Feminist Insights on the Global Health Workers Compact: Women in Global Health’s Perspective

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11 October 2024

At Women in Global Health (WGH), we celebrate the critical role of health workers in improving health outcomes and providing compassionate care to all, especially the most vulnerable. The majority of these workers are women. Yet, despite their indispensable contributions, they continue to face widespread inequalities in wages, leadership and working conditions. The Global Health and Care Workers Compact is a significant step toward addressing these imbalances, and a feminist reading reveals further structural opportunities that can be addressed to advance gender equality within the workforce.




Source: World Health Organization. (2023). Global Health and Care Worker Compact. Retrieved from WHO

Health and Care Workers: Overrepresented Yet Undervalued

According to the World Health Organization (WHO), women constitute nearly 70% of the global health and care workforce, yet they hold only 25% of leadership roles. This glaring gap in representation reflects entrenched gender norms that undervalue women’s contributions and limit their access to decision-making positions. At Women in Global Health we believe that leadership is critical for shaping policies that reflect the lived experiences of women workers. Without women’s representation in leadership, decisions that directly affect their working conditions are made without their input, perpetuating inequity.

The gender pay gap in health and care is equally troubling. Globally, women in this sector earn, on average, 24% less than their male counterparts, despite often working longer hours and shouldering unpaid caregiving responsibilities at home. This pay disparity is emblematic of a broader societal undervaluation of care work, which has historically been feminized and thus, underappreciated in economic terms. As WGH advocates, addressing these issues is not only about economic justice; it is about dismantling the structural discrimination that limits women’s opportunities.

Revaluing Health and Care Work

A feminist reading of the Compact reveals an urgent need to revalue health and care work. Historically, caregiving has been seen as “women’s work,” often relegated to the private sphere and underpaid in professional settings. Women in Global Health believes that improving pay and conditions for health workers is a step toward reversing this narrative and recognizing care work as essential to the functioning of health systems and economies.

Countries like Uruguay and Brazil provide examples of progress. Through initiatives like Uruguay’s National Integrated System of Care, caregiving is formally recognized and compensated, granting caregivers access to social benefits. However, such examples are rare, and the global health workforce remains underpaid and underprotected, especially in low- and middle-income countries. For instance, in India, Accredited Social Health Activists (ASHAs) are community health workers critical to rural healthcare but are excluded from formal social protection systems. Ensuring fair compensation and adequate support for these workers is key to advancing gender equity, particularly in regions that depend heavily on informal care workers.

Safe and Dignified Working Conditions for Women

Women in Global Health advocates that all health workers should be guaranteed safe, dignified, and conducive working environments, free from harassment and violence. This includes access to well-fitting personal protective equipment (PPE), secure employment contracts, and reasonable working hours. The COVID-19 pandemic exposed the vulnerabilities of health workers, with women disproportionately affected by burnout, unpaid care burdens, and poor working conditions.

In many low-income countries, community health workers often lack the most basic protective measures, such as PPE, and face unsafe working environments. From a feminist perspective, addressing these conditions is essential to prevent the exploitation of women, who are too often overworked and underpaid in unsafe settings.

Tackling Gender-Based Violence and Harassment

Gender-based violence and harassment are pervasive in the health and care workforce. Women in Global Health underscores that tackling workplace violence is a priority, particularly for women in informal or community settings, where supervision is limited, and reporting mechanisms are weak. Feminist analyses call for zero-tolerance policies against gender-based violence and strong reporting systems to create safe and supportive work environments.

Canada provides a model for addressing workplace harassment, implementing new regulations in 2021 under the Canada Labour Code that specifically aim to prevent workplace violence and harassment. These efforts, aligned with International Labour Organization (ILO) Convention 190, are steps toward ensuring that women health workers can perform their roles in safety and with dignity.

Promoting Women in Leadership

At WGH, we believe that leadership is central to achieving gender equity in the health workforce. Empowering women to take on leadership positions requires proactive measures, such as gender quotas, mentorship programs, and policy reforms that address the structural barriers women face. Norway, for example, has implemented gender-inclusive policies that have resulted in women holding 40% of leadership positions in health.

Fostering women’s leadership ensures that the voices of those who make up the majority of the workforce are reflected in policy-making, creating workplaces that are more equitable and responsive to the needs of women health workers.

Redefining Gender Norms and Care Responsibilities

The Compact calls for a gender-transformative approach that not only addresses workplace inequalities but also challenges the broader gender norms that have historically relegated women to unpaid or underpaid care roles. Women in Global Health advocates for policies that promote an equitable redistribution of caregiving duties, encouraging men to take on more responsibilities at home and supporting women in both their professional and personal lives.

This shift also includes expanding social protections for all health workers, especially in low-income and migrant contexts. Globally, more than half of health workers lack access to basic social protections like maternity leave or health benefits. Reforms that include these workers in formal systems are essential to creating a more just and supportive global health workforce.

Mental Health and Well-Being

Finally, a feminist reading of the Compact cannot ignore the psychological toll on women health workers. WGH acknowledges the importance of mental health support, especially for women balancing professional roles with unpaid caregiving duties at home. Mental health services, like those provided by the United Kingdom’s NHS, have proven essential in supporting health workers during crises like the COVID-19 pandemic.

Conclusion: A Feminist Path Forward

At WGH, we view the Global Health and Care Workers Compact as an important framework for advancing gender justice. A feminist reading underscores the opportunity for broader structural transformations to fully address the root causes of inequality in the workforce. This includes revaluing care work, ensuring equal representation in leadership, and implementing robust protections against violence and harassment. If the Compact is effectively implemented, it holds the potential to empower women in health, improve their working conditions, and secure their rightful place as leaders in global health.

 

Written by Maria de los Angeles Loayza,  Senior Gender Equality Specialist

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