Gender and leadership

Exploring leadership in health systems with a gender lens


This research aims to explore and understand the gendered career and leadership experiences of senior healthcare managers in Kenya, Nigeria and South Africa. Promotion of gender equality and empowerment has gained momentum in these three contexts with legislation and policies being put in place to advance this. This study contributes to understanding leadership development, organisational processes and structures specific to the health sector.

Study methods

The study uses a qualitative case study approach, focusing on senior health managers in Kenya, Nigeria and South Africa, building on existing RESYST governance work and collaborations. Data is generated through semistructured interviews and observations to support understanding the context within which leaders operate.

Emerging findings

Data analysis has been completed in all sites, and teams are currently writing up final reports. The emerging findings show that in all three countries, professional categories and hierarchies play a dominant role in career progression, with a tendency for medical doctors to be preferentially selected for leadership roles.

There appear to be, however, unique country-specific aspects in each setting:

  • Kenya: the intersection of professional hierarchies and gendered socio-cultural norms and expectations had an important influence. In particular, the role of women as child bearers and nurturers had significant implications for appointment to leadership positions and career progression.

  • South Africa: Although medical doctors were more likely to be selected for leadership positions, the intersection of professional category with race and gender had an important influence on leadership appointment and experience.

  • Nigeria: Formal and informal networks interacted with professional categories and hierarchies to play a critical role in whether and how healthcare managers progressed to leadership positions. The ability of healthcare managers to build and nurture networks with influential senior colleagues was found to be “rewarding” with regards to career progression and appointment to leadership positions.


Research summary: Exploring gender and leadership in health systems

Blog: Exploring leadership in health systems in Kenya with a gender lens

Poster: Exploring leadership in health systems in Kenya with a gender lens