Women leaders speak out: Gender Equality in the Global Health workforce - working for a new status q

The World Health Summit took place in Berlin in October 2017, with one of the very first panels investigating Gender Equality within the global health workforce. The organisers - Women in Global Health and Monash University, supported by Research in Gender and Ethics (RinGs) - organised an impressive panel to debate the challenges, and how far we have come, in promoting women as leaders in health.

Keynote speaker, Dr. Heidemarie Wieczorek-Zeul, former Federal Minister of Economic Cooperation and Development, Germany offered a policy perspective, arguing that it is important to strengthen women’s collective positioning and bring forward their ownership and support. Heidemarie pointed out that one woman alone can’t change things, rather women need to stand together and support each other to take up leadership roles such as finance and health ministers. Only in this way will women be able to change policy priorities and bring about real change for women in Africa and elsewhere.

Dr Tana Wuliji, from the World Health Organisation, reminded us that women learn that they are not leaders at a young age:that gender equality starts in the household when kids are small. The words we use to talk to our children, encouraging them and saying that they can be CEOs or presidents is important, we need to make sure we offer resources and opportunities to our children, no matter the gender. Tana stressed the importance of ‘decent work’ – which is productive, pays fairly, offers security, creates opportunities to progress, embraces the right to express concerns or organise, and which ensures fair treatment between men and women – as an entry point into gender transformative change both within the health sector and beyond.

Ms Olawumni Oduyebo, Founder of All Things Health Africa offered a private sector perspective. Picking up on the theme introduced by Tana, Olawumni explained how she, as a young girl, could not imagine herself as a leader of a company as there were no women CEO role models to look up to. Olawumni spoke about the barriers and challenges she experienced as a young woman entering the world of business and of how she had to work longer, harder, and smarter, to constantly prove herself. She relied on inner strength – ‘my mindset was the solution’ – and refused to accept the conventional roles reserved for women. Today Olawumni is herself a role model for other women, showing them that solutions do not need to be limited by the constraints society places on women and supporting them to achieve their visions.

Professor Charlotte Rees from Monash University spoke about the medical and academic context. This traditionally-masculine work environment creates a sense of un-belonging for women who, despite registering in high numbers as students, are underrepresented as leaders. Like Olawomni, Charlotte too needs to over-perform, ensuring she is active in research (while enjoying less access to resources, fewer collaborations, etc.). This is coupled with a tendency for women to undertake more teaching and administration roles, leading to larger burden on women in this area than their male counterparts. These teaching and administration roles are, however, not recognised for promotion.

Heidemarie, Tana, Olawomni and Charlotte – Doctors, Professors and CEOs. Four amazing women working to promote women’s leadership in diverse areas of health, in academia, in policy, in business and in international organisations. Their testimonies showed the complex, yet common ways in which gender, power and patriarchy play out to limit gender equity in health and to constrain women’s leadership opportunities in health systems. Underlying all their presentations were two questions, how far have we come and what can we do to bring about further positive change?

How far have we come?

In 1992, when the UK delegate of the UN’s Advisory Committee on Science and Technology for Development raised the issue of working on gender in science, in preparation for the Beijing Conference, the idea was met with considerable resistance. The delegate struck a bargain, support for another issue in order to get an agreement to promote gender equality in science. The resulting report was reviewed by developing country policy makers – who claimed that there wasn’t nearly enough evidence in the report – and by academic feminists – who thought the report under-theorized. The UN Advisory Committee realised the need to build its case for evidence and to build the links between knowledge and action. This need to build links between knowledge and action continues to this day.

