Health services. More men needed and better jobs for women

Some 9% of the world's GDP is spent in the health sector, which employs about 35 million persons. Beyond the importance of "health for all" per se, this sector is one of the largest and fastest growing in the world economy in terms of both employment and financial investment. Over the past three decades, employment in health services has been growing rapidly in most countries, often more rapidly than the population. Due to demographic and epidemiological conditions, the demands on health services are expected to increase even further. Today, because of a lack of financial resources, these demands are not always transformed into employment growth in the public health sector, but health services in the private non-profit and for-profit sectors are growing.

The health sector is a major employer of women, in some cases up to 80% of all workers in the sector. A wide range of health professions are traditionally female. The share of female nurses is often over 90%. Thus, in a number of countries, addressing gender issues in nursing professions against the background of staff shortage, means exploring possibilities to increasingly interest men to enter the field.

When looking at the hierarchy of employment and the more prestigious and better- paid professions, the situation appears quite different. Women are significantly under-represented in decision-making and managerial positions. Even in female-dominated professions, men are disproportionately well-represented in management.

In general, jobs held mainly by women tend to pay less than those in which men predominate. In the health sector of most countries, women have lower average earnings, even within the same job class. Due to a large variety of patterns of work organization and allowances, it is statistically difficult to establish whether women and men obtain different compensation for the same work. Different average incomes are frequently the result of gender-specific obstacles to training, promotion and career development. And certain work patterns, such as shift work and frequent overtime, might not be possible for women with family responsibilities and thus will reduce their average income.

Gender issues are important for the effectiveness and efficiency of health policy and the delivery of health services. In many cultures, women are the "guardians" of the family's health. Access to women is therefore of great importance for the effectiveness of public health policies. In many cultures, this is only possible through female health professionals.

Obstacles for women to enter and to remain in these professions include long periods of education and lifelong learning, as well as working hours and work organization which may not be compatible with family responsibilities during their professional life cycle. Because of the requirement for continuous, high-quality delivery of health services, these obstacles cannot be easily removed and often lead either to career breaks during periods of intensive family responsibilities, or to their leaving the workforce altogether. To counteract this trend, the health sector must offer women a number of incentives and facilities for them to enter - and to remain - in the health professions, and to enhance their professional careers. Among factors facilitating women's continuous participation in the sector are more flexible (but not precarious) working arrangements, facilities for family care during working hours and tailor-made career development. This flexibility is more difficult to create in the public service, than in the private sector.

What can the ILO do?

Disseminate information on gender issues specific to the health sector, which differs in this respect from other sectors
Raise gender issues in a specific chapter of the reports prepared for each meeting dealing with the sector
Include gender issues in analyzing the various aspects of the work in the health sector, such as employment, remuneration, human resource development, working hours, work organization, safety and health
Highlight gender issues in regional and national workshops with a specific focus on the respective socioeconomic environment
Promote the development of gender-disaggregated statistics (i.e., statistics broken down by gender) for health care occupations
Develop a checklist for monitoring and evaluating the ILO's activities in the health services sector, to ensure gender issues are brought into the mainstream

Employment creation in the health services is still growing in many countries; however, at a slower pace than in the 1980s. Despite the downsizing of certain job categories and the restructuring of health services toward more preventive and primary health care, many countries still face a scarcity of qualified personnel. This applies particularly to the nursing professions and general practitioners, professions which have a high share of women. Since an increase in recruitment is limited due to long education periods and difficult working conditions, many countries seek to extend the cycle of professionals staying in this sector and to encourage immigration of professionals from other countries. In general, it can be expected that women have a better chance to be more adequately represented on the career ladder and to be offered better facilities to carry out their professions. And men might be a still untapped source for recruitment into those traditionally female professions which lack qualified personnel.

Gender! A Partnership of Equals
Geneve: International Labour Office, 2000. 115 p.

Health services
More men needed and better jobs for women

Gender! A Partnership of Equals Geneve: International Labour Office, 2000. 115 p.

Health services More men needed and better jobs for women

Gender! A Partnership of Equals
Geneve: International Labour Office, 2000. 115 p.

Health services
More men needed and better jobs for women