TY - JOUR
T1 - Why are fewer women rising to the top? A life history gender analysis of Cambodia's health workforce
AU - Vong, Sreytouch
AU - Ros, Bandeth
AU - Morgan, Rosemary
AU - Theobald, Sally
N1 - Funding Information:
This work was carried out as part of RinGs research programme (Research for Gender and Ethics), under the financial support from the UK Department for International Development (DFID). RinGs provided both technical support and administered funding from DFID for us to carry out fieldwork, analysis, data interpretation and report writing, which was further developed as this manuscript. There was no direct involvement of DFID to provide technical support through-out the process of this study.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/8/23
Y1 - 2019/8/23
N2 - Background: An adequate and qualified health workforce is critical for achieving Universal Health Coverage (UHC) and responding to the Sustainable Development Goals (SDGs). Frontline health workers who are mainly women, play important roles in responses to crisis. Despite women making up the vast majority of the health workforce, men occupy the majority of leadership positions. This study aims to understand the career progression of female health workers by exploring how gender norms influence women's upward career trajectories. Methods: A qualitative methodology deployed a life history approach was used to explore the perspectives and experiences of health workers in Battambang province, Cambodia. Twenty male and female health managers were purposively selected based five criteria: age 40 and above, starting their career during 1980s or 1990s, clinical skills, management roles and evidence of career progression. Themes and sub-themes were developed based on available data and informed by Tlaiss's (2013) social theory framework in order to understand how gender norms, roles and relations shape the career of women in the health industry. Results: The findings from life histories show that gender norms shape men's and women's career progression at different levels of society. At the macro level, social, cultural, political, and gender norms are favorably changing by allowing more women to enter medical education; however, leadership is bias towards men. At the meso organziational level, empowerment of women in the health sector has increased with the support of gender working groups and women's associations. At the micro individual level, female facility managers identified capacity and qualifications as important factors in helping women to obtain leadership positions. Conclusion: While Cambodia has made progress, it still has far to go to achieve equality in leadership. Promoting gender equity in leadership within the health workforce requires a long vision and commitment along with collaboration among different stakeholders and across social structures. If more women are not able to obtain leadership roles, the goals of having an equitable health system, promoting UHC, and responding to the SDGs milestones by leaving no one behind will remain unattainable objectives.
AB - Background: An adequate and qualified health workforce is critical for achieving Universal Health Coverage (UHC) and responding to the Sustainable Development Goals (SDGs). Frontline health workers who are mainly women, play important roles in responses to crisis. Despite women making up the vast majority of the health workforce, men occupy the majority of leadership positions. This study aims to understand the career progression of female health workers by exploring how gender norms influence women's upward career trajectories. Methods: A qualitative methodology deployed a life history approach was used to explore the perspectives and experiences of health workers in Battambang province, Cambodia. Twenty male and female health managers were purposively selected based five criteria: age 40 and above, starting their career during 1980s or 1990s, clinical skills, management roles and evidence of career progression. Themes and sub-themes were developed based on available data and informed by Tlaiss's (2013) social theory framework in order to understand how gender norms, roles and relations shape the career of women in the health industry. Results: The findings from life histories show that gender norms shape men's and women's career progression at different levels of society. At the macro level, social, cultural, political, and gender norms are favorably changing by allowing more women to enter medical education; however, leadership is bias towards men. At the meso organziational level, empowerment of women in the health sector has increased with the support of gender working groups and women's associations. At the micro individual level, female facility managers identified capacity and qualifications as important factors in helping women to obtain leadership positions. Conclusion: While Cambodia has made progress, it still has far to go to achieve equality in leadership. Promoting gender equity in leadership within the health workforce requires a long vision and commitment along with collaboration among different stakeholders and across social structures. If more women are not able to obtain leadership roles, the goals of having an equitable health system, promoting UHC, and responding to the SDGs milestones by leaving no one behind will remain unattainable objectives.
KW - Cambodia
KW - Gender equity
KW - Health workforce
KW - Leadership
KW - Life history
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U2 - 10.1186/s12913-019-4424-3
DO - 10.1186/s12913-019-4424-3
M3 - Article
C2 - 31443658
AN - SCOPUS:85071508530
SN - 1472-6963
VL - 19
JO - BMC health services research
JF - BMC health services research
IS - 1
M1 - 595
ER -