Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Nairobi, Kenya.
Int J Health Policy Manag. 2022 Aug 1;11(8):1262-1273. doi: 10.34172/ijhpm.2021.06. Epub 2021 Feb 9.
Human resources are at the heart of health systems, playing a central role in their functionality globally. It is estimated that up to 70% of the health workforce are women, however, this pattern is not reflected in the leadership of health systems where women are under-represented.
This systematized review explored the existing literature around women's progress towards leadership in the health sector in low- and middle-income countries (LMICs) which has used intersectional analysis.
While there are studies that have looked at the inequities and barriers women face in progressing towards leadership positions in health systems within LMICs, none explicitly used an intersectionality framework in their approach. These studies did nevertheless show recurring barriers to health systems leadership created at the intersection of gender and social identities such as professional cadre, race/ethnicity, financial status, and culture. These barriers limit women's access to resources that improve career development, including mentorship and sponsorship opportunities, reduce value, recognition and respect at work for women, and increase the likelihood of women to take on dual burdens of professional work and childcare and domestic work, and, create biased views about effectiveness of men and women's leadership styles. An intersectional lens helps to better understand how gender intersects with other social identities which results in upholding these persisting barriers to career progression and leadership.
As efforts to reduce gender inequity in health systems are gaining momentum, it is important to look beyond gender and take into account other intersecting social identities that create unique positionalities of privilege and/or disadvantage. This approach should be adopted across a diverse range of health systems programs and policies in an effort to strengthen gender equity in health and specifically human resources for health (HRH), and improve health system governance, functioning and outcomes.
人力资源是卫生系统的核心,在全球范围内对其功能发挥着核心作用。据估计,高达 70%的卫生劳动力为女性,但这种模式并没有反映在卫生系统的领导层中,女性在其中代表性不足。
本系统评价探讨了现有文献中关于中低收入国家(LMICs)中女性在卫生部门领导层取得进展的情况,这些文献使用了交叉分析。
虽然有一些研究关注了女性在 LMIC 中向卫生系统领导职位晋升所面临的不平等和障碍,但没有一项研究在其方法中明确使用交叉性框架。这些研究确实表明,在性别和社会身份的交叉点上存在着限制卫生系统领导的反复出现的障碍,例如职业干部、种族/族裔、财务状况和文化。这些障碍限制了女性获得改善职业发展的资源,包括指导和赞助机会,减少了女性在工作中的价值、认可和尊重,并增加了女性承担专业工作和儿童保育以及家务的双重负担的可能性,并对男女领导风格的有效性产生了偏见。交叉视角有助于更好地理解性别如何与其他社会身份交叉,从而导致这些持续存在的职业发展和领导障碍得以维持。
随着减少卫生系统中性别不平等的努力不断增强,重要的是不仅要关注性别,还要考虑到其他交叉的社会身份,这些身份会造成独特的特权和/或劣势地位。在努力加强卫生和具体的卫生人力(HRH)中的性别平等以及改善卫生系统治理、运作和结果时,应该在各种不同的卫生系统方案和政策中采用这种方法。