Protect, Pay and Promote Women Health Workers
The Lady Health Worker programme in Pakistan have helped to double the child vaccination rate.

Each woman in the health workforce is powerful, capable of transforming individual lives, communities, and nations when supported in her role. Women health workers deliver care to approximately five billion people, mostly as nurses, midwives, and community health workers. They contribute $3 trillion to global health annually, half in unpaid work. 

Despite constituting 70% of the global health workforce, they often serve in low-status jobs, with little or no pay. Men hold 75% of health leadership roles and, on average, earn 28% more than women. Investing in these women is a smart move, offering an estimated 9:1 return on investment and contributing to women’s economic empowerment.

This World Health Worker Week (1-7 April), and ahead of the Africa Health Workforce Investment Forum in May, we call on governments and the global health sector to recognize the transformative contributions of women in the health workforce by developing and implementing policies to ensure their protection, pay, and promotions.

Immense potential of women in health

Women health workers play a dual role, improving health outcomes while advancing gender equality by serving as role models in societies where women’s participation is limited.

 Studies indicate that promoting gender equality within communities not only fosters economic growth but also enhances access to contraception and reduces child mortality. Moreover, these workers significantly contribute to economic prosperity by serving as frontline caregivers in rural areas with inadequate health infrastructure, promoting sexual and reproductive health and rights, and investing in the health and education of their families.

The World Economic Forum predicts that by 2050, the climate crisis will result in 14.5 million more deaths and $12.5 trillion in economic losses, with an additional $1.1 trillion in costs to health systems.  

Women and children will bear the biggest burden, highlighting the urgent need for women health workers to play a crucial part as part of a broader multidisciplinary effort in educating communities, supporting the delivery of healthcare in challenging conditions, and advocating for policies that mitigate the health impacts of climate change. As most of the health workforce, they can respond to climate-induced health emergencies like the rise in infectious diseases, the effects of extreme heat on pregnant women, and the rise in waterborne disease. 

Saving lives in Pakistan and Nigeria

Women health workers can help achieve universal health coverage, and foster stable, prosperous societies through global health security. This potential holds true everywhere.

For example, Pakistan and Nigeria – despite their unique cultures, politics, and economies – face similar challenges such as rapid urbanization, weak rural health care, high maternal and child mortality, extreme vulnerability to climate change, and gender inequalities. Ensuring we protect, support, and invest in women health workers is a high-impact solution.

Lady Health Workers (LHW) and community midwives in Pakistan, through initiatives like the Pathfinder ‘building healthy families’ program, provided critical support during the 2022 floods when a third of the country was under water. 

LHW canvassed districts in Sindh Province, reaching communities with 20,000 dignity kits for safe pregnancies, and information on nutrition, hygiene, and health, easing the floods’ toll. 

Midwives delivered babies at birthing stations that replaced flooded health clinics.  LHWs also played a crucial role during the COVID-19 pandemic, providing vital information on infection prevention and supporting isolated women at risk with information on gender-based violence services. 

Since 1994, when the LHW program began, these workers have contributed to the number of fully vaccinated children nearly doubling. They have helped to cut maternal and newborn deaths and increase family planning access.

A Nigerian mother and her baby who benefited from the Saving Mothers Giving Life programme

Similarly, Community Health Extension Workers (CHEWs), nurses, and midwives in Nigeria—mostly women—have saved numerous lives, through programs like Saving Mothers Giving Life. 

In Cross River State, CHEWs provided emergency obstetric and newborn care services in rural communities and referred complicated cases to higher-level health facilities leading to a 66% decrease in maternal mortality in supported health facilities over three years. 

In Akwa Ibom state, CHEWs learned how to offer clinical contraceptive methods—injectables and implants—at local health facilities, and within two years of the training, uptake of modern contraceptives doubled while the number of women with contraceptive implants tripled.

What we need to do now

Investing in women in the health workforce fosters health, development, and prosperity. To maximize this investment, we must protect, pay, and promote women, formalizing their roles within health system strategies, plans and budgets, and providing adequate training and mentorship from higher level providers. 

We must elevate women into leadership positions, ensuring they are involved in budget planning and on emergency response committees, and support them with woman-friendly policies like maternity leave, childcare support, and protection against workplace harassment and discrimination. We must ensure they receive a fair wage. Without these investments, the power of women in the health workforce will be a missed opportunity.

Dr. Tabinda Sarosh is Pathfinder’s President in South Asia, Middle East, and North Africa. She is accountable for the impact and performance of Pathfinder’s programs in Bangladesh, India, Egypt, Jordan, and Pakistan. 

Dr. Amina Aminu Dorayi is Pathfinder’s Country Director in Nigeria. She has extensive experience designing and managing health system and sustainable development programs seeking to improve the health of women, girls, and communities.


Image Credits: Women Deliver, Pathfinder.

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