Reflections on 'Decent Work- rights, roles and responsibilities' plenary at the 4th Global F

"Addressing global health challenges, building resilient, stronger health systems, providing universal health coverage and achieving the global goals (SDGs) cannot be done without consideration of the gendered aspects of the workforce. When we kicked off this forum, we heard ‘Jobs for health = Jobs for women!’ Let’s not forget this key message."

Dr. Roopa Dhatt started off her plenary speech reminding the audience that while all genders play a vital role in the health workforce, women contribute in greater numbers - 75% . They are the driving force of health. When we look closely at the health sector from a gendered lens - women are often under resourced, under paid or unpaid, under trained and not formally recognized, especially in carer roles which are increasing. As we heard from our health workers, our everyday heroes, during the storytelling evening on Monday, November 13th, women face many personal safety concerns on top of their everyday work. Studies over and over demonstrate the significant amount of harassment women face in the workplace. An expert group for the Royal Australiasian College of Surgeons, found that nearly half of fellows, trainees, IMGs reported being subjected to discrimination, bullying, sexual harassment. AMA-WA - 31% of doctors sexually harassment, 81% were women.

During the launch of the Gender Equity Hub on Monday, November 13th, we discussed how these gender biases and inequities results in a majority disenfranchised, disempowered talent pool. In top leadership roles in global health women’s leadership dwindles. In the Youth Forum the next day, we discussed that if we further dissect the leadership from an intersectionality lens, those taking on the toughest health challenges at the frontline are the least represented - nurses, CHWs and often not even counted. All this confirms how ingrained and deep rooted the power structures that shape the health sector and therefore the health and well being of all of us.

"The time for action is now, we have convincing enough data and evidence to inform action. Now we need to focus our energy on identifying solutions, learn from other sectors who are addressing similar challenges and accelerate progress toward greater gender equality. If we want to reach 18 million more in the health workforce, we need to put solutions forward that are about the greatest return on investment (ROI)."

The solutions we put forward now, at the forum and globally in the SDG era, are an opportunity to shift the culture for a more gender transformative global health community, where all health workers have rights and decent work.

In order to recruit, deploy and retain well-trained and motivated health workers, all people, regardless of gender and backgrounds, need to be equally valued, compensated, recognized/counted and supported.

Building on the evidence guided recommendations, we must develop, implement, and enforce gender transformative leadership through program and policies that empower all health workers to reach their maximum potential and be empowered drives of health in their communities.

  • Value: We must increase visibility and recognize the contributions of women in the health workforce - view them as leaders in their communities- who understand the complexity of social, economic, political, cultural, environmental drives. Research has shown over and over again the power of positive incentives- the more a person is valued, the more their confidence and commitment grows.

  • Compensate: Close the gender pay gap, this require labor force analysis 1- estimate the value of paid and unpaid health care contributions and recompsenate. And then implement change by 2- Men and women receive equal compensation for equal work. (The average gender wage gap is 23 per cent, but in health sector is is 26% )

  • Data: Close the data gap in the health workforce, especially on gender. It is not only imporant for monitoring progress, but crucial to the design, analysis and evaluation process of any health vision. Mandate both qualitative and quantitative quality data in civil, vital, national health systems, which includes gender disaggregated data and other demographics of power and privilege based on social, economic, cultural, environmental determinants. In an era of data revolution, this is a simple win-win add on.

  • Support: Policies without implementation and enforcement do not go far. Develop and implement an accountable framework with quantitative and qualitative indicators for gender equality and decent work in the health workforce, which goes through independent accountable reviews.

"Finally, we all in this room have a personal responsibility to advance decent work environments: Addressing our own personal biases shifts mindsets. Having this conversation to your community shifts norms. Bringing this to your organization will transform society."

Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has. - Margaret Mead

Take-away messages from the event:

  • Don’t forget the Health Worker: Decent Work must apply to all, it is a human right!

  • Decent work involves opportunities for work that is productive and delivers a fair income, security in the workplace and social protection for families, better prospects for personal development and social integration, freedom for people to express their concerns, organize and participate in the decisions that affect their lives and equality of opportunity and treatment for all women and men.

  • Health workers are not simply head counts; they are people with rights, roles and responsibilities.

  • Decent work is a human right. It is unacceptable that health workers are exposed to occupational risks and hazards, subjected to violence or targeted in conflicts.

  • Decent work sums up the aspirations of people in their working lives. From your own perspective, what measures can be taken to advance decent work and the rights of health workers to make progress towards UHC and SDGs.

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