Gender inequality in healthcare impeding services

Inequality in the healthcare sector hinders care delivery and resilience of health systems. This is according to Women at the Last Mile, a new report by Care International on how investments in gender equality have kept health systems running during Covid-19.

“The lack of recognition, protection against discrimination, and decision-making power of women in the health workforce undermines their own well-being and livelihoods. It also adversely affects healthcare systems’ adaptability and the availability of quality services,” it reads.

Women, the report shows, are severely under-represented in health leadership positions, with only 24.7 per cent of the world’s health ministers and 25 per cent of senior leaders in global health institutions. There is also limited investment in leadership and agency training or opportunities to which they can step up.

Also read: Report: Women in health, care earn 24pc less than men

As a result, women-specific health needs risk being overlooked, with priorities, policies and funding being diverted to tackle the Covid-19 crisis.

Bearing brunt of Covid

While the impact of pandemic on health systems has varied across countries, the report asserts that in almost all cases, women and girls were disproportionately affected.

“Due to the pandemic, around 12 million women have been unable to access family planning services, 86 per cent of countries have reported less access to contraceptive care, and 92 per cent of countries have reported a decrease in institutional births,” it adds. 

Moreover, the number of malnourished women increased from one in 20 to one in five in 2020. Reports on domestic and gender-based violence (GBV) against women increased, while child health and childhood immunisation decreased.

Women play critical roles in healthcare. Globally, they account for 70 per cent of the health and social care workforce and provide essential health services for about five billion people.

“In nursing and midwifery roles, their services range from sharing health information, delivering babies, to providing mental health counselling in a crisis. As professionals and informal community volunteers, they provide referrals for everything from hospitals to safely give birth, to places for survivors of violence to get support, justice, and care services,” the report notes.

Despite their key responsibilities, women health workers are disadvantaged and segregated by the existing environment in which they operate. Gender and social norms, plus community expectations, force women in healthcare to work twice as hard as men at their stations and homes.

“In addition, women are clustered into lower-status, lower-paid and unpaid roles while having to endure unpaid care,” the report states.

Also read: IWD2022: Women trailblazing in science 

Even with the challenges, women leaders, including frontline health workers, continue to build on pre-Covid investments and programmes in gender equality.

Skills and support network

By developing their technical and leadership skills, agency, and support networks, they were able to take on key roles to support the resilience of their communities and health systems through the pandemic.

Women in healthcare leveraged technology to ensure their communities could access information on the pandemic and other essential services. They created, adapted, and scaled up telemedicine consultations. They used existing relationships with health facilities and providers and new communication platforms developed for Covid-19 messaging to include pre-recorded messages and hotlines for sexual and reproductive health and rights, GBV, mental health topics and referrals.

They also worked to get mental health services to health workers who were suffering from burnout and other impacts of the pandemic.

The report recommends that women leaders, including frontline health workers, be equipped with technical and leadership skills. They should also be offered support for gender transformation.

Additionally, it proposes the recruitment and support of women from local communities. This, it says, will promote trust and familiarity between community members and health providers from similar cultural, socio-economic and other backgrounds.

Contributions by women leaders in the informal health sector, the report adds, should be recognised by their communities and the formal health system.