As women in health systems around the world respond to the pandemic, the need to address the burdens of inequity have become evident, Roopa Dhatt, M.D., co-founder and executive director of Women in Global Health, told attendees at the AAP Virtual National Conference & Exhibition.
“We know that global health is delivered by women, but it’s led by men, and the implications of this are being seen in the pandemic and the pandemic response,” Dr. Dhatt said. “There’s a complete imbalance in who’s providing care and who’s making decisions.”
Women also face a “pervasive reality that’s affecting health systems around the world,” she said. “Women are underpaid and unpaid.” The pandemic has exacerbated this, especially among the poorest women in health care in low-resource areas.
“The pandemic has really brought to bear the multiple roles the women play in both their professional and personal lives as they work while caring for families and homeschooling children. The research tells us that as we improve equity for women, we improve the health of their children,” said Beena Kamath-Rayne, M.D., M.P.H., FAAP, vice president, AAP Global Newborn and Child Health.
Early- to midcareer female pediatricians earn less than male pediatricians, even after adjusting for labor force, physician-specific job and work-family characteristics, according to 2016 findings from a AAP Pediatrician Life and Career Experience Study (https://bit.ly/38bhqUZ). Women are an increasing proportion of pediatricians but make less and do more child care work at home.
To shift the imbalance, Women in Global Health has launched COVID 50/50. The AAP is one of several global organizations collaborating in the campaign, which sheds light on the need for women in leadership in the pandemic.
“Women power is out there. … But are they making it into top decision-making roles within their own countries and national task teams?” Dr. Dhatt asked. “Women are still not getting leadership roles when it is a selection process.”
Women make up less than 5% of all leadership in lower resource settings and less than 5% of Fortune 500 CEOs in the private sector. On the front lines of the pandemic, women are 70% of the health care workforce but hold 10%, 20% and 16% of leadership roles in the U.S., World Health Organization (WHO) and WHO-China COVID-19 response, respectively. Among 87 countries, men make up 85% of the 115 national COVID-19 task forces, a recent study found (https://bit.ly/2HZLKqK).
Meanwhile, the impact of COVID-19 on women is significant, said Dr. Dhatt. “There are many aspects of it, ranging from safety at work, financial hardship, risk of infecting families, risk of infecting communities, stigma, mental stress. There’s also powerlessness that they cannot shape the decision-making that’s happening in their health system.”
The COVID 50/50 campaign includes “5 Asks for Global Health Security.” They are:
- Include women in global health security decision-making structures and public discourse.
- Provide health workers, most of whom are women, with safe and decent working conditions.
- Recognize the value of women’s unpaid care work by including it in the formal labor market and redistributing unpaid family care equally.
- Adopt a gender-sensitive approach to health security data collection/analysis and response management.
- Fund women’s movements to unleash capacity to address critical gender issues.
In a letter supporting Women in Global Health and the COVID 50/50 campaign, AAP President Sara “Sally” H. Goza, M.D., FAAP, wrote that the AAP acknowledges gender-responsive policies in global health security as important to advance gender equity. She outlined AAP commitments that include ensuring women make up 50% of external representation on international panels, forums and media opportunities by 2021, amplifying diverse viewpoints from women-led organizations, preventing single-sex composition of panels or programs at the AAP annual meeting and collecting sex desegregated data on the unpaid work that women do in health and social care.
“As pediatricians, we understand that gender equality improves the health of children,” Dr. Goza wrote. “As a leader in the global health sector, I will make it a priority to uphold the commitments of the COVID 50/50 campaign within the AAP and for our members.”