EDITORIALS & ARTICLES
Are women missing from health leadership in India?
Development by and for women is at the centre of India’s vision for inclusive growth. The Union Budget’s Nari Shakti initiatives reinstated this by equipping women with tools to steer change and lead the way towards a brighter tomorrow.
Leaders have the power to transform, and women are integral to this change story. In contexts where structural inequalities are endemic and support systems are fragile, such as in India, strong women leaders can bring about positive, lasting change in people’s lives.
Status of Women in the Healthcare Workforce
- Reaching leadership positions has proven to be especially rare for women, and the health sector is no different. As per a study published in the medical journal Lancet in 2021, women represent 71% of the global health care workforce and though both men and women progress similarly in this field in their early careers, women are five times more likely to face disruptions in their pathways.
- This gender gap in global health leadership is particularly troubling because women’s health and reducing unjust health inequalities are central to the field.
- Addressing this gap will not in itself solve all women’s health problems. But it is a first step that is overdue.
- India’s health system has been stretched to the breaking point many times during the pandemic, with the bulk of the caring burden on women.
- Women are estimated to make up to 30% of doctors and more than 80% of nurses and midwives. Medical staff in India and around the world have saved millions of lives, often while risking their own.
Challenges that Women Face
- The Indian landscape is aligned with global trends — women are not commonly found in senior positions in our country’s health domain. The common issues include:
- Low pays or Unpaid work
- Absence of agency
- Harsh realities of gender bias and harassment.
- Lack of networks and support systems
- The barriers faced by female health workers undermine their well-being and livelihoods, hold back broader gender equality and negatively impact health systems.
- Women in the health care sector earn on average 28% less than men with occupational segregation alone appearing to drive a 10% pay gap.
- This gap in earnings, multiplied over a lifetime, translates into poverty in older age for many women.
- And outside the formal labour market are the women whose work in health and social care is not even recognised, let alone paid.
Women’s own Health
- In India, women’s and children’s health are areas of concern with more than half of the cohort being anaemic and a large proportion suffering from malnutrition.
- As per the National Family Health Survey-5, in adolescent girls, anaemia has actually gone up from 54% (2015-16) to 59% (2019-21).
- These issues are closely related to socio-cultural factors such as early marriage, teenage pregnancy, and unsafe abortion, which lead to compromised nutritional and health status among young girls and their children.
- Further, with women taking up most of the household work, they are exposed to the threats of Neglected Tropical Diseases (NTDs) such as lymphatic filariasis. Often, they don’t even seek care on time, unless their husbands or guardians agree.
Significance of Women in the Healthcare Workforce
- Studies establish that placing more women in leadership positions not only increases organisational productivity but maximises the value of the female workforce.
- Having women at the front and centre of decision-making processes will help integrate nuances of our social fabric in policies.
- It is estimated that women in health contribute 5% to global GDP (US$ 3 trillion) annually, out of which almost 50% is unrecognised and unpaid.
- If women were able to participate in the economy equally, it would result in nearly an estimated $160 trillion increase in global GDP or a 21.7% increase in human capital wealth.
Road ahead
- More Investments and Creation of Opportunities: Effective leadership depends on intentional investment and creating opportunities to level the playing field.
- With the pandemic revealing the fragility of existing systems and the need for timely, efficient decision-making, it is critical to relook at our investments such that the health leadership at all levels is inclusive, diverse and equitable.
- Evolving with the Changes: Health leadership is largely centred on the ability to identify priorities, provide strategic direction to multiple actors within the health system and create commitment across the health sector.
- As health systems change, the leadership must modify and respond to political, technological, social, and economic developments that are essential for strengthening the health system.
- Bringing Women in Leadership Roles: Significantly, the Nari Shakti initiative and Mission Shakti were re-launched in the Budget session to deliver unified citizen-centric support for women through integrated care and safety, rehabilitation, for women as they progress through life. This is a step in the right direction.
- Having more women at the head of decision-making tables is urgent to introduce more women-centric interventions.
- It is extremely important to address social barriers, build resilient, inclusive health systems and for diverse perspectives to be integrated into health resource allocation, research policies and financing.
- A Collective Responsibility: We must make more concerted and intentional efforts to accelerate women’s leadership in health and optimise pathways to this.
- This requires changing perspectives, breaking away from deep-rooted sociocultural beliefs and making equal opportunities available to all.
- Only by believing in and working towards gender transformative leadership can we ensure that policy decisions benefit all and bring intergenerational change.
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