Delivered by Women, Led by Women: The Future of Global Health Leadership

Abstract

The authors note the disparity between leadership roles of men and women in global health and its effect on the response to COVID‐19. The work of their organization Women in Global Health is described, including “launching a Gender Equal Health and Care Workforce Initiative in 2021 in partnership with the Government of France and World Health Organization, convening governments and international organizations to leverage commitments for safe and decent work, equal pay and an equal say in leadership for women in health and social care.” They note that women are “80 percent of the world's nurses and 90 percent of the frontline health workers.” Yet the reality is that “women still deliver health systems led by men.” The authors outline their vision for global health leadership; in brief, and in their words: First, we must change the narrative and see women as drivers of global health, not solely as users of health systems…. Second, women in health and social care need a new social contract… Third, COVID‐19 showed that viruses do not respect national borders and we live in an interconnected world… Fourth, beyond gender parity in global health leadership, we need leaders of all genders to be gender transformative leaders.

Gender equality in the 21st century: Overcoming barriers to women's leadership in global health

“…For example, the McKinsey Global Institute estimates that if we achieve gender parity, in which women hold equivalent roles to men in the labor markets over approximately a decade, it will add between $12 trillion and $28 trillion to the global gross domestic product (GDP) by 2025; 69 however, much of the health and social care throughout the world provided by women is unpaid or unrecognized. 34 Data also show that women contribute $3 trillion annually to global health care but approximately half of their contributions, or 2.35% of the world's GDP, is uncompensated. 7,70 Furthermore, a major barrier to women's participation is the "gendered" stratification of global-health-care-work along gender lines due to stereotypical gender norms that devalue women and view certain caregiving work as women's work.…”

“…34 Unpaid women and girls provide an estimated 50% of uncompensated care to families and communities. 34 The estimated pay gap between men and women globally is estimated at 16%, but it is even higher in the health care and social sector industries. In high-income countries, it is estimated at between 26% and 29%.…”

“…6 Furthermore, women in health care globally are paid 28% less than men, and occupational segregation drives 10% of the pay gap. 34 In a simulated 40-year career projection, one US study reported that men physicians will earn an estimated $2 million or 24.6% more than women physicians. 73 Additionally, the American Dental Association reported that between 2019 and 2020, US women general practitioner dentists saw a 26.6% decline in net income compared to a 14.7% decline for similarly situated men practitioners.…”

“…Discussions of women in global health are often centered on women with formal academic qualifications, conventional professional training, and women from high-income countries. 34 This ignores a large segment of women health care workers living in low-or middle-income countries, rural and remote areas, and nations with gender employment restrictions. For these women, educationally or financially acquiring professional credentials may not be possible, and they lead and provide care that is often unpaid and unrecognized.…”

“…32 Furthermore, systemic shifts needed to bring about gender equity in global health leadership will require not only a network of women, but will also require their allies to help design, guide, and direct the behavioral and structural policy shifts (e.g., ethical, cultural, economic, socio-political, and occupational) needed for sustainable, equitable, and transformative change. 34 Using the Women in Global Health Ecological (WGHE) Model's five factors (e.g., public policy, community, institutional, interpersonal, and individual) as guidance, this manuscript highlights important persistent barriers to achieving gender equality and gender equity in global health leadership positions (See Figure 4). Additionally, the concepts of global leadership and global health are defined, and their historical origins are explored to assist health care leaders in reframing and providing a more inclusive narrative around these terms.…”