Gender Equal Health and Care Workforce Initiative Event Report

During the Generation Equality Forum in Paris, the government of France hosted a session with Women in Global Health and the World Health Organization to present commitments and expressions of support under the Gender Equal Health and Care Workforce Initiative (GEHCWI). The Initiative aims to increase visibility, and commitment to action on gender equity in the health and care workforce by increasing the proportion of women in health and care leadership roles; recognizing the value of unpaid health and care work, and the importance of equal pay in the health and social care sectors; protecting women in health and care against sexual harassment and violence at work; and ensuring safe and decent working conditions for all health workers, everywhere. The session issued an urgent rallying cry for action to address violence and harassment, as well as discrepancies in leadership, pay, and working conditions. We are thrilled to announce 30 commitments and expressions of support made under the Initiative, from governments, international organizations, and NGOs.

  • Women are the experts at the heart of health systems, they represent 70% of the health workforce, but only account for 25% of leadership positions in health. Health systems are weakened when women’s talent and perspectives are marginalized in health decision-making.
  • COVID-19 has disproportionately affected women, the pandemic has deepened pre-existing gender inequalities, exposing vulnerabilities in social, political, and economic systems, and rendering women more vulnerable to gender based violence and poverty.
  • Action to better support women in the health and care sector will make an immediate difference for women workers and also for the economy and well-being of the whole of society.
  • Four actions should be taken to achieve a gender equal health and care workforce:
  1. Ensure equal pay for work that is of equal value and ensure that all women in health system’s roles are fairly paid. Over one million women globally work unpaid or are grossly underpaid in critical roles in health systems.
  2. Create policies and measures to enable equality for women in health and care leadership roles.
  3. End sexual harassment and all kinds of violence against women in the health and care workforce.
  4. Protect the physical and mental health and wellbeing of women health and care workers, including through the provision of personal protective equipment (PPE) and vaccines.
  • A trained health and care workforce is the foundation for strong health. systems, universal health coverage (UHC), and global health security. The pandemic has deepened the projected global shortage of 40 million health workers. Health and care workers everywhere are exhausted, lives have been lost to COVID-19, large numbers face the lasting impact of long COVID and there are reports that health workers in many countries are planning to leave the profession. Addressing gender inequity in the health and care workforce is now critical to retain women in the profession and attract women to fill vacant positions.

Through the event, we aimed to turn applause into action for health and care workers. We ensured that the perspective of a frontline health worker, Dr Naimatou Moussa from Senegal/Togo, was heard alongside political leaders and other prominent voices from global health, including:

  • H.E. General Umaro Cissoko Embaló, President, Guinea-Bissau
  • H.E. Olivier Véran, Minister of Solidarity and Health, France
  • H.E. Dr Wilhelmina Jallah, Minister Health and Social Welfare, Liberia
  • Ms. Stéphanie Seydoux, Ambassador for Global Health, France
  • Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
  • Dr. Anuradha Gupta, Deputy Chief Executive Officer, The GAVI Alliance
  • Dr. Roopa Dhatt, Executive Director, Women in Global Health

“To achieve a generation of equality we need to push the bar up, in terms of payment, distribution, and acknowledgment of women’s work” -Dr. Nadine Gasman Zylbermann, President of the National Institute for Women, Mexico

We had the honour of having Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization give the opening remarks of the event. This opening provided the framing of the initiative and provided background about women in global healthcare and decision-making. The main takeaways are:

  • The COVID-19 pandemic has caused at least 115,000 health and care workers to lose their lives, and millions more have been infected
  • Addressing gender inequalities in the health and care workforce is a key step that we can take as leaders to recognize them for their service
  • 70% of health and care workers are women and women represent 90% of nurses and midwives and 50% of physicians
  • There are three areas that we should focus on to address gender equity in the health and care workforce:
  1. There must be equal pay for all work of equal value
  2. Women must be protected from harassment, discrimination, and violence in the workplace, especially in refugee camps and shelters
  3. Change must be driven from the top, with women in leadership positions. Women’s leadership should be proportional with their share of all jobs: 70% women and 30% men
  • The Generation Equality Forum gives us the opportunity to take action to address these issues

“The world is reliant on women to deliver health and care services. And we know that health is central. This reliance demands that we ask ourselves tough questions on workplace conditions and equity. Including how we value and reward women in the health and care workforce.” -Dr Tedros Adhanom Ghebreyesus

During our high level-event, the first set of commitments and expressions of support were made under the Gender Equal Health and Care Workforce Initiative. We have received commitments and expressions of support from 8 countries, 6 international organizations, and 14 NGOs, and continue to collect more.

Governments:

-The Minister of Gender, Family and Children of the Democratic Republic of Congo commits to train female healthcare workers and provide a fair salary to women in the healthcare sector.

-The Minister of Solidarity and Health of France commits to invest more than €8 billion to improve the working conditions of healthcare workers and enhance the value of healthcare professions.

-The Minister of Health of Costa Rica commits to strengthen standards to protect women from harassment and violence and to ratify ILO Convention 190 on Violence and Harassment at work before the end of the year.

-Ministry of Health of Liberia with Last Mile Health commits to increase the number of female community health workers employed in the National Community Health Assistant Program to increase gender parity in the program and the availability of high-quality health services for women.

-The Special Assistant to the Prime minister of Pakistan on Poverty Alleviation and Social Safety commits to create economic growth to provide employment opportunities for women.

