10 Key Issues in Ensuring Gender Equity in the Global Health Workforce

Gender inequity remains a challenge in the health workforce, with too few women making critical decisions and leading the work.

Demographic changes and rising health care demands are projected to drive the creation of 40 million new jobs by 2030 in the global health and social sector. In parallel, there is an estimated shortfall of 18 million health workers, primarily in low- and middle-income countries, required to achieve the Sustainable Development Goals (SDGs) and universal health coverage.

The global mismatch between health worker supply and demand is both a cause for concern and a potential opportunity. Since women account for 70 percent of the health and social care workforce, gaps in health worker supply will not be closed without addressing the gender dynamics of the health and social workforce.

The female health and social care workers who deliver the majority of care in all settings face barriers at work not faced by their male colleagues. This not only undermines their own well-being and livelihoods; it also constrains progress on gender equality and negatively impacts health systems and the delivery of quality care.

The World Health Organization (WHO), the Global Health Workforce Network, and Women in Global Health launched a report on the Status of Women to describe the social and economic factors that determine why few women leaders in global health and make a call for action to urgently address gender inequity.

Some of the key issues emerged from the report that can be addressed so as to bring about gender equity in the global workforce includes the following:

1. Women make up 70 percent of the health workforce but only 25 percent 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 percent of global health organizations are headed by men, and 80 percent of board chairs are men. Only 20 percent of global health organizations were found to have gender parity on their boards, and only 25 percent had gender parity at the senior management level.

3. Often, gender norms and stereotypes of jobs can affect the roles that women occupy.

Cultural labeling 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.

The gender pay gap is 25 percent – higher than average for 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 40 million new jobs will be needed by 2030 in the global health and social sector. Yet there is an estimated shortfall of 18 million 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 an enormous impact on achieving the Sustainable Development Goals (SDGs).

There is a healthy 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 prioritize 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.