“Male privilege pervades” Global health still delivered by women and led by men
Women are on the frontlines of the COVID-19 pandemic response. We have been hearing this sentence repeated in speeches, articles, blogs and online commentary for a year now. Yes, women make up 70% of the health workforce globally. Yet, when it comes to making decisions and leading global health, women continue to be largely absent.
Women continue to deliver global health while men continue to design and lead it. As the latest Global Health 50/50 report Gender Equality: Flying Blind in a Time of Crisis puts it, “male privilege pervades”.
The data speaks for itself: 69% of global health organisations are headed by men, and 80% of board chairs are men.
This gender gap in leadership is driven by pervasive gender inequality, stereotypes, discrimination, and power imbalances. Some women are further disadvantaged, for example on the basis of their race, class or gender identity. As an article on BMJ Global Health exploring the “broken system” of non-inclusive governance notes, “Men dominating leadership positions in global health has long been the default mode of governing.”
The newly-released Global Health 50/50 report is a sobering read. It notes that one-quarter of CEO and Board Chair positions in leading global health organisations changed hands in 2020, offering an opportunity to increase diversity. Yet, the figures stay the same from the previous year.
“Women continue to deliver global health while men continue to design and lead it.”
Men continue to hold 70% of leadership positions and nationals of high-income countries hold over 80% of these. One-third of organisations had parity (45-54% women) in their governing bodies or senior management.
COVID-19 task forces are largely led by men. In a study of 115 COVID-19 decision-making and expert task forces, only 3.5% had gender parity.
UN Women notes that while women are Heads of State and Government in only 21 countries worldwide, women’s leadership has been applauded for its greater effectiveness in managing the health crisis. Women Heads of Government in Finland, Denmark, Ethiopia, Germany, Iceland, and New Zealand are being recognized for the rapidity of the response they are leading, supported by transparent and effective communication of public health information.
This pervasive gender inequality also shows in the gender pay gap. Overall in the health sector, the gender pay gap is at 25% - higher than average for other sectors. Women health workers are clustered into lower-status and lower-paid (often unpaid) roles.
And this gap does not disappear at the leadership level: CEO salaries at the 34 US-based NGOs in the Global Health 50/50 report sample were found to be consistently higher for men. On average, women CEOs were paid $308,000, while men CEOs were paid $415,000 – a gender gap of $106,000 per year.
As women tackle COVID-19 in their various health and caretaking roles influenced by traditional gender norms, they continue to face unacceptable challenges. These include violence and harassment at the work place, lack of proper training and support, and absence of menstrual hygiene products and other essential products. Masks and other personal protective equipment are often designed and sized for men, leaving women at greater risk of exposure to the virus.
Studies are showing that between 20-70% of the health workforce are struggling with mental health issues (stress, insomnia, depression) since COVID-19. Healthcare workers experience high levels of depression, anxiety, insomnia, and distress. Women health workers, including nurses, have been disproportionately affected.
The theme for this year’s International Women’s Day, “Women in leadership: Achieving an equal future in a COVID-19 world,” reminds us that there is no equal future without equal participation at all levels. The prevailing power imbalance and privilege in leadership needs to be challenged with concrete actions and accountability mechanisms to move away from “business as usual”.
“Participation is not enough: women, in all their diversity, must be able to meaningfully influence and shape the design, implementation and monitoring of COVID-19 preparedness and response plans, policies and budgets.”
Women’s equal and meaningful participation in national COVID-19 response and recovery plans is critical for ensuring their needs are met. Mere participation is not enough: women, in all their diversity, must be able to meaningfully influence the design, implementation and monitoring of COVID-19 preparedness and response plans, policies and budgets.
Women have a right to shape decisions that affect their lives. Diverse, inclusive leadership is urgently required at all levels - local, national and global. This is not only needed to increase the effectiveness and long-term sustainability of the current pandemic response, but to stop existing inequalities from becoming further magnified.
