Women Post-Covid

Provocation Piece

Arush Lal

Vice Chair on the Board of Directors for Women in Global Health

Why Gender Equity Must Underpin the Future of Public Health

Arush Lal @Arush_Lal

The global response to COVID-19 wasn’t just a pivotal moment for public health, it was also a missed opportunity to recognize the outsized contributions of women in the health and care workforce.

Women make up over 70% of health workers worldwide. So how we support the health workforce can be a powerful litmus test for our progress toward gender equality. Unfortunately, we are failing — and COVID-19 has only made this worse.

Here are five key recommendations to build gender-transformative, intersectional, and equitable health systems and care workforces that truly meet the needs of all people:

1. Elevate women to decision-making roles in public health. Despite comprising the vast majority of health workers, women make up less than 25% of global health leadership roles. One study found that of 115 COVID-19 decision-making and expert task forces, 85.2% were majority men and only 3.5% exhibited gender parity. By excluding the vital perspectives of women as leaders in healthcare, we curtail our ability to proactively address vulnerabilities and blindspots, such as the gendered impacts of lockdowns and service disruptions.

The NACWG can help champion the inclusion of women leaders in all public health decision-making bodies, and at all levels – from community health posts to global representation at the WHO. This should be accompanied by robust visibility of women health experts in media and health campaigns who are equipped to discuss the impacts of gender inequity on our health systems.

2. Ensure safe and decent working conditions for health workers as an investment in health and gender equity. From emergency rooms to our own homes, women disproportionately serve as our first line of defense against infections – exposing them to greater risk during outbreaks like COVID-19. To compound this, personal protective equipment like gloves and masks are largely designed for male bodies – placing women workers at even greater danger.

Building a gender-transformative health workforce includes ensuring safe and decent working conditions with robust resources and supplies to protect from infection. However, this should be complemented by policies and accountability mechanisms to protect women from various forms of sexual and physical harassment and intimidation in the workplace, as well as ample support systems to prevent exhaustion and mental stress.

3. Recognize and pay for women’s unpaid work in the health and care workforce. From Glasgow to Guatemala City, gendered social norms around the world obligate women – particularly women in poverty or from minority backgrounds — to fulfill the majority of unpaid household and childcare responsibilities. Additionally, women are disproportionately clustered into informal and low-wage positions that lack adequate social protections. For example, just 14% of community health workers across the African continent are salaried.

Scotland can serve as a global champion for gender equality post-COVID by recognizing, formalizing, and fairly compensating women’s health and care work. This includes crafting policies that protect against unexpected unemployment that could have long-term implications on income and career progression for women. Equally, greater regulations and workplace policies can be instituted nation-wide that help equalize the labor sector, such as implementing standardized paid family leave and offering greater economic safety nets to sectors where women are disproportionately clustered.

4. Address public health risk factors through gender-sensitive and data-driven approaches. One of the biggest barriers to gender equity is a lack of information. Often, data collection during the pandemic was conducted through specific apps or online platforms, excluding women who were unable to access them due to socioeconomic constraints. However, even the limited data suggests that COVID-19 exacerbated women’s perceived risks of violence and insecurity and disrupted health services that women rely on (e.g., sexual, reproductive, and maternal health services).

Health systems can better serve the needs of women across diverse groups by collecting and transparently publishing data disaggregated by sex, gender, and other demographic indictors. Additionally, the response to outbreaks like COVID-19 should center intersectionality in public health and conduct research on disruptions to women-focused health services, from cancer screenings to gender-based violence prevention.

5. Invest in cross-cutting initiatives that strengthen public health and gender equity. Civil society organizations focused on women’s issues are routinely underfunded, and often first on the chopping block during a major crisis. These organizations, however, are vital to post-COVID recovery, as emerging data points to exacerbated learning gaps and unpaid care work for girls and women.

Funding organizations and movements that sustain the diverse needs of women is critical to “building back better” toward a more equal and just society. These NGOs are essential to advocating for reduced gender gaps in health or targeted interventions to ensure education. They also play an important role in supporting women get back to work or find refuge from unsafe environments. Finally, initiatives that engage male allies can be transformational in addressing the drivers and roots of gender inequity as we build a fairer society.

Simply put, global health security rests on the backs of women who are largely under-paid, under-protected, and under-recognized. The COVID-19 crisis saw major gender disparities in workforce participation and uncompensated labor. If left unaddressed, these inequalities are likely to continue. As we prepare for years to come, our health systems must be redesigned to take the intersectional needs of women, men, and gender minorities into account, including through diverse decision-making, workforce protections, paid labor, gender-sensitive data, and improved funding. Repositioning gender equity and health workforce as two inextricably linked issues can ensure we strengthen healthcare systems well before the next pandemic.

Arush Lal @Arush_Lal

Arush Lal is Vice Chair on the Board of Directors for Women in Global Health — a global movement with 40+ chapters around the world challenging power and privilege for gender equity in health. Lal also serves as a Community and Civil Society Representative for the Access to COVID-19 Tools (ACT) Accelerator and a consultant for various organizations, including the World Health Organization. Lal is a doctoral candidate researching global health politics and governance at the London School of Economics and Political Science.