With 69% of global health organisations headed by men and 75% ignoring gender parity at senior management level, it is a well know fact that women deliver global health and men lead it. Gender bias, the health industry needs another 200 years for women to have an equal say and pay, in a system designed for men.
How healthy is the healthcare industry?
Looking into the global healthcare, we want to address some crucial questions. No doubt, there is progress on gender parity but while woman leadership is different for different countries and sectors, from a global community perspective, latest reports show that discrimination, inequalities and exclusion are still going to be the “norm” for another 200 years. On Women’s international day, I am grateful my daughter is an accountant BUT I have to ask myself: What if my grand daughter will embrace a profession in the healthcare industry?
The inside finding of the World Health Organisations are far from healthy for the healthcare industry globally.
“Global health is predominantly led by men: 69% of global health organizations are headed by men, and 80% of board chairs are men. Only 20% of global health organizations were found to have gender parity on their boards, and 25% had gender parity at senior management level. Health systems will be stronger when the women who deliver them have an equal say in the design of national health plans, policies and systems. Workplace gender biases, discrimination and inequities are systemic, and gender disparities are widening. In 2018 it was estimated that workplace gender equality was 202 years away – longer than 2016 estimates. “
Is the healthcare system designed for women’s leadership?
We all agree that changing healthcare industry existing structure is a very complex matter. My question is why female healthcare professionals are expected to fit into a system that is designed for men? The same report states: “many countries still lack laws on matters that underpin gender equality and dignity at work, such as sex discrimination, sexual harassment, equal pay and social protection.
Women in global health are underpaid and often unpaid. It is estimated that women in health contribute 5% to global gross domestic product (GDP) (US$ 3 trillion), out of which almost 50% is unrecognized and unpaid. The World Economic Forum Global gender gap report 2018 estimates the average gender pay gaps by country at around 16%. The unadjusted gender pay gap appears to be even higher in the health and social care sector, estimated at 26% in high-income countries and 29% in upper middle-income countries. “
The logic behind the gender pay gap, largely set in men’s favour and considered an universal, accepted truth doesn’t hold any logic… Can’t we see and measure the negative impact of this status quo during women’s lifetime economic challenges? Let’s face it, after dedicating their lives serving in the medical profession, women expect poverty in old age. The report carries on stating:
“In sectors that are female dominated, work is typically undervalued and lower paid. Workplace violence and sexual harassment in the health and social sector are widespread and often hidden. Female health workers face sexual harassment from male colleagues, male 3 patients and members of the community.
It is often not recorded, and women may not report it due to stigma and fear of retaliation. Violence and harassment harms women, limits their ability to do their job, and causes attrition, low morale and ill-health. In Rwanda, female health workers experience much higher rates of sexual harassment than male colleagues, and in Pakistan, lady health workers have reported harassment from both management and lower-level male staff. Occupational segregation by gender is deep and universal.”
Can women leadership heal the existing segregation in health care globally?
Seems the horizontal segregation ( women dominate nursing and men dominate surgery) is a reality that is going to hunt us all for the next 200 years. Men seniority and the higher-status, higher-paid roles (vertical segregation). that is embedded in the healthcare industry globally, are constantly widened by societal gender stereotypes and patriarchal thinking. Same report is reinforcing the need to invite more women at the top of the industry and recommends that women are recognised for their talent.
“Occupational segregation by gender drives the gender pay gap and leads to loss of talent (for example, with few men entering nursing).
It is time to change the narrative. Women, as the majority of the global health and social care workforce, are the drivers of global health. Research and policy dialogues on gender and global health to date have neglected this reality and have focused on women’s health and women’s access to health (both vitally important).
It is critical to record and recognize all the work women do in health and social care – paid and unpaid – and bring unpaid health and care work into the formal labour market. Women form the base of the pyramid on which global health rests and should be valued as change agents of health, not victims.
Gender-transformative policies should be adopted that challenge the underlying causes of gender inequities. Such policies are essential to advancing gender equality in the health and social workforce. Adding jobs to the health workforce under current conditions will not solve the gender inequities that exacerbate the health worker shortage, contributing to a mismatch of supply and demand and wasted talent.
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.
The focus of research in the global health and social workforce should be shifted. Research priorities must prioritize low- and middle-income countries; apply a gender and intersectionality lens; include sex- and gender-disaggregated data; and include the entire health and social workforce, including the social care workforce.
As an outsider who experienced the benefit of being treated by an exceptional woman surgeon, I wonder if this woman doctor is considered for leadership… She definitely saved my life! The interesting fact is that I had to refuse a male doctor who is considered to be the best in his field and when I asked for a female doctor instead, my request created controversy and delays. While my first surgery was performed by a top male surgeon, and I am grateful for the miracle he performed, my second surgery is the reason I am still alive.
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