“MOBILIZING OUR LEADERS”: A multi-country qualitative study to increase the representation of women in global health leadership

CGH faculty, staff, and collaborators* in Haiti, Tanzania, and New York worked together to complete a multi-country study to increase the representation of women in global health leadership. Many studies have revealed that there are worldwide gender disparities in leadership positions across governmental, non-governmental, scientific and research institutions. Despite being a global issue, it is mostly observed in low- and middle-income countries.

Multiple initiatives and policies have been developed to promote women into power and leadership positions across institutions, but just a small percent is occupied by women, and they face many challenges which constrains their efficiency. Gender inequity in research and health fields greatly affects the reporting of results by sex, medical interventions, and decision-making processes.

This multi-country study was conducted among women across low, middle- and high-income countries at four major academic centers for clinical care and research in Haiti, India, Tanzania, and the United States through focus group discussions and in-depth interviews exploring gender-based challenges to career advancement for women in global health. Participants were female health trainees and faculty members. Participants from these four culturally and economically diverse countries reported strikingly similar gender-based barriers toward career advancement, including cultural power imbalance, institutional power imbalance, and restricted agency; also, motivation to seek leadership roles and balancing maternal and family responsibilities with career advancement were matters of concern. To practically address these challenges, women provided suggestions falling into three intervention categories: robust reporting systems, peer support and mentorship, and gender equity and leadership training.

This study helped to reveal that gender discrimination is systemic and hinders women’s career progression. Gender imbalance and sexual harassment additionally affects women’s mental health and productivity. Addressing these inequities is foundational in decolonizing global health. Future research exploring the intersection of gender, race, sexual identity and orientation, socioeconomic status, and cultural background is essential to better understand how identity interacts with career advancements and equity and further, reshape women’s and global health.

The full article will be published in PloS Global Public Health in February 2023.

* Claudia T. Riche 2 11, Lindsey K. Reif 1 11*, Natalie T. Nguyen 1, G. Rinu Alakiu 1, Grace Seo 1, Jyoti S. Mathad 1 3, Margaret L. McNairy 1 3, Alexandra A. Cordeiro 1, Aarti Kinikar 4, Kathleen F. Walsh 1 3, Marie Marcelle Deschamps 2, Sandy Nerette 2, Smita Nimkar 5, Neema Kayange 6, Hyasinta Jaka 7 8, Halima M. Mwaisungu 9, Domenica Morona 10, Thandiwe Yvonne Peter 11, Nishi Suryavanshi 5, Daniel W. Fitzgerald 1, Jennifer A. Downs 1 7, Adolfine Hokororo 6

Affiliations:

1 Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York

2 GHESKIO, Port-au-Prince, Haiti 3 Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York

3 Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York

4 BJ Government Medical College and Sassoon Hospital, Pune, India

5 BJ Government Medical College – Johns Hopkins University Clinical Trials Unit, Pune, India

6 Department of Pediatrics, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania

7 Department of Medicine, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania

8 Department of Internal Medicine, Mwanza College of Health and Allied Sciences, Mwanza, Tanzania

9 Department of Medical Ethics, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

10 School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

11 Department of Administration, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

Article by Grace Ruselu