A Wake-up Call for UHC – Time to Recognize Women in Health Workforce Inside View 09/05/2023 • Roopa Dhatt & Sharan Burrow Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Registered nurses Fatmata Bamorie Turay (left) and Elizabeth Tumoe, look after newborns at the Princess Christian Maternity Hospital, in Freetown, Sierra Leone. As the United Nations multi-stakeholder meeting on universal health coverage (UHC) convenes on Tuesday afternoon in New York, we urge that women health workers are properly recognized and rewarded The global health workforce crisis is no longer a looming possibility. It is a reality. Pre-pandemic the World Health Organization (WHO) projected a global shortage of 10 million health workers by 2030 and since then the situation has significantly deteriorated. Staff shortages are reported ever more frequently, health workers strike more often and high-income countries increase their incentives for nurses to move from low-income countries. So why is it that recent international documents on global health, including the G7 foreign ministers’ communique on 18 April, fail to acknowledge the crucial role of health workers in the achievement of universal health coverage (UHC)? Why don’t health ministers and heads of state address the real reasons for the emptying rosters, the rock-bottom morale and the sky-high burnout? Women make up a significant majority of the health workforce, comprising 70% of overall health and care workers and 90% of frontline staff. They lead the delivery of health to five billion people and contribute an estimated $3 trillion annually to global health, half in the form of unpaid work. They are the backbone of our health systems. Underpaid, excluded from leadership But this is how we reward them. They are paid 24% less on average than their male counterparts – if they are paid at all. There are plenty, in fact six million of them estimated to be grossly underpaid or unpaid. As Samantha Power, Administrator of USAID, rightly acknowledged recently, there should be no such thing as working for free when you are providing lifesaving care. Three-quarters of all leadership roles in health go to men who benefit from a male bonus syndrome of more opportunities for promotion, higher salaries and lower expectations at home for family care. Workplaces are increasingly unsafe, with reports of increased gender-based violence in health rising. There are issues with sexual abuse, exploitation and harassment. During the pandemic, women have suffered from a lack of infection control equipment or if it was available, trying to adjust personal protective equipment purchased in men’s sizes, increasing the risk they faced. They were the ones on the front lines, trying to explain why services like sexual and reproductive health care had been deprioritised and there was no support available. Two women healthcare workers caring for an infant. Opportunity for a reset This year is an opportunity for a reset. Heads of state will travel to the UN on 21 September and release a new global commitment to Universal Health Coverage. In advance of this, on 8-9 May, they have invited civil society to give suggestions for what to include in their negotiations. While diplomats might be overwhelmed with a long list of asks, we want to remind them that health does not deliver itself. Vaccines, drugs and technology are no good sitting in storage. Hospitals and health centers are just buildings and beds without nurses or doctors. There is no early warning system for disease, no maternal care and no programs for primary health care unless staff are trained, retained and on shift. So, for the governments who are preparing the negotiations, here is our prescription for prevention: Fully deliver on all commitments to gender equality and the rights of women and girls in UHC, made at HLM 2019 Guarantee gender equality in health systems leadership and decision-making at all levels, including use of quotas and targets for women in leadership and all-women shortlists for selection until gender parity is achieved. Give particular attention to geographical diversity Close the gender pay gap, and value and appropriately remunerate unpaid and underpaid health and care workers, including community health workers Design, properly resource and deliver health systems based on gender-responsive policies and health services and the elimination of gender inequality and discrimination Resource and deliver universal access to sexual and reproductive health services as essential services, and mainstream them in national health policy frameworks Monitor and evaluate progress towards universal health coverage in data and analyses disaggregated by sex, gender identity and other relevant stratifiers Women health and care workers have faced systemic bias and traumatizing work conditions. If the world wants operating health systems, governments have an opportunity to check the lists and triage women health workers to the top. Dr Roopa Dhatt is Co-Founder and Executive Director, of Women in Global Health. Sharan Burrow is the former General Secretary of the International Trade Union Confederation Image Credits: World Bank/Flickr, Photo by Mufid Majnun on Unsplash. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.