Female health leaders are good for a nation’s wellbeing, wealth, innovation and ethics, but remain an underused resource, particularly in low and middle income countries, a global review of evidence shows.
There should be more and sustained investment to maximise women’s potential and reap the benefits of their contribution, the study published in the journal BMJ Global Health concluded.
In Time’s most recent health list, recognising the world’s 100 most influential people in health, 13 of the 20 named in the leaders section are women.
Yet despite making up 70% of the healthcare workforce as a whole, and 90% of the nursing and midwifery workforce, women hold just 25% of leadership roles, researchers found.
While there is good evidence that female leaders make a positive difference to maternal and healthcare policies and to tackling health inequalities, until now it has not been clear what their impact might be on global health.
To find out, researchers from the School of Public Health at Johns Hopkins University led a scoping review of peer reviewed research.
In total, 137 relevant articles met the eligibility criteria and were included in the review.
Studies were tagged positive if they reported an improvement, increase or benefit of the assessed outcome as a result of women’s leadership. They were tagged negative if they reported a decrease, weakening or worsening of the assessed outcome.
Most papers in the review reported a positive impact of female leadership: 119 (87%) were positive and statistically significant.
The review identified female leaders’ positive influence on six areas of impact: financial performance, risk and stability; innovation; engagement with ethical and sustainability initiatives; health outcomes; organisational culture and climate, including reputation, employee retention and team cohesion and communication; and influence on other women’s careers and aspirations.
Even the studies reporting mixed findings still largely pointed to positive results, particularly when modified by other factors.
“What is less clear is why women leaders have this impact, particularly in the face of overt and covert biases, discrimination, harassment, patriarchal norms, etc,” the researchers wrote.
The answer, they suggested, may lie in women’s more effective transformational leadership behaviours and their tendency to use more democratic and participative styles.
“In all sectors, across leadership roles and across geographies, women’s leadership can produce positive results,” the researchers wrote.
“Women leaders’ success, however, cannot be separated from the contexts in which they work and unsupportive environments can affect the extent to which women leaders can have an impact.”
They concluded: “Increased and sustained investment in women’s leadership within the health sector can lead to improved outcomes for organisations and their clients.
“Such investments must not only target individual women, but also seek to foster organisational cultures that promote and retain women leaders and support their independent decision making.”
In a linked editorial, the BMJ’s international editor, Dr Jocalyn Clark, argued that men’s monopoly on global health leadership was at odds with the scientific evidence.
And in the current context of the backlash against rights and diversity, equity and inclusion efforts, it was even more important to advocate for gender equality, she said.
“Change is the responsibility of everyone – not just women,” she wrote. “But clearly, more women appointed to leadership positions could drive transformative change in these biased systems.”