-The President of the Republic of Guinea-Bissau commits to ensure that all levels of government will do the needful to meet the commitments of the four pillars of the Initiative.

-The United States made an expression of support to women in the global health workforce and affirmed their support of the Gender Equal Healthcare Workforce Initiative and its pillars.

International Organizations:

-The GAVI Alliance commits to champion gender equity in leadership in the health and care workforce by supporting women’s leadership in immunisation programmes, promote safe and decent working conditions, ensure equal pay and protection from sexual harassment and violence at work, for women in the health sector, as well as to work to ensure vaccine equity.

-The Global Financing Facility (GFF) commits to fight for women’s leadership over the next five years and to support female leaders as change agents in health ministries, human development sectors, and other health leadership positions.

-The International Labor Organization (ILO) commits to advocate and promote investments in the health sector, advance equal pay for equal value, and contribute to the elimination of violence and harassment by strengthening occupational safety and health management systems.

-The Organization for Economic Co-Operation and Development (OECD) commits to improve the collection and analysis of gender data in the health and care sector to support women’s leadership and strategic planning.

-The Global Fund commits to gather precise information to take the necessary decisions to improve the working conditions of community workers and strategy in five West and Central African countries.

-The International Drug Purchasing Facility (Unitaid) commits to ensure equity in leadership positions within the organization and to hold anti-violence and harassment training for Unitaid teams, and to promote innovation.

NGOs:

-Amref Health Africa commits to increase training for women in the health sector to foster more leadership.

-The Community Health Impact Coalition commits to ensure that women make up 50% of external representation in panels, forums, and media opportunities, as well as research leads and principal investigators. They commit to provide safe and decent working conditions and to work towards the goals of the four pillars of the Initiative.

-The International Confederation of Midwives (ICM) commits to enhance the respected status and autonomy of midwives globally. This work will be accomplished in collaboration with global partners and will include the dissemination of a new professional framework and enabling environment policy.

-The International Council of Nurses (ICN) commits to support all four pillars of the initiative to address gender inequalities in the health and care workforce.

-The International Pharmaceutical Federation (FIP) commits to address inequalities through the implementation of the 21 FIP Development Goals, particularly goal 10; Equity and equality.

-Jhpiego commits to advance gender transformative leadership, with women as leaders in the health workforce, not only by focusing on individual skills but also by deliberately transforming the formal and informal gender power structures and discriminatory practices to promote gender equality in health institutions.

-Last Mile Health commits to increase the number of female community health workers employed in the National Community Health Assistant Program to increase gender parity in the program and the availability of high-quality health services for women.

-Muso commits to support the mission, vision, values, and goals of the Gender Equal Health and Care Workforce Initiative and Women in Global Health.

-Population Services International (PSI) commits to ensure that PSI’s client-facing women healthcare workers have equitable access to the COVID-19 vaccine.

-Seed Global Health commits to support the implementation of gender-responsive policies in global health and global health security, as well as to provide health workers with safe and decent working conditions.

-UHC2030 commits to champion gender equity in the health and care workforce by calling to increase the proportion of women in health and care leadership roles, in line with the UN Political Declaration on UHC related to women’s empowerment in the health workforce.

-White Ribbon Alliance commits to ensure that the voices, lived experience, and demands of healthcare workers themselves, especially midwives, are heard and acted upon by decision-makers at all levels.

-Solthis commits to support the capacity building of women health care workers, including community workers to promote leadership with institutional, technical, and associative partners in Africa.

-Women Deliver commits to conduct global advocacy and prioritize key policy windows including the United Nations General Assembly, as well as to contribute to relevant alliances and networks, such as amplifying the initiative at the Women Deliver 2023 Conference.

We thank governments, multilateral organizations and NGOs who pledged a commitment through the Gender Equal Health and Care Workforce Initiative.

The GEHCWI continues to garner commitments and expressions of support from governments, international organizations, and NGOs. The next set will be announced at a GEHCWI event in the margins of the UN General Assembly in September 2021. By the end of 2021, the Initiative aims to garner sufficient commitments to bring together a significant group of governments and organizations in the field to have critical mass and lead sustainable change for gender equity in the health and care workforce.

All commitments made under GEHCWI will be measurable and from 2022 the Initiative will report on progress made against these commitments and continue to influence change in wider policy processes at global, regional, and national levels.

The COVID-19 pandemic has exposed deep inequalities between and within countries, including the gender inequities in the health and care workforce that disadvantage and harm women and also harm health systems. After 18 months of the COVID-19 pandemic, inequality is deepening, evidenced by the ‘shadow pandemic’ of violence, increased poverty, and unpaid work experienced by women, and also evidenced by the highly unequal geographical distribution of COVID-19 vaccines. Health and care workers, the majority of whom are women, have stepped up with exceptional commitment and courage to meet the challenge of the pandemic, putting their own lives and health at risk. Health and care workers are exhausted and many are suffering high levels of stress — and the pandemic is far from over. In almost all countries, women in the health workforce are still managing heavy workloads and no end is in sight. If and when the number of COVID-19 patients decreases, health workers will be challenged to address the huge backlog of other conditions and diseases displaced by the pandemic. Through GEHCWI, Women in Global Health will continue to advocate for gender equity in the health and care workforce as the right thing to do but also the smart thing to do and the critical foundation for strong health systems and global health security.

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Women in Global Health

Women in Global Health is a global movement that is challenging power & privilege for gender equity in health.