Table 4 Implications for action

GLOBAL ACTIONS

Develop a conceptual framework:

A unified conceptual framework for gender in the health workforce would span pre-service and continuing education and employment systems and include a taxonomy with significant gender inequalities as they operate in the health workforce, including gender discrimination and inequalities defined in measurable terms and workforce and health systems consequences.

Possible consequences: clogged health worker educational pipelines, recruitment bottlenecks, attrition, lower productivity, worker maldistribution.

Produce research guidance:

A community of gender and HRH research practice similar to the Joint Programme on Workplace Violence in the Health Sector[47] should produce research guidance based on the conceptual framework, identifying a gender and HRH research agenda and developing guidelines for systematic research.

Practice community: representatives from UN Women, World Health Organization, International Labour Office, Global Health Workforce Alliance, International Council of Nurses, Public Services International, and nongovernmental organizations (NGOs) specializing in HRH and health systems strengthening.

Improve global HRH governance in health systems strengthening efforts:

Bring international human/labour rights and employment law discourse into HRH discourse, develop sample HRH policies to reflect this, and integrate human/labour rights and gender equality principles into global consensus documents. (Note: gender equality in the workforce will require cooperation between governments, workers’ unions, professional associations, and NGOs.)

Consensus documents: declaration following the next global HRH forum; WHO Global Code of Practice on the International Recruitment of Health Personnel; guidelines for HRH assessments and observatories.

COUNTRY ACTIONS

Reform national HRH leadership and governance:

Apply the protections available to workers in international human rights conventions, national constitutions, equal opportunity policies and laws, and labour codes to national HRH policies and HRM practice standards.

Examples: adapt affirmative action policies to health worker recruitment or promotion initiatives; raise HRH stakeholders’ awareness of gender in the workforce through training; strengthen HRH leaders’ capacity to use HRIS gender reports to identify gender trends in the workforce as the basis of HRH strategies; and conduct country-specific gender and HRH research.

INSTITUTIONAL ACTIONS

Improve institutional HRH governance by equalizing opportunity and promoting gender equality in health education settings and workplaces:

Anticipate health workers’ lifecycle needs, recognizing that sociocultural factors call for vigilance to assure equal opportunities, nondiscrimination, and gender equality in the workforce. This entails developing workplace policies, allocating resources, and restructuring education and work settings to integrate family and work and reflect the value of caregiving for women and men.

Examples: prohibit workplace discrimination through nondiscrimination and equal opportunity policies. Make it easier to integrate work and family life, by: including paid maternity, paternity, and parental leave; offering part and flexible-time options, job sharing and access to child care in incentives packages; revising any workplace policy or practice that directly or indirectly privileges unmarried or childless workers in hiring, pay, promotion, and so on, or that penalizes female health workers because of marriage, pregnancy, motherhood, and family caregiving status.