Use human resources information systems (HRIS), to analyze sex-disaggregated data about the composition and structure of your health workforce. Determine whether vertical or horizontal segregation may be present.

Suggested data analyses

• Gender distribution of each cadre

Some jobs or responsibilities are viewed as “women’s work” or “men’s work.” These beliefs may limit health workers’ occupational choices, contributing to creating cadres that consist primarily of one sex. Here is an example of horizontal occupational segregation across health workforce cadres.

What could be the reasons for these differences?

• Could there be unequal opportunities between male and female prospective students in health professional training to pursue certain programs of study?
• Could gender stereotypes prevent male or female health workers from pursuing certain careers?
• Are there discriminatory recruitment and hiring practices?

Distribution of health workers in the government sector in Uganda, 2012

When we review the sex-disaggregated distribution of the Ugandan public health sector, differences can be observed from one health worker cadre to another. Some cadres that may be considered “masculine,” such as doctors and pharmacists, have more men than women. The nursing cadres which may be considered more “feminine” due to their caregiving role, are more heavily represented by women. These differences indicate occupational segregation.

 

• Average years to promotion, by sex

Perceptions about the type of work that a woman or man should be doing that are not based on qualifications or abilities can delay career development and advancement.

In the sex-disaggregated data analysis from Kenya in the figure below, female nurses/midwives worked for an average of 14.6 years before getting a promotion, while their male counterparts worked for an average of 12.7 years before promotion; this difference of almost two years indicates unequal opportunities.

 

 

• Gender structure of top-level management

Negative stereotypes of women as managers, regardless of their individual qualifications or experience, can lead to vertical occupational segregation. In the example of sex-disaggregated data from the Ugandan public health sector, the vast majority of top-level senior managers are men (U1), while women are the majority in entry- and lower-level positions (U4-U8). This indicates vertical occupational segregation.

Distribution of Public Health Sector Workforce Jobs at 12 Representative Sites by Sex in Uganda, 2012 (N=6,450)

Source: Newman, Settle, and Mugisha, 2012

Country examples

• Lesotho: Interviews and focus groups revealed a perception that women are often expected to be the primary family caregivers. These roles are reproduced in community-based HIV/AIDS caregiving, and women are not compensated for this work .
• Tanzania: An analysis of health facilities found that the nursing and midwifery cadres primarily consist of women, while the clinical officer and physician cadres primarily consist of men.
• Austria, Canada, Czech Republic, Denmark, Finland, France, Germany, Hungary, Netherlands, Norway, Poland, Russian Federation, Slovakia, Slovenia, Spain, Switzerland, United Kingdom, United States: An analysis of labor force surveys for 18 countries with developed economies found that women made up higher proportions of lower-level professions and smaller proportions of managerial or leadership roles.