Gender-equality path to health: Conversations at The Future of Global Health 2017

Women in Global Health’s Research Coordinator Mehr Manzoor attended The Future of Global Health 2017 and writes about what she learned.

The Future of Global Health 2017 (TFGH17) was held on March 1st, 2017, and jointly organized by the Global Health Council and the Global Health Fellows Program II. I attended the event as a lead hub conversation leader and the topic of our hub-conversation was “The gender-equality path to health and why it is so hard to make lasting change”. This event offered a great platform for young emerging professionals in the fields of global health to meet people in their areas of interest, build valuable connections, share common goals and engage in powerful conversations to stimulate thought as well as ideas for future work. The event was attended by over 400 participants from various sectors including private, not-for-profit, government, academia and donors.

The discussion on gender-equality and women’s rights are often termed as ‘elephant in the room’; which in itself highlights the complexity of the problem and reflects our slow progress in face of challenges. Gender-inequalities are real and gender stereotypes are hard to break. Intersections of gender and health further create inequalities that create large burden of diseases for women and put them in a vulnerable position. Globally, these inequalities affect women and children’s lives and affects their health outcomes due to unfair distribution in terms of access to care, nutrition, water, sanitation and education. There is an economic cost of gender inequality with estimates around $12 trillion for global economy. According to IMF, closing the gender gap would increase the GDP of United States by 5% and that of Egypt by 34%. Additionally, investing in women promotes long-term development and productivity, improves the health of children, increases school attendance of children and creates healthier communities. In short, investing in women and girls is integral to development and is smart investment that yields great socio-economic dividends for the future.

TFGH17 provided an opportunity to have a very timely discussion on gender equality. March is widely recognized and celebrated as the month of women’s liberation and cause with “International Women’s Day” just a week following. We must acknowledge that the women’s movement has made great strides forward and the world is recognizing the need to address the gender gap. It is evident that there is a great urgency in the development community to make gender equality a global priority and Sustainable Development Goal (SDG) 5 is dedicated to achieving gender equality and empowering all women and girls. Globally women contribute $20 trillion to world economy as consumers and about 80% of the health choices for their families, children and themselves.

Inequalities within global health also reflect a phenomenon that I call the Global Health Paradox. Women are dominating the field of global health, constituting 75% of the health workforce but only 14.6% executive officers and 12.4 percent of board directors within United States. Understanding this paradox and addressing this gender gap within global health leadership lies at the heart of what we do at Women in Global Health, forms the foundation of my doctoral research and was the agenda of our dialogue at TFGH17 to engage participants in meaningful conversations on understanding the systemic and structural barriers women face but also engaging their thought to identify strategies that will infuse women’s network and movement within global health leadership.

Most of the participants of our hub-conversation were young female professionals in global health, some of them having recently graduated from college. None of the male participants in the room joined our conversation. I hypothesize it to be due to the use of word ‘gender’ in our hub topic. In my observations, the word ‘gender’ usually implies women and I often see that when this word is used in course titles at my university, male students don’t often enrol in that course. Gender is a social construct and according to John Scott ‘gender’ becomes a lens through which we signify power dynamics in relationships between men and women. Leadership is a gendered concept and Joan Acker in her article “Gendering Organizational Theory” argues that gender is part of the logic that creates institutional barriers for women. Thus, to address gender gaps and the paradox, we need to engage both men and women in the conversation.

I engaged participants in an activity using design-thinking tools with the purpose to identify actionable strategies to address gender inequalities in global health leadership. First part of the activity involved highlighting the social and structural barriers women face in achieving positions of leadership.

What are the barriers women face?

Several key barriers were identified that included social, cultural, and patriarchal norms that limits women’s spheres to domestic life. Women’s burden of unpaid domestic work, lack of decision-making within homes and their social identify as just a child-bearer limits how society looks at women and demarcates women’s sphere’s from those of men. Women’s reproductive rights and lack of access to family planning services were also identified as barriers to women’s career growth. Providing birth control facilities to women advances women’s empowerment. Young girls are often coerced into supporting male siblings and made to do help mothers in domestic work while the male siblings go to schools. Studies have shown that girl’s domestic labor has harmful affects on their schooling especially among low socio-economic households. Unequal access to education and lack of control over financial resources limits women’s autonomy and choices.

Institutional barriers and lack of political will to address women’s issues were also emphasized by the participants of the study. One major barrier identified by the participants was that women may also be creating barriers for themselves and other women in their communities and households. Examples of such women include mother-in-laws, especially in developing countries with stronger patriarchal norms who try to control their daughter-in-law’s agency. Other examples include lack of women mentors or support networks for young female professionals aspiring to be leaders. Upon discussing the major differences between male and females, participants highlighted that women often feel shy in front of male counterparts and are likely to be less confident as compared to men.

The other half of the activity, engaged students in highlighting the strategies that would enable more women’s representation in global health leadership.

What can we do to address gender gap in global health leadership?

Capacity building and leadership training opportunities of women were identified as a key strategy to enable more women in the leadership pipeline. Leadership role modelling could help women gain insights of the relevant skills they need to be effective leaders. Empowerment of women through education and access to financial resources would be essential for sustainable and lasting change. Many participants agreed that the change has to be driven at policy and institutional level to create the case for greater gender equality at the workplace and engaging feminist men as champions to advance women’s cause. One participant shared that the change needs to begin at homes by defining family values and developing men’s respect for the women in the house such as their mothers, sisters, wives, and daughters that would translate into them respecting all women in society in the long run. This would ultimately change societal norms and how society views women’s role. Another participant shared that women’s personal connections to gender issues makes them passionate about the cause and builds their momentum towards change. This would require more women’s support networks so that they could work with like minded individuals and also gain inspiration. Women supporting women networks are highly needed in global health field and it could be ideal platforms to engage momentum in addressing gender gaps in global health leadership. These networks would also provide women a source of encouragement and the opportunity to gain advocates and supporters for career growth.

The three take-away points from the event for me were:

1. Support women-mentoring-women networks within global health.

2. Engage male champions by inviting them to participate in conversations addressing gender inequalities within global health.

3. Invest in women’s capacity building initiatives and leadership skills trainings.

The conversations were very stimulating and inspiring. Such platforms provide ideal environments to generate dialogues that identify the elephant in the room, recognize it as a problem and engage in meaningful ways to identify strategies that catalyze change.