Shortages and maldistribution of the health workforce exist across the globe. In 2006, the World Health Organization (WHO) identified 57 crisis countries whose health workforces fall below the minimum recommended health worker density threshold of 2.3 doctors, nurses, and midwives per 1,000 people (WHO 2006).
As countries face numerous human resources for health (HRH) challenges, the production and development of health workers to overcome this shortage has been a major focus of many governments’ HRH strategies. Interventions aimed at strengthening health professional education systems have ranged from curriculum development to increased financing to institutional management reforms. A less widely acknowledged but equally important challenge is gender discrimination in health professional education settings and its effect on students and faculty.
Gender discrimination is “any distinction, exclusion, or restriction made on the basis of socially defined gender roles and norms that prevents a person from enjoying full human rights” (WHO 2001, 43).
There are a number of forms of discrimination that can affect students’ opportunities, experience, and ability to complete their studies and can limit faculty members’ career satisfaction, advancement, and economic opportunities. These include:
Pregnancy discrimination: Exclusions, restrictions, or distinctions made on the basis of current or potential pregnancy, childbirth, or related conditions, with an unwillingness to hire, promote, or retain female students or workers who may get pregnant and leave school or the workforce or who require maternity leave and benefits
Family responsibilities discrimination: Exclusions, restrictions, or distinctions against individuals (such as pregnant women, mothers and fathers of young children, parents of disabled children, and individuals who care for their aging parents or sick spouses/partners) based on their responsibilities to care for family members. Due to the informal nature of their work, caregivers are often unfairly perceived as not being committed.
In this tool, discrimination on the basis of pregnancy and/or family responsibilities is referred to as “caregiver responsibilities discrimination.”
Sexual harassment: Unwanted, unwelcome, or offensive conduct of a sexual nature that changes the terms and conditions of school or work, where either a person’s rejection of, or submission to, such conduct is used explicitly or implicitly as a basis for a decision that affects that person’s career; or conduct that creates an intimidating, hostile, or humiliating work environment for the recipient
Gender stereotyping: Preconceived ideas whereby males and females are assigned characteristics and roles determined and limited by their sex (adapted from Council of Europe 2011)
Gender stereotyping can result in the following:
Occupational segregation: The concentration of women and men in different occupations, jobs, and tasks, or at different levels in an employment or job hierarchy
Wage discrimination: Systematically paying lower wages and/or reduced benefits to women or minorities not based on objective differences in the work performed, seniority, education, qualifications, experience, or productivity
Gender discrimination may result in faculty and staff leaving the educational institution, and students not graduating and entering the health workforce. This has consequences for the quality and scale of health services, particularly since gender discrimination primarily affects female health professional students and health workers, who constitute a large proportion of many countries’ health workforces (Standing 2000, WHO 2008, George 2007).
This tool will help you to learn more about these issues.