Leveling the ground for women in healthcare leadership for sustainable development in Africa

March 17, 2022

This year the International Women’s Day is marked under the theme, “Break the bias”,  with calls for renewed attention to women’s status as regards equality, bias, stereotypes and discrimination.  As we celebrate the successes that have been achieved in advancing women’s rights, the ongoing COVID-19 pandemic demands a reflection on the status of women. The Pandemic has increased pre-existing inequalities but more so for girls and women. The bulk of the informal sector is made up by women and girls and have been  hardest hit by job losses, forced to take on more unpaid care work, impeded access to healthcare,  increased incidences of sexual and gender based violence among other issues. 

Women’s status in the public health sector globally is critical given the vital role women play especially as caregivers . This situation is mirrored in sub-Saharan Africa where there is a significant number of women in healthcare, mostly pursuing careers in nursing and/or midwifery. However, very few women occupy leadership positions owing to gender dynamics in the sector, and the privileges and vulnerabilities that come with their roles. 

The Successes

For decades, global leaders have committed to actions, including the Beijing Declaration , in order to address gender inequality in all sectors.  Agenda 2030 is explicit on ‘leaving no one behind’ and, in part, stresses  gender equality, promotion of full and productive employment and decent work for all, access to health and promotion and enforcement of non-discriminatory laws and policies for sustainable development. Several affirmative initiatives to address gender inequality in different sectors have been implemented in African countries with varying levels of success. For instance, affirmative action on education in Kenya, Tanzania and Uganda has resulted in more girls joining institutions of higher learning. The African Union’s Agenda 2063  aims at promoting girls’ involvement in science, technology and innovation (STI) through the provision of career guidance and in partnership with several UN agencies, it has implemented projects aimed at increase women’s employment and leadership in science. On its part, UNESCO and its partners have provided mentorship to girls in Kenya, which focused on helping them make informed career choices in Science, Technology, Engineering and Mathematics (STEM).

The Challenges

In spite of the existing legal and policy interventions in the region, more work needs to be done as several challenges persist. Prevailing patriarchal attitudes and practices embedded in social and cultural norms, stereotypes and discrimination in the workplace; and poor funding and planning for education and science initiatives serve to limit the growth of women in science leadership positions in the region. In addition, the low number of women scientists limits the nature of the evidence generated as women’s perspectives are largely absent.

The way forward

Under this year’s theme, progress for women and societies demands that biases are broken in the recruitment, reward, recognition and retention of women in the upper echelons of leadership in global health. In order to provide a stable foundation for women’s participation in health leadership in Africa, a review of existing legal and policy frameworks to ensure that they promote equality, diversity, and inclusion for all is urgently needed. 

Frameworks ought to enhance girls’ education, support healthy work environments and continuous professional development.  In addressing current legal and policy gaps that negatively impact on women’s contributions in the health sector, other dimensions of equality such as social class, race affect the numbers of women in healthcare leadership need to be looked into. Laws that ensure equal pay for work, gender-mainstreaming in the health sector, strict enforcement of the two thirds gender rule,  establishment of gender offices, political goodwill and commitment serve to encourage women to compete for leadership positions. 

Putting social norm change at the centre of current and of future initiatives could be one of the most effective means to guarantee that the region will be on track to fulfil its promises on gender equality and women’s empowerment. However, changes in social and cultural norms and practices are complex processes that demands a lot of advocacy, engagements and training of power-holders. To promote the achievement of these changes, partnerships with and between civil society and political and cultural leadership are necessary.

 Mentoring programs to provide career support and networking among women working in health are vital. This would also require engagement between women scientists and young girls to encourage greater female uptake of STEM careers. Initiatives such as Project Girls for Girls which empowers girls to lead is a great example of this. 

Currently, there is no monitoring and evaluation framework to track the presence and contributions of women in global health leadership. In the absence of this structure more research is needed to examine the impact of women in the health sector, including leadership.  Positive lessons learnt from similar initiatives in different regions may be borrowed and replicated in other areas. For example, upon realising that the grants they offered mainly benefitted men, the South African Medical Research Council, which offers grants to health professions decided to overhaul its application review process. This move has resulted in stratification of the grants offered among different research cadres taking into consideration that some women (re)join health research when they have completed childbearing. 

Conclusion 

Although many obstacles still prevail in the path to gender equality and women’s rights, levelling the terrain for women in global health is one important contribution to improving the health and wellbeing of people across Africa and beyond. This will ultimately result in a world that is more diverse, equitable and inclusive for all.