Gender-Transformative Leadership: A Participatory Toolkit for Health Workers

Women make up 70% of the 200 million workers globally who contribute to the health and social sector, but women only hold 25% of leadership roles.¹ What’s more, nearly half of women’s contribution to global health is informal or unpaid.¹Norms related to job choice, division of household responsibilities, working conditions, institutional policies, and the presence, or lack, of role models all contribute to gender segregation by occupation and women’s ability to advance professionally.¹

A lack of gender balance at every level of health leadership is detrimental—health systems lose female talent, perspectives, and knowledge because of it. The World Health Organization (WHO) notes that equal representation of genders at all levels of an organization and in different health sub-sectors leads not only to an empowered workforce, but also to improved quality of care and solutions shaped by a better understanding of health systems.¹

The COVID-19 pandemic provides a clear example. Despite the pandemic’s disproportionate effect on women and girls, in part because of their overwhelming presence on the front lines as health care workers and caregivers, women are underrepresented in decision-making. Women comprise just 10% of the representatives of the U.S. Coronavirus Task Force and 20% of the WHO Emergency Committee on COVID-19.² A global survey of 30 countries found that women represent an average of 24% of national-level decision-making bodies on COVID-19.³ By failing to include women’s voices, we not only lose critical technical expertise, but also increase the risk of implementing policies that fail to account for the gender dimensions of health emergencies.² Losing gains in access to sexual and reproductive health services, overlooking negative consequences of epidemics on maternal and child health, failing to address the increased risk for gender-based violence—specifically intimate partner violence—due to lock-downs, and limiting conversations on economic recovery to the formal sector are just some of the consequences of gender-blind policies that do not also consider the intersectional needs of women.^2–4 (Intersectionality recognizes that women are not a homogenous group, and that gender interacts with other determinants like age, geographical location, sexuality, class, religion, ethnicity, citizenship, and disability to shape access to services and health outcomes.⁵)  

Given this backdrop, there is no better time than now to invest in gender-transformative leadership to promote gender equality in health organizations and, more broadly, in the communities where they work.⁶ (Gender-transformative leadership development offers deliberate consideration of both formal and informal gender power structures and discriminatory practices.⁶) To address factors contributing to the global gender gap in leadership, Jhpiego’s recently launched Gender Transformation for Health: A Toolkit for Health Workers covers topics like global disparities in women’s leadership, gender as a determinant of career advancement, gendered patterns of communication, mentorship and sponsorship, and linkages between power, gender norms, and sexual harassment. 

The toolkit reflects numerous calls to action for equitable representation of women in global health decision-making. The strategies shared in the toolkit’s modules apply an intersectional lens and complement existing leadership curricula, providing tools to health care workers and managers to advance gender equality. The approach is particularly relevant in the context of today’s pandemic, but it can also be used long-term to spur greater inclusion of women’s voices in global health. 

References:

1. World Health Organization. Delivered by women, led by men: a gender and equity analysis of the global health and social workforce. 2019. World Health Organization. https://apps.who.int/iris/handle/10665/311322. License: CC BY-NC-SA 3.0 IGO
2. Women in Global Health, Women of Color Advancing Peace and Security. Operation 50/50: 90+ Women Experts Working in Health Security. https://www.womeningh.org/operation-50-50.
3. CARE. Where are the Women? The Conspicuous Absence of Women in COVID-19 Response Teams and Plans, and Why We Need Them. 2020. https://www.care-international.org/files/files/CARE_COVID-19-womens-leadership-report_June-2020.pdf
4. Devex. Ensuring women’s representation in COVID-19 policymaking. Gender Data Series: Mitigating the impact of COVID-19 on women and girls. June 9, 2020. https://pages.devex.com/gender-data-covid19#upcoming-event.
5. Davies SE, Harman S, Manjool R, Tanyag M, Wenham C. Why it must be a feminist global health agenda. The Lancet. 2019; 393 (10171): 601-603. https://doi.org/10.1016/S0140-6736(18)32472-3.
6. Keeling A, Manzoor M, Thompson K, Dhatt R. Women in Global Health Gender Transformative Leadership: A New Vision for Leadership in Global Health. 17 November 2018. https://c8fbe10e-fb87-47e7-844b-4e700959d2d4.filesusr.com/ugd/ffa4bc_5f193fb461714a27a87aafbf3a8828bb.pdf.