India needs more women leaders in health care
Development by and for women is at the centre of India’s vision for inclusive growth. The Union Budget’s Nari Shakti initiatives reinstated this by equipping women with tools to steer change and lead the way towards a brighter tomorrow.
Leaders have the power to transform, and women are integral to this change story. In contexts where structural inequalities are endemic and support systems are fragile, such as in India, strong leaders can bring about positive, lasting change in people’s lives.
Effective leadership depends on intentional investment and creating opportunities to level the playing field. Health leadership is largely centred on the ability to identify priorities, provide strategic direction to multiple actors within the health system and create commitment across the health sector. As health systems change, the leadership must modify and respond to political, technological, social, and economic developments that are essential for strengthening the health system.
With the pandemic revealing the fragility of existing systems and the need for timely, efficient decision-making, it is critical to relook at our investments such that the health leadership at all levels is inclusive, diverse and equitable.
Reaching leadership positions has proven to be especially rare for women, and the health sector is no different. As per a study published in the medical journal Lancet in 2021, women represent 71% of the global health care workforce and though both men and women progress similarly in this field in their early careers, women are five times more likely to face disruptions in their pathways.
This gender gap in global health leadership is particularly troubling because women’s health and reducing unjust health inequalities are central to the field. Addressing this gap will not in itself solve all women’s health problems. But it is a first step that is overdue.
The Indian landscape is aligned with global trends — women are not commonly found in senior positions in our country’s health domain. To change this across the country, gender discrimination, unpaid work, absence of agency, lack of networks and support systems are some factors that need to be addressed. Studies establish that placing more women in leadership positions not only increases organisational productivity but maximises the value of the female workforce.
Having women at the front and centre of decision-making processes can help integrate nuances of our social fabric in policies. For instance, in India, women’s and children’s health are areas of concern with more than half of the cohort being anaemic and a large proportion suffering from malnutrition. In adolescent girls, anaemia has actually gone up from 54% (2015-16) to 59% (2019-21), as per the National Family Health Survey-5.
These issues are closely related to sociocultural factors such as early marriage, teenage pregnancy, and unsafe abortion, which lead to compromised nutritional and health status among young girls and their children. Further, with women taking up most of the household work, they are exposed to the threats of neglected tropical diseases such as lymphatic filariasis. Often, they don’t even seek care on time, unless their husbands or guardians agree.
These intersecting challenges must be accounted for while designing solutions. Significantly, the Nari Shakti initiative and Mission Shakti were re-launched in the Budget session to deliver unified citizencentric support for women through integrated care and safety, rehabilitation, for women as they progress through life. This is a step in the right direction.
Having more women at the head of decision-making tables is urgent, to introduce more interventions, address social barriers, build resilient, inclusive health systems and for diverse perspectives to be integrated into health resource allocation, research policies and financing.
We must make more concerted and intentional efforts to accelerate women’s leadership in health and optimise pathways to this. This requires changing perspectives, breaking away from deep-rooted sociocultural beliefs and making equal opportunities available to all. Only by believing in and working towards gender transformative leadership can we ensure that policy decisions benefit all and bring intergenerational change.