Leading up to this year’s International Women’s Day, the U.S. Agency for International Development (USAID) introduced a new Gender Equality and Female Empowerment Policy. The goal of the policy is the advancement of gender equality and empowerment of women and girls to participate fully in and benefit from development. We are excited about the launch of this new policy. For IntraHealth, gender equality in the health workforce means women and men having equal opportunities to choose a health occupation, develop requisite skills and knowledge, be fairly paid, enjoy equal treatment, and advance in a career.¹

Over the past two years USAID has taken many steps to accelerate progress toward the Millennium Development Goals by mainstreaming gender into development efforts. Gender mainstreaming is the process of incorporating a gender perspective into policies, strategies, programs, project activities, and administrative functions, as well as into the institutional culture of an organization.²

However, finding that “global efforts to reduce gender gaps have met only partial success” especially in regard to education and economic inclusion, the new policy provides “guidance on pursuing more effective, evidence-based investments in gender equality and female empowerment” which are critical to better development results.³ Both USAID’s gender mainstreaming process as well as the new policy offer lessons and guidance to achieving this year’s International Women’s Day theme of connecting girls and inspiring futures.

The new policy mandates that all USAID investments contribute to the following three outcomes. I have outlined issues related to each that affect women’s and girls’ participation in the health workforce as well as some of the health sector responses needed.

1. Reducing gender disparities in access to, control over and benefit from resources, wealth, opportunities, and services—economic, social, political, and cultural  

• Access to education: While progress has been made in achieving gender parity in primary education, girls still lag behind in terms of secondary and tertiary education.
• Gender stereotypes: Throughout the educational system, stereotypes limit girls’ opportunities to access careers in health and, once girls are employed in the health field, limit their career advancement and training opportunities.
• Occupational and task segregation: Female health workers are typically confined to a narrower range of work, in less well-paid, lower-grade jobs. Female health workers are less likely to have benefits, on-the-job training, and opportunities for promotion than male health workers.
• Gender gap in technology: Women are less likely to have access to technology, including mobile phones.

Health workforce leaders must put in place systems to identify and monitor gender discrimination in education and employment and vigorously implement and enforce equal opportunity laws and policies. The health sector has an opportunity to reduce the gender gap in technology by ensuring that female health workers have access to mobile phones and all of their benefits, including financial inclusion, and connections to education and health care.

2. Reducing gender-based violence and mitigating its harmful effects on individuals and communities

• Gender-based violence in schools: Educational enrollment, retention, and completion are negatively affected by the actual, or perceived, threat of gender-based physical, sexual, and psychological violence in, around, and traveling to and from schools. Girls are also at risk for sexual harassment and abuse by teachers and male classmates.
• Gender-based violence in the workplace: Violence continues into the health workplace and ranges from sexual harassment, offensive and unwelcome comments, hostile work environments, coercion, to sexual assault and rape.

Efforts must be made to ensure the safety and fair and equitable treatment of girls in schools so they are more likely to stay in school, delay sex and avoid pregnancy, and reap all of the benefits from having done so. Health sector personnel need to be trained on workplace violence and gender discrimination, and zero-tolerance codes of conduct for sexual harassment should be developed and enforced.

3. Increasing the capability of women and girls to realize their rights, determine their life outcomes, and influence decision-making in households, communities, and societies

• Leadership skills: Gender stereotyping holds women back from positions of management because of a perceived or real lack of leadership skills. Men are often viewed as “natural” leaders or presumed breadwinners and, therefore, more deserving of higher-paid management positions. Women may lack opportunities to develop leadership skills because of women having been channeled into lower grades of work—“vertical segregation”—that are less likely to provide opportunities for promotion or to exercise authority or control.
• Cultural expectations regarding pregnancy and childcare: Cultural expectations around reproduction and family responsibilities result in female workers foregoing training opportunities, scaling back work, or leaving the workforce.

Health systems can create favorable conditions for women’s empowerment by fostering women’s leadership within the health sector, combating stereotypes, and providing more flexible working conditions. Female health workers also must have access to family planning so they can plan their families. They can then reap the long-term benefits of fully participating in the paid health workforce and choose jobs where they can work more hours, acquire more skills, earn more money, and have more opportunities for job advancement.

Connecting girls to future careers in health will require more than putting a single policy or affirmative action in place. Organizations implementing USAID-funded programs will need to mirror USAID’s gender mainstreaming and integrating efforts. In country, it will require many new policies and practices. Organizational cultures of ministries of health, health facilities, and primary, secondary, and tertiary schools must change. Families and communities must also change their views of what is possible for their daughters, and girls must change how they envision their own futures.  

By connecting girls and inspiring their futures in health, we not only work toward gender equality but also toward increasing the pool of health workers ready and equipped to address the health and development challenges of today and tomorrow.  

References and Additional Resources

1.  Newman, C. Gender Equality in Human Resources for Health: What Does This Mean and What Can We Do? IntraHealth International.  http://www.intrahealth.org/files/media/gender-equality-in-human-resources-for-health/gender_equality_hrh.pdf

2.  Defining Gender and Related Terms, Interagency Gender Working Group, http://www.igwg.org/training/DevelopingSharedVocabulary/DefiningGenderRelatedTerms.aspx

3.  USAID Gender Equality and Female Empowerment Policy http://www.usaid.gov/our_work/policy_planning_and_learning/documents/GenderEqualityPolicy.pdf

4.  GHI Supplemental Guidance on Women, Girls, and Gender Equality Principle http://www.ghi.gov/resources/guidance/161891.htm