Feminisation of the health workforce and wage conditions of health professions: an exploratory analysis

Abstract

Background: The feminisation of the global health workforce presents a unique challenge for human resource policy and health sector reform which requires an explicit gender focus. Relatively little is known about changes in the gender composition of the health workforce and its impact on drivers of global health workforce dynamics such as wage conditions. In this article, we use a gender analysis to explore if the feminisation of the global health workforce leads to a deterioration of wage conditions in health. Methods: We performed an exploratory, time series analysis of gender disaggregated WageIndicator data. We explored global gender trends, wage gaps and wage conditions over time in selected health occupations. We analysed a sample of 25 countries over 9 years between 2006 and 2014, containing data from 970,894 individuals, with 79,633 participants working in health occupations (48,282 of which reported wage data). We reported by year, country income level and health occupation grouping. Results: The health workforce is feminising, particularly in lower-and upper-middle-income countries. This was associated with a wage gap for women of 26 to 36% less than men, which increased over time. In lower-and upper-middle-income countries, an increasing proportion of women in the health workforce was associated with an increasing gender wage gap and decreasing wage conditions. The gender wage gap was pronounced in both clinical and allied health professions and over lower-middle-, upper-middle-and high-income countries, although the largest gender wage gaps were seen in allied healthcare occupations in lower-middle-income countries. Conclusion: These results, if a true reflection of the global health workforce, have significant implications for health policy and planning and highlight tensions between current, purely economic, framing of health workforce dynamics and the need for more extensive gender analysis. They also highlight the value of a more nuanced approach to health workforce planning that is gender sensitive, specific to countries' levels of development, and considers specific health occupations.

Hiding in Plain Sight: The Absence of Consideration of the Gendered Dimensions in ‘Source’ Country Perspectives of Health Worker Migration

“…For example, the fact that many health workers are women might explain inadequate remuneration levels and the generally low social status ascribed to the work of women health workers overall (Shannon et al 2019). In South Africa, where female health workers were described as "preferred" for "innate" personal characteristics and cultural reasons, and in India where males are directed away from these roles considered only for women, may be linked to the general devaluing of this work re ected in the pay inequity of nursing vis-à-vis other workers' roles such as medicine, where men have traditionally predominated.…”

“…Indeed, women migrants are over-represented globally in health and care sectors in which care-work has typically been undervalued because of its gendered female nature (Folbre, 2012). Nurses and other female health workers are disproportionately impacted by government austerity and cutbacks to healthcare investment given their predominance in the sector (Shannon et al, 2019). Yet, while the migration of women as skilled health workers contributes signi cantly to global labour markets and migration patterns, the "gendered effects of migrant health workers on their personal and professional lives within the context of speci c health occupations and speci c recipient and source health systems" (George 2007;p.37) remains poorly understood.…”

Hiding in Plain Sight: Gendered Dimensions of Health Worker Migration from ‘Source’ Country Perspectives

“…Moreover, nurses and other feminized health workers are often disproportionately impacted by health government austerity and cutback to healthcare investment (Shannon et al 2019). Yet, while the migration of women as skilled health workers contributes signi cantly to global labour markets and migration patterns, the "gendered effects of migrant health workers on their personal and professional lives within the context of speci c health occupations and speci c recipient and source health systems" (George 2007; p. 37) remains under explored.…”

Dimensões da qualidade de vida no trabalho: representações de equipes de enfermagem em ambiente hospitalar

“…A abordagem da QVT tem ocorrido em pesquisas envolvendo diferentes categorias profissionais 4,5,8 . Esta abordagem explora as potencialidades junto aos profissionais de enfermagem devido à sua magnitude como força de trabalho nos serviços de saúde 9,10 e pelos impactos da QVT na saúde e trabalho desses trabalhadores 11 e, consequentemente, no serviço prestado aos usuários.…”