Yet, there is no shortage of research and evidence of women’s exclusion from all areas of leadership. Popular books address the topic in business (Lean In) and in academia (Why so slow, Professor Mummy); and an endless succession of academic papers examine women’s performance in social and natural science (Sassler et al., 2016; Howe-Walsh and Turnbull, 2016), in business (Kurtulus and Tomaskovic-Devey, 2012; Haslam and Ryan, 2008), and in global health (Javadi et al., 2016; Bevan and Learmonth, 2012). There is also no shortage of metaphors to describe the processes that leads to women’s exclusion. The term ‘glass ceiling’, with which we are all familiar, is accompanied by the ‘glass cliff’, referring to the fact that women executives are more likely than men to be put in leadership roles during periods of crisis, when the potential for failure is highest (Husu, 2005). A ‘chilly climate’ describes male-dominated environments in which both structural conditions and relationships marginalise and devalue women, creating psychological barriers about women’s ability and efficacy (Dugan et.al., 2013). Women have to navigate a ‘crystal labyrinth’ in which networks and relationships are critical to achieve scientific prowess and status, yet are confronted by a lack of transparency around work relationships and with unequal access to mentors (McCullough, 2011). ‘Sticky floors’ refer to the difficulties women experience in progressing to senior leadership and ‘glass escalators’ delineate the lack of senior women in some professions, particularly health and nursing, despite large numbers of women working in these domains (Freehill et.al., 2015). Women’s routes to success are thus filled with dead ends, wrong turns and backtracking before being able to, ultimately, achieve success (McCullough, 2011).

These metaphors are evidence of the depth and breadth of research on women’s inequality in business, academia, policy, international organisations associated with health and act as a reminder of the power of gender stereotypes to shape women’s experiences of work and leadership and of the fact that, while some women are able to become high-profile leaders, the general environment in which they operate is hostile.

What can we do to bring about change?

How can women’s leadership and gender equality within the global health workforce be promoted? Delegates shared ideas of how to bring about positive change through a series of case studies presented by Prof. Jan Coles, Ms Sonia Singh, Dr. Sharyn Tenn and Ms. Sreytouch Vong, respectively. They emphasised the importance of getting gender-based violence education embedded in medical curricula; recognised the opportunities for change in the private sector and the value of new innovations – controlled by women – that protect women from HIV. Emerging from these case studies were several proposals for change, such as policy interventions, male support for women’s activities, specific gender champions, designated committees to ensure equal opportunities, and flexible training structures. A lot of discussion focused on the need to support individual women as well as addressing broader social, political and power dynamics that act as barriers and for the need to take action at all levels – institutional, political and individual to promote gender equity in the global health workforce. More importantly, the panel and discussion reminded me how actions, big and small, can contribute to better equity for women; of the need to link the wealth of evidence now available to action, and most importantly, of how we all – junior staff members, senior women, men, mothers, academics, boys, politicians, guardians, girls, colleagues, teachers, fathers, collaborators – have a role to play in bringing about positive change.

  • Bevan, V., Learmonth, M., 2012. “ I Wouldn’t Say it’s Sexism, Except That… It’s All These Little Subtle Things”: Healthcare Scientists’ Accounts of Gender in Healthcare Science Laboratories. Social Studies of Science 0306312712460606.

  • Haslam, S.A., Ryan, M.K., 2008. The road to the glass cliff: Differences in the perceived suitability of men and women for leadership positions in succeeding and failing organizations. The Leadership Quarterly 19, 530–546. doi:10.1016/j.leaqua.2008.07.011

  • Kurtulus, F.A., Tomaskovic-Devey, D., 2012. Do Female Top Managers Help Women to Advance? A Panel Study Using EEO-1 Records. The ANNALS of the American Academy of Political and Social Science 639, 173–197. doi:10.1177/0002716211418445

  • Sassler, S., Glass, J., Levitte, Y., Michelmore, K.M., 2016. The missing women in STEM? Assessing gender differentials in the factors associated with transition to first jobs. Social Science Research. doi:10.1016/j.ssresearch.2016.09.014

  • Javadi, D., Vega, J., Etienne, C., Wandira, S., Doyle, Y., Nishtar, S., 2016. Women Who Lead: Successes and Challenges of Five Health Leaders. Health Systems & Reform 2, 229–240. doi:10.1080/23288604.2016.1225471

  • Howe-Walsh, L., Turnbull, S., 2016. Barriers to women leaders in academia: tales from science and technology. Studies in Higher Education 41, 415–428. doi:10.1080/03075079.2014.929102

  • Parker, M., Welch, E.W., 2013. Professional networks, science ability, and gender determinants of three types of leadership in academic science and engineering. The Leadership Quarterly 24, 332–348. doi:10.1016/j.leaqua.2013.01.001

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