International Women’s Day (IWD) is a global day marked annually on March 8, celebrating the social, economic, cultural and political achievements of women — while also marking a call to action for accelerating gender equality. The first International Women’s Day occurred in 1911, supported by over one million people. This year’s campaign theme for IWD is #EachforEqual, highlighting the fact that each one of us can help create a gender equal world. An equal world is an enabled world.
The discussions around gender equality in Nigeria’s health sector reveal the alarming imbalances and access to health that exist between men and women in Nigeria. While there have been strides towards ensuring that women have more access to healthcare services, the conversation about equality goes deeper than this, and touches all aspects of the health sector, notably leadership, education, and empowerment. Nigeria Health Watch spoke to several leading health advocates to understand the gaps that women face when it comes to gender equality in healthcare, and what can be done about it.
Nigeria Director, MSD for Mothers, Iyadunni Olubode, noted that the inequality faced by women in the health sector has roots outside health. “Gender inequality in health stems from inequalities in other areas; education, access to capital, representation, among other things. If women are not at the table, their interests cannot be adequately understood and addressed,” she said.
The gap in leadership came up as one that needs to be addressed if the Nigerian health sector has any hope of becoming #EachforEqual. According to the WHO, there is a gender distribution in the health workforce. Women account for 70% of the health and social sector. In the African region, women account for 28% of physicians and 65% of nurses. Dr. Adaeze Oreh, Senior Health Policy Advisor and Consultant Family Physician at the Federal Ministry of Health, pointed out that while there are many women in the health workforce, it’s a different picture at the top levels of leadership. “I see gaps in female representation in leadership of health sector projects,” she said, adding, “There is no scarcity of women in the health workforce. In fact, the foot soldiers in healthcare are mostly women. However, due to inequitable gender constructs on roles and capabilities, when it comes to being entrusted with leadership roles, that’s where the enormous gap is.”
Dr. Amina Aminu Dorayi, Country Director, Pathfinder International, Nigeria said it’s important for women to have equal opportunities for leadership positions that affect decision making for health, and that health insurance should also take women into consideration. “Health insurance initiatives should be inclusive and address the needs of all Nigerians, especially women with low purchasing power,” she said.
Dr. Simeon Onyemaechi, Executive Secretary of the Anambra State Health Insurance Agency (ASHIA), was more specific in his analysis, pointing out that there are gaps in the “appointments of Chief Medical Directors for Federal Teaching Hospitals and Federal Medical Centres. There are more males in these positions.”
The lack of representation results in a power imbalance and lack of recognition, according to Kasarachi Omitiran, who noted that in Nigeria’s patriarchal society, as a woman, “you need to work twice as hard as your male counterparts for your work to be acknowledged.”
For Vivian Nwogu, Founder, Nurse Hub Africa, the gaps in representation have resulted in glaring differences in remuneration for female-dominated health workforce cadres. “Doctors are paid far more than nurses and this is because more doctors are men. They have the advantage of having people to speak for them at policymaking tables. The nursing profession in Nigeria is dominated by women and this means little or no representation at policymaking tables,” she said.
Dr. Ifeanyi Nsofor, Director of Policy and Advocacy at Nigeria Health Watch, said remuneration should also be provided to community health workers who are usually volunteers. “Community health workers are mostly women, they should be paid salaries,” he said.
Olubode said that besides representation, there is also not enough funding for women’s health in Nigeria. “How much is worth spending to prevent a woman’s death?” she asked. Nigeria’s maternal mortality figures have consistently been a cause for concern for development experts. Olubode pointed out that increased investments in improved quality and coverage of maternal care and in the HPV vaccine for cervical cancer care would go a long way in ensuring that women get proper care for the health issues that are unique to them.
Gender equality is essential for economies and communities to thrive. Beyond a women’s issue, it is a business issue. And in the Nigerian health sector, it’s a life and death issue.
Nigeria needs to consider the long-term benefits of funding women’s health. “It is short term thinking not to invest in women’s health,” Olubode said, adding that Nigeria also needs more skilled and empowered female health professionals. Her reason is simple — empathy. “Women feel more comfortable talking to other women about health challenges. Women understand women’s health better than men. We must encourage women to go into the sciences, become doctors and pharmacists, lab scientists so that we have more people representing our health interests,” she said.
For Dr Oreh, intentionality in assigning competent women to leadership roles is key to drive #EachforEqual. “By entrusting leadership opportunities to females who merit them, they learn to stretch themselves work-wise and hone and develop their unique leadership skills,” she said, adding that closely related is the dire need for women in leadership to mentor the women coming after them. “That is the only way to encourage younger females to strive for success despite challenges and develop a consistent pipeline of competent, skilled, driven and emotionally intelligent female health leaders,” she said.
Dr. Onyemaechi says ensuring women are represented in leadership should come from Nigeria’s highest office. “There should be advocacy to the President to ensure 30% affirmative action in these appointments. There are qualified women who should occupy these positions,” he said.
For Dr. Nsofor, women’s participation in the health system, both as users of healthcare and as leaders in the sector, starts with a sure, solid foundation. “We need to ensure that the girl-child is in school,” he said. The evidence is glaring that educating the girl-child has rippling positive effects on the family, the community and the nation at large.
It’s time to elevate women’s voices in the Nigerian health sector. “Give them a platform to express their health needs, wants, preferences and feedback. Time and again studies show stark differences in how women and men prioritise their needs. We must encourage and insist that providers of healthcare start with women’s needs and prioritise women’s feedback,” Olubode said.
This International Women’s Day, as you celebrate the strides that women have made all over the world, actively choose to challenge the stereotypes and fight the bias that often reinforce gender inequality in the Nigerian health sector. Each of us can do something to broaden perceptions and improve situations for women. Collectively, each one of us can help create a gender equal health sector in Nigeria.
We can all choose to be #EachforEqual. Happy International Women’s Day!
How are you promoting gender equality in your part of the Nigerian health sector? Who are your gender equality heroes? Let us know on our social media platforms, @nighealthwatch on Twitter and @nigeriahealthwatch on Facebook and Instagram.