Lack of Mentors, Patriarchal Work Cultures and Familial Responsibilities Identified as Key Challenges to Mid-Career Women in Health in India

BusinessWire India
New Delhi [India], July 5: WomenLift Health organized a media roundtable on 'Women's Leadership in Health: What will it take to break the glass ceiling?' at the India International Centre, New Delhi to address persisting gender inequities in leadership in the public health sector in India. The event showcased findings from a titled, Comparing barriers and enablers of women's health leadership in India with East Africa and North America' by WomenLift Health and Bixal.

Despite women making up a sizable majority--approximately 70-75 percent--of the global health workforce, they are underrepresented in senior leadership roles, particularly at the higher executive or board levels. In India, women make up to 80 percent of the workforce, particularly among community health and care workers; these numbers, however, do not translate to senior decision-making positions, thereby resulting in key gaps in addressing the health needs of women in the country.

From 2021 to 2022, WomenLift Health and Bixal conducted 79 interviews and 153 surveys with mid-career and senior women working in healthcare across India, East Africa, and North America. The study aimed to unpack the specific barriers to and enablers for leadership faced by women in healthcare in India, compare their experiences with women in other regions, and unearth concrete pathways to address systemic inequities in healthcare leadership.

Findings showed certain universal barriers faced by women health leaders across contexts: overt and implicit biases in traditionally patriarchal and hierarchical work cultures, reproductive demands, and familial responsibilities and expectations placed on women. Enabling factors, on the other hand, included female mentors, professional networks, and leadership based on empathy and team building. In India, findings showed that overt rather than implicit biases in the workplace, familial expectations of early marriage, social norms, and ageism affect women's careers more acutely in comparison to similar women in East Africa and North America.

"The conversation around leadership (in healthcare) so far has focused on what leadership is; much less is spoken about how leadership should be. Our research shows that leadership traits valued by women often differ greatly from those that define traditional workplace structures. Moreover, to conceptualise a more inclusive model of leadership, we must expand existing notions of leadership beyond the boardroom and corporate models," says Dr. Shagun Sabarwal, South Asia and Monitoring, Evaluation, and Learning Director, WomenLift Health highlighting the key recommendations of the Lancet study.

The roundtable discussion included key voices spanning the healthcare ecosystem in India to address the barriers and map the road ahead for women's leadership in health through collaborative, long-term action, at the individual, institutional, and societal levels, including building space spaces for female networks, creating access to mentors, and promoting conducive workplace policies. Speakers explored both the first-hand experiences of women working in healthcare in India and ways to address institutional gaps to build inclusive workplaces.

"The question of leadership in health must be addressed at the grassroot level and young people are a vital link to addressing the issue. The National Health Mission is working in an inter-ministerial collaboration oath- ensuring access to health-related information, services, and commodities for young people, with a focus on young girls as when they take care of their health, the health of the family is taken care of, and in turn, the health of the community," said Dr. Zoya Ali Rizvi, Deputy Commissioner for Adolescent Health, National Health Mission, Ministry of Health and Welfare.

Discussing what an effective leader looks like, Dr. Renu Swarup, Former Secretary, Department of Biotechnology, Ministry of Science and Technology added "Women leadership is about creating an enabling ecosystem which in holistic. Professionals cannot be divided on gender; they came into the ecosystem based on their merit. It is important to place focus on both equality and equity. As institutions, it is important to build a strong foundation for fostering women leaders. It cannot be an inverted pyramid; institutions must nurture women throughout their careers and let them recognize their own strength."
Lizz Ntonjira, Communications and Engagement Director, WomenLift Health highlighted that "While some industries have seen significant growth among women in leadership positions, the health care industry continues to move slowly. Some of the current leaders have implicit bias against women in leadership positions because of the way things have always been in healthcare. It is for this reason that WomenLift Health is committed to working with partners around the world to accelerate the advancement of talented women into senior leadership by investing in mid-career women and influencing the environments in which they live and work."
Dr. Narendra Kumar Arora, Executive Director, The Inclen Trust International focusing on foundational issues said "India's rural care is heavily dependent on ASHA workers, but the management is by male leaders, resulting in overlooking of challenges faced. When we look at leadership positions held by women, while there are provisions of representation, these remain tokenistic in nature. Affirmative action is not sufficient, and there is a need to ensure development of processes for women's leadership that are not just representative, but also transformative. It is essential to address the social barriers and build comprehensive roadmaps to nurture women professionals in healthcare."

Dr. Shirshendu Mukherjee, Mission Director, Grand Challenges of India, Ministry of Health and Welfare, discussing male-allyship in workplaces stated "Throughout the last decade, I have mostly worked under several women leaders and all of them have done exemplary work. For a workplace to be inclusive, there is a need to work towards complementarity. I think as male allies, it is our responsibility to ensure that institutions are sensitive to the needs of working women. Working towards building inclusive policies within institutions is also pertinent when it comes to breaking the glass ceiling, particularly, in public health."

Placing focus on the questions of intersectionality, Dr. Aqsa Shaikh, Associate Professor of Community Medicine at Hamdard Institute of Medical Science and Research added, "The first need is to place women at the table and understand lived experiences. An individual has multiple identities impacting their social positions in different manners, and it is critical that there is discourse around intersectional identities in healthcare. Leadership cannot be restricted to corporate spaces; it is essential to look at non-formal and indigenous healthcare spaces and learn from local structures."

Dr Aparna Sharma, Additional Professor, AIIMS, remarked "The solution is hidden in the problem, and it has to come from the ground level. If the position of women healthcare professionals is strengthened at the grassroot level, the fundamental barriers hindering them from ascending to leadership positions become easier to address. In my practice, whenever I discuss transformational leadership, it comes down to three aspects - incubating motivation, providing opportunities for mentorship and modeling and fostering ambient learning spaces; and initiatives and policies aimed at promoting leadership of women must place emphasis on these."

Deepika Sharma, HIV Division Chief, USAID talking from her experience said "The proportion of senior leadership roles held by women in the Global North have been more, relatively in comparison to India. The basis of this dichotomy rests in the societal and cultural norms of the ecosystem. Equality and equity are not the same thing. Equality will open the door for you, equity will help you get through the door. Fostering transformational leadership, with equality and equity as its pillars is the need of the hour."

The event concluded with a vote of thanks delivered by Sanaya Chandar, Senior Manager - Strategic Communications, WomenLift Health, India.
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