The COVID-19 pandemic revealed to our global society the extent of our social nature, the wide range of essential professions from cashiers to physicians, and more. Yet one lesson that’s gained momentum in the past year is the efficacy of women leaders. Particularly in the political arena, national leaders who have maintained control on COVID spread throughout the pandemic like New Zealand’s Prime Minister Jacinda Ardern and Iceland’s Prime Minister Katrín Jakobsdóttir are popular examples of how women are leading the way for success, in terms of COVID-19 and otherwise [4,8]. This trending recognition of women leaders gives insight into a critical aspect in the advancement of gender parity in leadership, not only in areas like politics but also in health .
On the frontlines of the delivery of health worldwide, women greatly outnumber men, accounting “for 70% of the health and social care workforce” . Despite women making up the majority of those delivering care, there still exists an evident gap in gender parity in health leadership as “69% of global health organizations are headed by men, and 80% of board chairs are men” and a mere “25% [of global health organizations] had gender parity at senior management level” . This persistent trend in underrepresenting women in leadership positions denies beneficiaries of these women’s skills and expertise .
This underrepresentation is expressly concerning in light of the COVID-19 pandemic, as its effects are gendered and the burdens are compounding. As the majority of frontline workers, women’s exposure risk is increased. Since many of them also adhere to the traditional social norm of being the primary caretaker at home, their family members’ risks are also raised . In an effort to prevent transmission to their loved ones they care for, many health workers have tried avoiding immediate family, but in many cases, this is an unfeasible and emotionally-taxing solution for the female workers who also are caretakers at home. Heightened feelings of anxiety and depression were reported by all health workers as well, especially early in the pandemic, but these feelings were intensified for women health workers who were torn between demanding professional and domestic responsibilities . This was especially the case for health workers who were also single mothers or those with an unequal burden of domestic responsibilities compared to their partner, such as mothers shouldering a majority of the burden of managing their children’s now virtual education .
Moreover, the pandemic’s effects on childcare and education are multifaceted. From the perspective of adult women, 10 million [working women] (17% of all working women) rely on childcare and schools to keep their children safe while they work.” Building on this, the lack of access to regular education will be devastating for thousands of girls globally. In March of 2020, “UNESCO estimated that the pandemic was preventing 1.52 billion children from attending school” . As The Lancet reports that a lack of education is found to increase the risk of female genital mutilation, early marriage, teenage pregnancy, sexually-transmitted diseases, and unpaid labor for girls, among other detriments . A “UNFPA analysis reports [the delay due to COVID-19 in initiating prevention programs] is projected to lead to an additional 13 million child marriages, as well as 2 million female genital mutilation cases over the next decade that otherwise would have been averted, that is, a 33% reduction in progress” . Evidence such as this supports the tangible repercussions of the COVID-19 pandemic on women and girls, underscoring the importance for their needs to be appropriately and actively met.
As a general population, “women and girls are disproportionately affected by armed conflict and humanitarian emergencies” . Economically, the pandemic has been devastating for women. The Lancet reports “an estimated 740 million women are employed in the informal economy . In developing nations, such work constitutes more than two-thirds of female employment.” Without employment, women are unable to provide for themselves or their dependents – destabilizing their ability daily lives and overall health. At the same time, in non-developing nations like the United States, “women account for about 77% of workers in occupations that require close personal contact and cannot easily be done remotely, such as food preparation, health-care support and personal service” . The influence of gender on the COVID-19 pandemic’s economic impacts are unlike those in previous recessions, with the Wall Street Journal reporting that “‘Every recession is a ‘mancession’ except this one’” . With women being expected to assume domestic responsibilities, the Boston Consulting Group finding that “women were spending 15 hours more a week on domestic labor than men were, at 65 hours versus 50 hours, compared with a pre-Covid balance of 35 hours and 25 hours,” the ability for them to balance competing, demanding responsibilities often forces them to sacrifice their career . This is especially true in cases where the higher-earning spouse is the one to keep their job, yet “about 70% of husbands in dual-income heterosexual couples earned more than their wives” in 2018 . Once again, leaving women’s careers at a disadvantage, pushing them out of the professional sphere and into domesticity.
Financial implications from COVID-19 also manifest themselves in the form of increased financial dependence on partners. This financial dependence, in combination with a lack of access to support services and the mandated isolation and stay-home-orders, trap victims of gender-based or domestic violence with their abusers, exacerbating this endemic violence. It’s been found that in the last year, “some 243 million women are thought to have experienced sexual or physical abuse at the hands of an intimate partner at some point” and in France one week after the first lockdowns, “domestic violence reports had surged by 30%” . Though, it is likely that even these numbers are under-representative of the true magnitude as domestic violence reports often go under-reported . This could be especially applicable because of the effects of the lockdowns (i.e. isolation and constantly being with their abusers), increasing the barriers for them to seek help. The elevation in vulnerability for women, particularly during and after crises, is a persistent issue and one that must continue to be worked toward eliminating.
At the same time, due to inadequate representation in leadership, women lack the substantial decision-making power to address their concerns. In previous health crises, such as the Ebola outbreak, “women were less likely than men to have power in decision making around the outbreak and their specific needs, resulting in their health needs being largely unmet” . Furthermore, the detriments from women’s absence are intersectional as “women do not form a homogenous group; therefore, when women are excluded in decision making and policy implementation, other groups are also disadvantaged” . Expanding women’s leadership is not only beneficial for the immediate future, but studies have supported that women leaders are powerful role models and thus generate a “ripple effect” for future generations [9,6]. In fact, “experience shows that a systematic and intentional gender lens leads to more effective local, national and global responses and management of infectious disease outbreaks: women’s leadership and contributions are critical to curbing infection rates and enabling resilience and recovery” .
For far too long, underrepresented demographics have been forced to deal with inadequate responses both in and out of crises. Diverse representation in health leadership creates the opportunity to normalize the diversity of the global population and human experience. It also begins the process of creating programs that are effective in catering to the unique needs of the populations these leaders represent. Caring for the global population at each of its microlevels requires leaders who both recognize and understand the plethora of challenges, and multilayered complexities, of their populations. But the expansion of women leadership must be more than a title, it must have concrete impacts and center on gender-inclusive policies . COVID-19 has catalyzed many shifts to our health system and an excellent time to prioritize gender-inclusivity is while the processes are still malleable. And that time is now.
Edited by: Annie Feng
Illustrated by: Alexandra Laufer