children and their concerns [7].
Our recent article “The role of women’s leadership and gender equity in leadership and health system strengthening”, published as part of Global Health, Epidemiology and Genomics’ themed collection on Women in Global Health, outlines our agenda for action. To achieve gender parity in the global health community we argue for:
1. Leadership that is gender responsive and institutionalised
2. Development of enabling environments for women’s leadership
3. Research and data disaggregated and reflexive in terms of sex and gender
To read our call to action in full, read the article here: The role of women’s leadership and gender equity in leadership and health system strengthening
References:
1. WHO Health Systems Framework. (http://www.healthsystemsglobal.org/blog/9/A-new-era-for-the-WHO-health-system-building-blocks-.html). Accessed 15 June 2017.
2. Langer A. Women and health: the key for sustainable development. Lancet 2015; 386: 1112–1114.
3. Central Intelligence Agency. World Leaders, 2016. (https://www.cia.gov/library/publications/world-leaders-1/AF. html). Last accessed 20 April 2016.
4. World Health Organization. The 68th World Health Assembly, registered Delegates. Accessed 20 May 2015
5. World Health Organization. Women and Health. 2009. (http://www.who.int/gender/women_health_report/ full_report_20091104_en.pdf). Accessed 20 April 2016.
6. Mckinsey. Mckinsey Global Institute Report. (http://www. mckinsey.com/global-themes/employment-and-growth/ how-advancing-womens-equality-can-add-12-trillion-toglobal-growth). Accessed 24 April 2016.
7. Downs JA. Increasing women in leadership in global health. Academic Medicine 2014; 89: 1103–1107
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