International Women’s Day: unlocking the full potential of women at work in the European Region

Andy Aitchison

Each year on 8 March the global community recognizes International Women’s Day as a time to reflect on and celebrate progress made towards women’s rights, as well as to build momentum and support for further action. This year, the United Nations theme for the day is “Women in the changing world of work: Planet 50-50 by 2030”, referring to achieving true gender equity by the year 2030. This theme encourages people around the world to commit to effective implementation of the Sustainable Development Goals, particularly Goal 5: achieve gender equality and empower all women and girls.

“Progress towards the Sustainable Development Goals relies on unlocking the full potential of women at work,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “The health sector, being such an important employer of women, is a good place to start.”

Women as a vital part of the health workforce

On average, 45.6% of women in the WHO European Region participate in the labour force; only 32 of the 53 countries in the Region have a women’s labour participation rate greater than 50%. The health sector, however, is one area where the majority of employees are, in fact, women. Health systems rely heavily on the work of women in roles ranging from physicians to nurses to midwives and allied health professions.

A policy brief from the United Nations High-Level Commission on Health Employment and Economic Growth states that, in most countries, women’s share of employment in the health and social sector is much higher than their share of employment in the economy as a whole. In 2013, 52% of all physicians in the European Region were women, up from 47.7% in 2000. Women have also surpassed the desired 50-50 gender breakdown in other segments of the health workforce. Indeed, health systems could not function without the contribution of millions of female workers in the Region. Nevertheless, while the figures alone may tell a story of progress, it is vital to look below the surface to understand that female employees still face significant barriers in the health sector.

Barriers to reaching true gender equity

Across the health workforce women remain underrepresented in leadership positions within the medical hierarchy and among highly paid specialities. Studies also indicate that gender stereotypes persist in the health workforce and that women health professionals often choose careers based on whether they will allow them to balance work and family.

Furthermore, the burden of informal (and/or unpaid) health care falls disproportionately on women. Women perform three times more unpaid work than men, and this disparity is exacerbated in some countries by social expectations and shortfalls in the supply and quality of the formal health workforce. For example, the United Nations High-Level Commission states that health care services depend heavily on women who contribute as informal caregivers, particularly for children and older people. In some countries the share of women leaving their countries to work abroad in domestic labour, such as informal care, is disproportionately high.

The positive association between income, gender equality and sustainable development is also well established. Yet the gender wage gap persists, hindering efforts to achieve gender equity goals. Women in the European Union, for example, earn about 16% less per hour, despite having qualifications equivalent to their male counterparts. No country in the WHO European Region has yet achieved wage equality for equivalent work.

New approaches needed to attract, support and retain women health workers

The growing number of women in the health sector requires new approaches and ways of thinking about how work is structured and defined. The sector’s changing landscape necessitates early planning to respond to changes in work patterns, to allow more flexible workplace policies and to place a greater focus on how to attract, develop and retain female health workers. A strong evidence base on women in the health workforce will be critical to informing and guiding such new policies. To create supportive work environments that allow women to advance in their careers to leadership and management positions, and to close gender gaps in certain specialities, it is critical to consider the evidence base carefully and implement policies that have the needs and interests of working women at their core.

Transformative policies are also needed to promote an equal share of domestic responsibilities, in an effort to reduce the burden of unpaid care currently placed largely on women. Both social and economic benefits can be achieved by encouraging men to take a more active role in household responsibilities and caring for children and elderly family members, allowing for a more equal balance within families when it comes to professional and domestic responsibilities.

European women’s health strategy enables progress towards reducing gender inequities

At the 66th session of the WHO Regional Committee for Europe, the 53 countries in the Region adopted a new Strategy on women’s health and well-being. The Strategy aims to enable progress towards reducing gender and socioeconomic inequities for women in the Region. It is designed to help health planners work towards improving the health and well-being of women and girls, with a view beyond maternal and child health, ensuring that policies and health systems are gender-responsive and based on a life-course approach.

The Strategy puts forward four key recommendations that relate directly to women in the health workforce and aim both to address the impact of gender and social, economic, cultural and environmental determinants and to improve the health system response to women’s health and well-being. These include:

  1. promoting gender equity in all workplaces, across all levels;
  2. reducing the negative impact on health and well-being of precarious employment and working conditions;
  3. ensuring women’s work is equally valued to that of men, and that women’s paid and unpaid contributions as care providers are recognized, valued and compensated; and
  4. supporting models of care that do not increase the pressure on women and put them at risk of social exclusion, examples of which include policies that increase men’s participation in caring for their families.

The Strategy on women’s health and well-being is underpinned by the values of Health 2020, the European health policy framework, which acknowledges that gender is a determinant of health. It also supports the implementation of the Sustainable Development Goals linked to gender equity and reducing inequalities.

Taking action towards a sustainable health workforce

A framework for action towards a sustainable health workforce in the WHO European Region is on the agenda for the 67th session of the WHO Regional Committee for Europe, to be held in September 2017 in Budapest, Hungary. The framework supports the United Nations High-Level Commission’s recommendations for gender-related issues in the health sector, including the removal of societal barriers that prevent women from making an optimal contribution to the sector.