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Women on the Front Lines of Care: Seven Ways to Show We Care

“As a nurse or a midwife working in a low-resource setting in rural Africa, you are a part of the community. You interact with your clients at church, at school, wherever you go, and your reputation depends on very simple things. It depends on the child you save when they come to your clinic. It depends on the pregnant woman who walks out of your health care facility with a live baby—who might even be named after you, if all went well." —Stembile Mugore, SwitchPoint 2013In many countries, up to 75% of health workers are women. They serve on the front lines of care, where the conditions can be grueling, dangerous, and unhealthy; where wages are often low (especially compared to the wages of men who do similar work); and where women are all too often subject to stigma, discrimination, and gender-based violence. According to the Global Health Workforce Alliance and the World Health Organization, we need 7.9 million more health workers worldwide than exist today. And by 2035, that shortage will grow to 12.9 million. 

Simply adding members to the health workforce isn’t a solution. 

But simply adding members to the workforce isn’t a solution. We have to keep the ones we have. And that means making jobs that work for women.There is no doubt that clients value women in the clinic, in the community, and on the front lines of care when lives are saved. But do we who care about global health value women in the health workforce? And if we do, do we care enough to keep them?Here are a few things we need to do to show how much we value women in the health workforce:

  1. Start with rights. Everyone has the right to decent work, to equal pay for work of equal value, to a high standard of health, to determine the family size they want, and more. Let’s make the global health workplace an environment that supports these rights for all health workers.
  2. Recognize that women’s lives are different from men’s lives based on the reproductive and family roles they play. Let’s reshape the workplace in ways that support women having children when they want them, taking care of the families they have, and having access to family planning services so they can choose when and whether to have children. Health workforce policies need to allow for part-time work, flexible hours, and paid parental leave. Career structures and policies should allow women to leave the workforce and re-enter without losing professional ground. 
  3. Support economic opportunity for women. Women deserve the opportunity for well-paid employment, as well as equal pay for work of equal value. The health sector must make sure that the pay scales for frontline health workers—positions that are predominately held by women—offer women the same potential for independent economic well-being that men have. (Also read this excellent post: Resolutions: Female Entrepreneurs Are Key to Sustainable Global Development.)
  4. Create a decent, positive, and safe health workplace. Let’s establish workplaces that meet occupational safety and health standards and do everything we can to encourage women to stay in the health workforce. We must acknowledge that gender-based violence happens in the health workplace—and we must change that. Housing, transportation, educational opportunities, and career growth all make a difference in whether women on the front lines of care can stay in the areas where they’re needed. 
  5. Pay attention to gender all along the pipeline, from recruitment to graduation. What will encourage more women to enter—and stay in—health professions? It starts with youth. Girls must learn about health professions in primary school. Community conversations must encourage parents to make sure their girls finish school. We must make sure women who enter training make it to graduation. Scholarships and bridging programs can help. Youth are not only the future beneficiaries of health care—they are the future of the health workforce. Can we use the youth bulge to create a health worker bulge?
  6. Take community health workers seriously. This predominately female cadre has tremendous potential to link clients to the health system. So why do we ask community health workers to work for free or for a pittance? We need to show community health workers we value them by taking them seriously. This means salaries, policies, career paths, and the equipment and supplies that allow them to work.
  7. Build legal and policy frameworks that uphold gender equality. Even as we take specific steps to keep women in the health workforce, we also need to address gender equality as a societal issue that cuts across all professions. We cannot bring about lasting change in the health sector—or any other single sector—without addressing gender equality broadly.

What else can we do to make health care a field in which women across the globe can prosper?  Let’s talk solutions.