Women make up more than 70% of the global health workforce; however, in many countries they are over-represented in informal, low-status and low-paid ‘care’ roles and are under-represented in professional categories and in leadership positions. 

To understand this issue it is important to investigate the role of gender norms, roles and relations in career progression and leadership. Researchers from the Health Policy Research Group have explored this issue by carrying out detailed interviews with both male and female senior healthcare managers in Nigeria.

Key findings

• Gender beliefs and stereotypes influence how men and women are perceived to be as leaders. Female managers are less accepted as leaders than men - including by women.
• Gender is not the only factor that affects perceptions and experiences of leadership. In Nigeria, it intersects with other factors including age, marital status and professional hierarchies, where there is an assumption that medical doctors are better suited to management roles. 
• Individuals in professions viewed as higher up the professional hierarchy, e.g. doctors, resented being instructed by managers from lower professions. These tensions pose challenges to health care managers to handle strains between multi-disciplinary staff, and for those who are not doctors, to command respect from their team.

A recent publication on the role of gender equity and women’s leadership in health system strengthening, co-written by RESYST researchers, sets out an agenda for action to build gender equity in global health leadership. The agenda and corresponding policy implications are relevant to the Nigerian context and should be considered by health policymakers and healthcare organisations.