Gender equality in global health leadership: Cross-sectional survey of global health graduates

Abstract

Women comprise two-thirds of the global-health (GH) workforce but are underrepresented in leadership. GH departments are platforms to advance gender equality in GH leadership. Using a survey of graduates from one GH department, we compared women's and men's posttraining career agency and GH employment and assessed whether gender gaps in training accounted for gender gaps in career outcomes. Master-of-Public-Health (MPH) and mid-career-fellow alumni since 2010 received a 31-question online survey. Forty-four per cent of MPH alum and 24% of fellows responded. Using logistic regression, we tested gender gaps in training satisfaction, career agency, and GH employment, unadjusted and adjusted for training received. Women (N = 293) reported lower satisfaction with training (M7.6 vs 8.2) and career agency (leadership ability: M6.3 vs 7.4) than men (N = 60). Women more often than men acquired methods-related skills (95% vs 78%), employment recommendations (42% vs 18%), and group membership. Men more often than women acquired leadership training (43% vs 23%), award recommendations (53% vs 17%), and conference support (65% vs 35%). Women and men had similar odds of GH employment. Accounting for confounders and gender-gaps in training eliminated gender gaps in five of six career-agency outcomes. Panel studies of women's and men's career trajectories in GH are needed.

Postgraduate Employment Outcomes of Undergraduate and Graduate Public Health Students

“…Two articles focused on graduates of schools or programs of public health in multiple countries, 3 focused on Australia, 2 focused on Canada, and 1 each focused on Vietnam, the United Kingdom, and South Africa. Fourteen articles focused on subareas of public health (3 on health communication/education, 40 -42 3 on maternal and child health, 43 -45 5 on global health, 46 -50 1 on industrial hygiene, 51 1 on nutrition, 52 1 on Aboriginal health), 53 5 articles focused on undergraduates, 54 -58 and 3 articles focused on doctoral graduates. 45,59,60 Two articles focused on postgraduate employment outcomes of a subset of graduates who had previously participated in a volunteer program, 57,61 and 1 focused on international students.…”

“…Seventeen studies were surveys of the alumni of a single school or program of public health using mail, telephone, or online survey methods. 40,44,45,48,50,52 -55,57,58,61 -66 Three studies were surveys sent to graduate programs, 41,43,67 7 were surveys of alumni of multiple schools or programs of public health, 11,42,46,47,49,56,68 2 were based on nationally collected surveys of doctoral recipients in the United States, 59,60 3 were national data collections from numerous schools and programs of public health, 11,20,22 and 1 used data from the published websites of multiple schools and programs of public health. 63…”

“…Sixteen studies combined all survey responses of alumni from several graduating classes. 40,42 -48,50,51,57,58,62,64,66,68 However, by mixing the employment outcomes of recent graduates with the employment outcomes of graduates who had years of experience, it was not possible to discern how their training affected them during their career. Seven studies used protocols in which a consistently defined cohort year of graduates was surveyed at a consistent and specific number of months postgraduation (typically 6 months or 1 year after graduation); used 1 or multiple graduating cohorts from the same school or program of public health, each measured at consistent time frames postgraduation; and did not mix multiple graduating cohorts into 1 data set.…”

“…11,20,22,23,49,54,63 Seven studies did not indicate clearly which cohorts were included. 41,50,52,53,56,67,68 The data for studies of doctoral graduates using the National Science Foundation’s annual Survey of Earned Doctorates, which are collected annually from all doctoral graduates in the United States, 59,60 were gathered before graduation. One study was unclear about whether the people surveyed were still students or alumni.…”

“…Most articles made no attempt to assess the differences between responders and nonresponders, 20,40 -45,48 -51,54 -57,63,68 did not describe their survey instrument or its development, 43 -45,48,51 -56,64 and did not describe field testing the survey, institutional review board approval, or statistical methods. Although the standards for designing surveys recommend consulting with experts in the field, 69 and career services professionals often are responsible for gathering employment data, only 4 studies consulted with such professionals.…”