“Women are strongly encouraged to apply”- But can we?

Much has been said about gender equality. Yet more than thirty years after the Beijing Declaration on Gender Equality, the World Health Organization acknowledges that progress remains frustratingly slow (1).

In the health workforce, women still make up the vast majority but remain underrepresented in leadership positions, medical specialties and policy platforms. Pay gaps still persist. The structural conditions that would allow women to truly lead, and not just participate, remain largely unaddressed. Closing this gap is not simply a matter of agreeing with gender equality policies (2).

There has been much talk about decolonising global health, but perhaps it is time to also begin ‘de-patriarchalising’ it. While there should be no need to justify why women deserve a place at the leadership table, evidence from Rwanda and India shows that when women lead and governance prioritises their perspectives, there are measurable benefits in achieving vital health metrics. Women are more effective catalysts for improving public health outcomes than their male counterparts. Women in leadership do not just represent their communities; they transform the conditions within them.

We have become comfortable with the language of inclusion while avoiding the harder work of structural change. “Women are strongly encouraged to apply” has become a ritual phrase, but what does it actually do? Is that encouragement enough to get a woman through the door, let alone over the finish line? Consider the global health conferences with no provision for nursing mothers. The training programmes that expect women to simply leave the children behind. The workplaces, including some that proudly prefer hiring women, where women must pump at their desks or in restroom stalls. These are not minor inconveniences. They are structural barriers that quietly drain the strength of that woman-professional and lead to some women quitting before they get started in leadership.

As a mother of two young children, I have experienced this firsthand. I have had to pass on significant professional opportunities, not because I lacked ambition or qualification (I had, in typical fashion, been ‘strongly encouraged to apply,’ did so, and in many instances was selected), but because accepting them meant bending over backwards at great personal cost. No one should have to keep choosing this or that. The real goal is not to give women more options in the abstract; we must ensure the options we create are actually accessible and ‘selectable’.

The Way Forward

Achieving gender equality in global health leadership requires organisations to build ecosystems where women can genuinely thrive: flexible work and training hours, dedicated nursing rooms as standard infrastructure, on-site childcare facilities, and pay equity enforced rather than merely aspired to.

Women must also champion one another. The tradition of “I went through it the hard way and survived, and so must you” must end. We must be positive role models and help the next generation find a better world to live and work in.

Men in positions of influence must become active champions: amplifying women’s voices, creating space at decision-making tables, and crucially, examining where they themselves may be silencing women, whether overtly or through the more subtle, ambient ways power tends to operate. Elevation without protection is incomplete.

Equality must live in the architecture of our institutions, in the rooms we build, the policies we enforce, and the cultures we refuse to tolerate. Until individuals and organisations commit to that level of change, all the declarations in the world will remain precisely that: words on paper (3).

Women need institutions adapted to the multifaceted roles we aspire to juggle: leaders, caregivers, professionals, and human beings. These are not one-time exceptions to be accommodated reluctantly. This is who we are. Build accordingly.

References

1. WHO (2025). Building a healthier world by women and for women is key to achieving gender equality.
2. Bhalotra S, Clots-Figueras I. (2014). Health and the Political Agency of Women.The Lancet.
3. UN Chronicle. Women’s Leadership: Promoting Global Health and Well-Being.