Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
Women in Global Health, Washington, District of Columbia, USA.
BMJ Glob Health. 2022 Aug;7(8). doi: 10.1136/bmjgh-2022-009312.
While an estimated 70%-75% of the health workforce are women, this is not reflected in the leadership roles of most health organisations-including global decision-making bodies such as the World Health Assembly (WHA).
We analysed gender representation in WHA delegations of Member States, Associate Members and Observers (country/territory), using data from 10 944 WHA delegations and 75 815 delegation members over 1948-2021. Delegates' information was extracted from WHO documentation. Likely gender was inferred based on prefixes, pronouns and other gendered language. A gender-to-name algorithm was used as a last resort (4.6%). Time series of 5-year rolling averages of the percentage of women across WHO region, income group and delegate roles are presented. We estimated (%) change ±SE of inferred women delegation members at the WHA per year, and estimated years±SE until gender parity from 2010 to 2019 across regions, income groups, delegate roles and countries. Correlations with these measures were assessed with countries' gender inequality index and two Worldwide Governance indicators.
While upwards trends could be observed in the percentage of women delegates over the past 74 years, men remained over-represented in most WHA delegations. Over 1948-2021, 82.9% of delegations were composed of a majority of men, and no WHA had more than 30% of women Chief Delegates (ranging from 0% to 30%). Wide variation in trends over time could be observed across different geographical regions, income groups and countries. Some countries may take over 100 years to reach gender parity in their WHA delegations, if current estimated trends continue.
Despite commitments to gender equality in leadership, women remain gravely under-represented in global health governance. An intersectional approach to representation in global health governance, which prioritises equity in participation beyond gender, can enable transformative policymaking that fosters transparent, accountable and just health systems.
尽管估计有 70%-75%的卫生工作者为女性，但这并未反映在大多数卫生组织的领导角色中，包括全球决策机构，如世界卫生大会（WHA）。
我们分析了会员国、准会员和观察员（国家/地区）在 WHA 代表团中的性别代表性，使用了 1948 年至 2021 年期间 10944 个 WHA 代表团和 75815 名代表团成员的数据。代表的信息是从世卫组织文件中提取的。根据前缀、代词和其他性别语言推断出可能的性别。最后，还使用了性别到姓名的算法（4.6%）。呈现了世卫组织各区域、收入组和代表角色的女性代表人数 5 年滚动平均值的时间序列。我们估计了每年 WHA 推断的女性代表人数的（%）变化±SE，并估计了 2010 年至 2019 年期间各区域、收入组、代表角色和国家实现性别均等所需的年数±SE。使用各国的性别不平等指数和两个全球治理指标评估了与这些指标的相关性。
虽然在过去 74 年中，可以观察到女性代表人数的上升趋势，但在大多数 WHA 代表团中，男性仍然过多。在 1948 年至 2021 年期间，82.9%的代表团由大多数男性组成，没有任何 WHA 的首席代表中女性超过 30%（从 0%到 30%）。不同地理区域、收入群体和国家的趋势在时间上存在很大差异。如果按照目前的估计趋势继续下去，一些国家可能需要 100 多年才能在 WHA 代表团中实现性别均等。
尽管在领导方面承诺实现性别平等，但女性在全球卫生治理中仍然严重代表性不足。一种交叉性的全球卫生治理代表性方法，优先考虑超越性别的参与公平，能够实现变革性的决策制定，促进透明、负责和公正的卫生系统。
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