It has been one full year since the World Health Organization declared COVID-19 a global pandemic. As most of you will know, while the health impact so far has been bad enough, the social and economic fallout of the pandemic also had a negative impact on gender equality. To be honest, it does not surprise me that COVID-19 has disproportionately affected the lives of women. In a way, it has only highlighted the unequal practices, norms, and (in)visible barriers women have faced in the name of patriarchy, throughout history. For example, women spend more time in taking care of their families and children and this work has only increased due to work from home practices; women face a greater burden of gender-based violence – which has worsened during lockdowns; they are overrepresented in service-sector jobs that have been hardest hit during the pandemic such as education, travel, childcare and retail (resulting in job loss or furloughs); and women and girls face a greater threat to the violation of their basic human rights with Covid-19 further worsening the situation – see for example the increase in child marriages during the pandemic as girls were made to drop out of schools. None of these problems are new, but COVID-19 has exacerbated them. However, the pandemic also presents us with a unique opportunity to undo gender inequality.
As we celebrate International Women’s Day, I thought it would be timely for me to reflect on how COVID-19 is shaping the nature of work within global health, a sector crucial to the pandemic response, with 70% of the workforce comprising of women. My findings from my PhD research (forthcoming publication(s)) on gender equality in global health organizations only have made me more aware of how global health workplaces are plagued with fixing-the-women approaches. These approaches are unfair and sexist as they tend to hold women accountable for fixing the inequalities they face at work. It is not the women who are “broken”, but rather the entire global health system that was not designed to keep gender differences in mind. In my research, I refer to these as the gender inequality regimes of global health organizations.
Global health organizations and workplaces do not work for men and women in the same way. We have seen this for example with how female health workers struggled with ill-fitted personal protective equipment (PPEs) during the pandemic, designed for a 6ft 3inch person like a rugby player, subjecting them to high levels of risk and exposure to the virus. Leanne Wood, a Welsh politician labeled this as a “scandal within a scandal.” I could not agree more. Imagine being a nurse, treating patients with equipment that not only does not really protect you, but also makes you feel uncomfortable! In her book, Invisible Women, author Caroline Criado-Perez highlighted this issue of how the majority of PPEs are designed for a male body and that female healthcare workers are often told things like “your face shape is weird” – she argues that it is not a weird shape, it is a female shape! It highlights an organizational culture, that is not only gender blind, but rather male-centric.
Women’s voices have also been largely absent from decision-making and leadership roles during the pandemic. A study found only 3.5% of the COVID-19 task forces had gender parity, while men dominated 85% of the COVID-19 decision-making and key advisory bodies. Gender stereotypes and discrimination are responsible for a lack of women in leadership roles according to a WHO report.
The new Global Health 50/50 report
These trends are also made visible by the Global Health 50/50 initiative, that just published its fourth annual report, “Gender equality: Flying blind in a time of crisis”. One of the surprising findings of the report is that while 79% of the global health organizations commit to gender equality, only 40% define gender in their public communications and several lack workplace policies such as workplace gender equality policy (61%), diversity and inclusion policies (51%), transparency in sexual harassment policies (44%), and board diversity policies (20%). The report also surveyed CEO salaries at the 34 US-based NGOs, and found that on average, women CEOs were paid $308,000, while men CEOs were paid $415,000 – a gender gap of $106,000 per year! The report fills a crucial data gap and presents a strong case that rhetoric is not enough. Indeed, rhetoric is easy, as it helps gain legitimacy or jump on the “bandwagon” of gender equality in an era of #MeToo and Women marches. Credibility, on the other hand, can only be built with action. And that is what needs to change. I hope this report can serve as a benchmark for future progress and motivate global health leaders to #ChooseToChallenge (as per the IWD 2021 campaign theme) to dismantle the gender inequality regimes of global health workplaces.
“We are skeptical of reductive approaches to complex and embedded social challenges, such as inequality around gender or class, but if we had to suggest just one change, it would be to shift the focus from the leadership of global organizations to the rank and file. That is not to say that leaders have no role, but rather to acknowledge that incentives to sustain the status quo are baked into the system. For change, we need greater attention to supporting change from below. Supporting staff to organize, to mobilize and to hold management to account. We hope that our report findings, and the resources we share, serve to support the rank in their efforts for greater social justice.” – professors Kent Buse and Sarah Hawkes, co-directors of Global Health 50/50 summed it up nicely when I asked them (in an email conversation) to recommend one area of change. They challenge global health organizations to be truly bold in their actions while disrupting the notion of leadership and how we define it.
Gender inequality regimes of global health can be undone. The report offers a ray of hope, with notable improvements in terms of greater commitment to gender equality, and an increase in women in leadership, senior management, and governing bodies since the first report was published in 2018. The report can serve as a guide to measure progress as global health organizations strive to build back better post COVID-19.