Dr. Sigrun Møgedal had been asked to give the participants an introduction to the Lancet issue "Advancing women in science, medicine and global health" (Feb 09, 2019, Volume 393, and Number 10171) as food for thought before the group discussions.
Dr. Sigrun Møgedal’s broad areas of engagement have been in the HIV/AIDS response, human resources for health, health and development policy, strategy and delivery, global partnerships and governance. Sigrun is currently Vice Chair of Save the Children Norway, and sits in the global board of Save the Children.
Links to papers:
Time for gender-transformative change in the health workforce
Lessons from Sweden's feminist foreign policy for global health
Gender equality in science, medicine, and global health: where are we at and why does it matter?
Summary of the presentation
In her introduction, Dr. Møgedal stated that global health is about achieving the health targets for SDG 3 (ensure healthy lives and promote wellbeing for all at all ages). Sustainable development goal three has several targets that are interconnected. Women are at the center of SDG 3, as many targets address determinants of women’s health. For an effective «Women in Global Health» response, actions on SDG 3 and SDG 5 (to achieve gender equality and empowerment of all women and girls) need to be linked. Gender diversity is essential for achieving SDG 3 and 5. There is need for collaboration between different sectors as global health is interconnected.
Advancing women in science, medicine and global health
Dr. Sigrun Møgedal used three papers from the Lancet to illustrate how gender diversity is both an opportunity and a challenge in Global health. The articles were retrieved from the Lancet, Feb 09, 2019, Volume 393, and Number 10171.
The three papers included:
- Betron et al.: Time for gender-transformative change in the health workforce
- Irwin et al.: Lessons from Sweden's feminist foreign policy for global health
- Shannon et al.: Gender equality in science, medicine, and global health: where are we at and why does it matter?
Time for gender-transformative change in the health workforce
The paper identified the following issues:
- There is a shortfall of health care professionals and as such there are opportunities for female employment
- The need for gender, health workforce and decent work agendas: transformative dividend
- In governance women are absent in decision making, the workplace norms are male biased, women are discriminated against, undercompensated and experience sexual harassment in the workplace
To encourage women participation in the workforce and promote a conducive work environment, several issues must be addressed:
- Recruitment and retention
- Upward mobility
- Maternity and paternity leave
- Mentoring schemes
- Social behaviour change strategies
- Participatory dialogue, power relations
- Accountability
Dr. Sigrun felt that some pertinent issues had not been addressed or raised within the papers. This included:
- With regards to service provision- community demand and support, working in teams, hierarchy in the health system and the bottom up approach
- With regards to science- gap, research and development policy and systems, relevance issues LMIC/LIC, research collaboration and medical schools
- Under public health- integrated delivery (polio!), surveillance, epidemic preparedness, and epidemic response
Sweden's feminist foreign policy for global health
The Lancet paper identified the following opportunities created by the feminist foreign policy:
- Peace and development
- Priority to sexual and reproductive health and rights
- Gender in all situations
The paper questions the practicality of the policy within Sweden and abroad in certain areas. The areas include:
- Practical implementation
- Contradictions (arms, migration policies)
- Depends on actors –diplomacy, ODA
- Risk if in-consistency at home
- Unequal salaries
- Watching domestic environments
- Regular, open debates
- Not a state of being, but norm
- Policies need to be constantly renegotiated
In governance, there is need for:
- Representation and gender balance in international organizations
- Combating discrimination against women
- Equitable access for men and women
- Sexual and reproductive health and rights implemented properly
- Data to be disaggregated by gender
- Improved conditions for women
- Watching gender vulnerability in crises
- Ensuring finance for gender equality including in research and development
Dr. Sigrud critiqued the paper for not tackling public health issues; it focuses more on SDG 5 than SDG 3. Authors of the paper failed to state what the paper means for health.
Gender equality in science, medicine, and global health: where are we at and why does it matter?
From the paper, Dr. Sigrud identified the need for gender equality. Gender equality matters because:
- Mixed gains, persistent challenges
- Under-representation in management, leadership and governance
- It is needed for human right, peace, human potential and sustainable development
- It is a strong determinant of health and economic development
- It improves productivity, innovation, decision-making, satisfaction
- Gender diverse workforce improves access and health outcomes
- There are gender differences in medical practice
- Transformative policies not enough
- Social movements drive change
- As women got more integrated in medicine, feminist principles faded
Identified issues to be tackled include:
- Gender Equality Inherent political
- Biases in governance-gendered power relations
- Differential exposures to disease and disability, vulnerabilities and health risks
- Biases in health research structures and systems- STEM
- Biases in health systems
- Stress and anxiety low morale & self-esteem when not gender equality is not sufficient standards/gender metrix
- Big female/male differentials; researchers, publications international collaboration
- A feminizing workforce (75%)
- Barriers to career progression «invisibility» -gender pay gaps
- Workforce maldistribution- limits access, inefficiencies
- Discrimination-transgender issues
- Unsafe working conditions-absence of social protection
Dr. Sigrud stated that women need to work together to give each other strength, help each other and work together on publications and international collaboration.
Dr. Sigrid critic of the paper was its limited public health focus. Her closing remark was that gender diversity is essential for gender equality.