Investing in Rural Health Workers for the Economic participation and empowerment of rural women and

This week and last, thousands of women and girls, and their allies, are meeting at the United Nations in New York for the 62nd Commission on the Status of Women (CSW). CSW was created to address and report on progress on women’s empowerment and gender equality, and has recently been tasked with reporting on the progress of Sustainable Development Goal (SDG) 5 on gender equality. Recognizing their unique needs, this year’s theme is focused on rural women and girls. Aiming to convey the transformative power of women in the health workforce to achieve gains across the Sustainable Development Goals, World Health Organization (WHO), Women in Global Health, the Permanent Mission of Ireland to the UN, and International Labour Organization (ILO), with the support of the Global Health Workforce Network Gender Equity Hub, co-convened a side event “Investing in Rural Health Workers for the Economic participation and empowerment of rural women and girls”.

Dr. Roopa Dhatt, Executive Director, Women in Global Health highlighted, in her opening remarks, that women and girls are much more than recipients of care – and that women health and social care workers, as 70% of the health and social workforce, deliver care to over 5 billion people. She furthered that not only would investments in the health and social workforce avert a potential 18 million health worker shortage by 2030, it would also have a transformative effect on the economic participation and empowerment of rural women and girls.

Amb. Brian Flynn, Deputy Permanent Representative, Permanent Mission of Ireland to the United Nations emphasized that an investment in health has a multiplier effect on economic growth and job creation. As such the majority, €80 million, of Ireland’s overseas aid in 2017 was dedicated to global health programming. He highlighted that rural women and girls are often poor and marginalized and are those that the health services are trying to reach, and that it is these same women who should be empowered to join the health workforce.

Dr. Tana Wuliji, Technical Officer, Health Workforce Department, WHO, utilized advances in Guinea to highlight the importance of investing in the rural health workforce, and impact on the employment prospects and health of rural women and girls. WHO established a threshold of 4.45 health workers per 1000 population required to advance the health-SDGs, yet Guinea only has 0.7 health workers per 1,000. Despite the enormous need for more health workers, as is common in many countries, 11,500 trained Health Technical Officers are unemployed. To address this unique issue, Guinea, with the support of WHO and other UN agencies through the UN Development Assistance Framework, have established a rural health worker pipeline project to train and employ 18,000 community-based health workers through a step-ladder approach by 2020. It is projected that this program has the potential to prevent nearly 40,000 deaths and 1.2 million cases of illness in children under the age of 5.

Two rural health workers, Ms. Mercy Owuor, from Kenya and Dr. Mayara Floss from Brazil captured the unique needs and sacrifices of rural health workers, but also their transformative power for women and girls in rural communities. Ms. Owuor spoke of the impact rural work had on her two sons, aged 4 and 7, who, due to the lack of adequate schooling in the community she worked, remained in the city during the week. Dr. Floss, spoke of how initially the community she worked with wanted to know if she was married, and questioned her qualifications to be working in their community, questions not asked of her male colleagues. Despite these unique struggles, the women saw immediate impact on the communities they served, and the transformative affect women health workers have on rural communities. Capturing this astutely during the panel discussion, Ms Owuor noted “It’s about the value that health workers bring to a community. Highlighting their value is a key part of achieving universal health coverage”.

Joined on the panel by Alette Van Leur, Director of Sectoral Policies Department, ILO and Shirley Dorismond, Vice President of FIQSANTE-Canada and representative of the trade union Public Services International (PSI), a lively discussion ensued about the impact investing in women health workers can have on gender equity and the communities they serve. Key takeaways included:

  • The provocative question “is the global health workforce underpaid and under-invested in precisely because it is predominantly women?”

  • Informal work, decent work and the gender pay gap are key issues in the health and social sector. Moving health work from the informal sector to the formal sector through better investments and ensuring decent work for all health workers (including community health workers that are often women who are unpaid) is key. Despite the fact that 173 countries have ratified the ILO convention on equal remuneration, greater government action is needed to close the pay gap.

  • Working in the rural health workforce should not be by accident, health workers should be provided with opportunities and supported to work with rural communities during their training.

  • There is no other sector that employs more women than healthcare. Investing in health workers presents a massive opportunity to be gender transformative, and it is more important now more than ever before.

Dr. Dhatt summarized the key messages that the health and social workforce shortfall is an intersectoral, societal-wide challenge and that all stakeholders have an important role in closing the gap through joined up approaches at the global, regional and national level. Given that the majority of the health and social workforce are women and half of women’s $3 trillion USD annual contribution to global health goes unpaid, it is also a gendered issue. The under-valuing, under-recognition, under supported workforce and workplace harassment is deep rooted in power structures and patriarchy. Finally, she summed up the opportunity at hand – the triple gender dividend, firstly that investing in the health and social workforce is the only way we will meet the global health needs, avoid health security disasters like pandemics, reach Universal Health Coverage and achieve the SDGS; secondly that it will boost gender equity and empowerment through education, training and decent employment creation that will primarily benefit women; and thirdly that it is a force multiplier for inclusive growth.

This session was organized on behalf of the Global Health Workforce Network Gender Equity Hub, which seeks to accelerate large-scale gender-transformative progress to address gender inequities and biases in health and social workforce for the SDGs. If you are interested in learning more about the hub please contact

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