Involve more Nurses and Midwives in leadership roles

Creating gender equity in nursing and midwifery leadership remains key. Generally, women comprise almost 70% of healthcare workers globally and nearly 90% of the nursing and midwifery workforce. However, it is estimated that they hold only around 25% of leadership roles in health. 

Women bring creativity and critical services to all levels of society, from the home to the office or health facilities, and boardroom. Yet their achievements and contributions often go overlooked, unacknowledged, or even minimized.

Today, 08th March is International Women’s Day, a reminder to appreciate those who are typically forgotten or pushed to the side. For example, nurses and midwives constitute more than 70% of the healthcare workforce, however, their involvement in health leadership remains low.  

If leadership roles were allocated proportionally (assuming that women and men have equal merit) then, since women are 70% of health workers, 70% of health sector leaders would be women. This applies to the nursing and midwifery fraternity too. 

However, this is the opposite of the current situation where men are less than 30% of the health workforce but hold 75% of leadership roles. The default health worker is a woman, and the default health leader should be a woman too. 

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Surprisingly, there is no shortage of women in the health leadership pipeline. In fact, in most countries, women are the majority of healthcare workers.  There are leaks in the pipeline that mean leadership is not inevitable for women in health. Men are promoted as women stand still in their careers, facing ‘glass ceilings’ to leadership roles at every level. A ‘glass elevator’ has been reported in some countries for men in nursing who, although a minority, hold a disproportionate number of senior nursing roles.

One author once said, “Lack of representation is one symptom of a broken system where governance is not inclusive of gender, geography, sexual orientation, race, socio-economic status or disciplines within and beyond health-ultimately excluding those who offer unique perspectives and expertise.”

Remember, leadership in health is as diverse as women themselves. Although the majority of women health workers do not hold formal leadership roles, women are still a driving change at all levels in health from community to global. At the same time, women want recognition, and equal career progression and aspire to senior decision-making roles and the benefits that go with them. Diverse women working in health have an equal right to leadership including the nurses and midwives.

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I therefore urge the Government of Uganda through the Ministry of Health and other relevant entities to avail more nurses and midwives’ leadership positions and constantly involve them in meaningful policy making and decision making. 

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The author is; Lilian Nuwabaine Luyima; BSc Nurse and MSN-Midwife & Women’s Health Specialist


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