Feminization of the medical workforce in low-income settings; findings from surveys in three African capital cities

Abstract

BackgroundWomen represent an increasingly growing share of the medical workforce in high-income countries, with abundant research focusing on reasons and implications of the phenomenon. Little evidence is available from low- and middle-income countries, which is odd given the possible repercussion this may have for the local supply of medical services and, ultimately, for attaining universal health coverage.MethodsDrawing from secondary analysis of primary survey data, this paper analyses the proportion and characteristics of female physicians in Bissau, Maputo and Praia, with the objective of gaining insights on the extent and features of the feminization of the medical workforce in low- and middle-income settings. We used descriptive statistics, parametric and non-parametric test to compare groups and explore associations between different variables. Zero-inflated and generalized linear models were employed to analyse the number of hours worked in the private and public sector by male and female physicians.Results and discussionWe show that although female physicians do not represent yet the majority of the medical workforce, feminization of the profession is under way in the three locations analysed, as women are presently over-represented in younger age groups. Female doctors distribute unevenly across medical specialties in the three cities and are absent from traditionally male-dominated ones such as surgery, orthopaedics and stomatology. Our data also show that they engage as much as their male peers in private practice, although overall they dedicate fewer hours to the profession, particularly in the public sector.ConclusionsWhile more research is needed to understand how this phenomenon affects rural areas in a broader range of locations, our work shows the value of exploring the differences between female and male physicians’ engagement with the profession in order to anticipate the impact of such feminization on national health systems and workforces in low- and middle-income countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-015-0064-9) contains supplementary material, which is available to authorized users.

“I did not know it was a medical condition”: Predictors, severity and help seeking behaviors of women with female sexual dysfunction in the Volta region of Ghana

“…Appropriately, most women in our study sought formal help from a General Practitioner (GP) or a Gynecologist for their conditions. Ghana, like most countries, is undergoing a gender redistribution of the physician workforce [71][72][73][74]. The estimated 1:8,481 patient to provider ratio [75] has traditionally tipped in favor of male doctors [76][77][78][79], including Obstetric/Gynecologists (ObGyns) [80], even though there is ample literature to support the notion that women, particularly those in conservative cultures, prefer female OB-GYNs, given the intimacy of the services rendered by these providers [81][82][83].…”

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

“…The feminisation of the health workforce-the movement of women into occupations where they were formally under-represented [1]-is a phenomenon that has been extensively documented in global health research [1][2][3][4][5][6][7][8][9][10][11][12][13]. In medicine, women have moved from exclusion from the profession to the majority of medical graduates in many countries around the world [2,3].…”

“…In medicine, women have moved from exclusion from the profession to the majority of medical graduates in many countries around the world [2,3]. Feminisation of the medical profession has been recorded in countries as diverse as Bangladesh [4], Canada [5], Cape Verde [6], Guinea Bissau [6], Israel [7], Mozambique [6], Oman [8], the UK [3] and the US [9]. In dentistry, the proportion of women is projected to increase to 28% globally by 2030 [10].…”

Gender and physician specialization and practice settings in Ecuador: a qualitative study

“…Furthermore, subsequent studies have found that women physicians in Mexico are underemployed, though the reasons for this (e.g., whether this is because of discrimination in graduate training, occupational choices, or working in public vs. private sectors) are not completely understood [7]. A recent study including physicians in three African capital cities found the proportion of women physicians to range from 28.1% in Bissau, Guinea-Bissau to 56.4% in Praia, Cape Verde, and that women across all three cities were over-represented in the younger age groups [8]. Further, women physicians also predominated in primary care specialties and on average worked fewer hours per week than their male peers, particularly in the private sector.…”