Women in Global Health’s watchlist for WHO’s Executive Board

26 January 2023

This week we interviewed Women in Global Health Policy Associates, Dr. Kalkidan Lakew and Ms. Becca Reisforf ahead of the upcoming WHO Executive Board. The policy team will be tracking discussions relevant to WGH’s policy priorities. In particular, they will be focused on the challenges and opportunities facing women in the health sector and the significance of developments for women health workers.  

What policy areas are Women in Global Health tracking at the upcoming Executive Board meeting of the WHO? 

Ms. Becca Reisdorf: This year we are watching three broad areas: Universal Health Coverage, Pandemic Prevention, Preparedness and Response, and Prevention of Sexual Exploitation, Abuse and Harassment. The High-Level meetings on UHC and Pandemic PPR are coming up in September 2023, so we are interested to hear from WHO Member States on these topics.

 

What is the representation of women at this year’s WHO EB? Can you say more about the general context and trend for women’s representation at senior level? 

Ms. Becca Reisdorf: The Executive Board consists of 34 representatives from Member States and this year 21% of them are women. During the pandemic, this number had dropped drastically, reaching a 10-year low of 6% last year, with just two women on the board. We are encouraged to see that we have returned to pre-pandemic numbers, and we are especially glad to see a woman Chair, Dr Kerstin Vesna Petrič, from Slovenia. However, we will continue to call on WHO and Member States to include women in senior decision-making roles, towards the achievement of gender parity.

 

What impact is the lack of representation of women having on health systems and health program delivery?

Ms. Becca Reisdorf: Women make up 70% of the health and care workforce and 90% of patient-facing roles, and they have been applauded for their contributions to front-line health delivery during the pandemic. Women health and care workers are experts in the communities they serve, with nurses, midwives, and community health workers often the first or only point of contact for patients.

Their firsthand experience means women in leadership are likely to expand public health agendas, prioritizing issues such as sexual and reproductive health services and personal protective equipment designed for female bodies. With more women entering into the leadership space, girls and young women — as well as boys and young men — will have women role models to look up to, breaking the stereotype of men as “natural leaders.”

Sidelining women leads to a loss of expertise that hurts the decision-making process and negatively impacts the health of populations, as women leaders have reportedly implemented particularly effective COVID-19 responses that are both timely and evidence-based. Also, when women are involved, health discussions are more comprehensive. Due to their extensive experience working in health systems, women are more than qualified to make public health decisions.

 

It seems obvious that sector-wide change is needed, what measures should be taken?

Ms. Becca Reisdorf: National policies that mandate quotas to advance gender parity in global health decision-making bodies are effective. Countries must step up and nominate women for WHO’s executive board and other international bodies, such as the forthcoming intergovernmental negotiating body for the pandemic treaty, and nomination processes need to be transparent.

Official development assistance should be tied to performance on gender parity in global forums. Governments must work to provide child care and other gender-responsive mechanisms that enable women to balance their lives and lead. Deliberate action must be taken toward closing the gender pay gap that sees women earning 23% less than their male counterparts.

Two women on WHO’s executive board were representing the health interests of nearly 4 billion women and girls, and this is unacceptable. Power and privilege must be recognized and disrupted. The systemic bias and discrimination keeping women in subordinate roles within the health and care sector must be ended to ensure that gender is mainstreamed and that global health benefits fully from the talent and expertise of women.

 

Women in Global Health recently published its #HealthToo report related to the sexual exploitation, abuse and harassment (SEAH) of health workers. What is the impact of SEAH on the health workforce?

Dr. Kalkidan Lakew: Sexual Exploitation, abuse and harassment (SEAH) among female health workers has an impact on their physical and mental health. It also hinders their career development and progression and in the long term contributes towards the great resignation of health workers. This will further widen the leadership gap we witness in the sector.  SEAH among health workers compromises the quality of care provided to clients and affects the overall provision of health services. Unless SEAH is addressed proactively, it will carry a healthcare and societal cost. At a bare minimum, health institutions must ensure a safe work environment for health workers. 

 

What are you asking of the WHO Executive Board on this point?

Dr. Kalkidan Lakew: We want two things, one: we want member states to warrant a safe work environment for their health workers, including eliminating SEAH, and two: we want zero-tolerance policies converted into action and accountability measures at all levels. 

 

In terms of accountability on SEAH, what more needs to be done?

Dr. Kalkidan Lakew: Leaders have been turning a blind eye to the problem of SEAH in the health sector. Our recent report on #HealthToo, highlighted the depth of the problem through the lived experience of female health workers. What we need is zero tolerance on SEAH and swift action against leaders who tolerate it. It is important that all stakeholders including governments, multilateral agencies, global health organizations, CSOs and professional associations work together and share responsibility for eliminating it.

 

We know that the political declaration at the 2019 United Nations High-Level Meeting on UHC included strong commitments on gender equality. Are you satisfied that these commitments are being delivered? What are the challenges currently facing the achievement of gender equal UHC?

Dr. Kalkidan Lakew: No, we are not satisfied and we don’t believe enough is being done. In general, UHC progress is not on track. Especially since the COVID-19 pandemic, the world has moved further away from the 2030 targets set in the political declaration including those commitments made on gender equality. For example, sexual and reproductive health services have been deprioritized and removed from essential services list, policies on women’s health and rights are being overturned and women are still excluded from decision-making roles despite their majority representation. 

It is known that women make up 70% of the overall health workforce and 90% of frontline staff. However, they continue to deliver health, while men lead it. We need stronger commitments with in-built accountability measures to implement them on time. 

 

Watch the video interview and stay tuned to WGH’s social media platforms where we will be posting live updates from Geneva.