• Opinion by Roomi Aziz (Islamabad, Pakistan)
  • Interpress service

Within the framework of global health, the day is an opportunity to examine discrimination from the perspective of health care workers, who face barriers based on race, gender and other socio-economic and cultural factors.

In the context of a global health workforce under siege by the threat of the great health divide, it is particularly important to examine the impact of discrimination on health systems at the global, national and local levels.

It is widely recognized that Human Resources for Health (HRH) plays a critical role in achieving Universal health coverage and that Sustainable Development Goals. According to the World Health Organization, there is an expected shortage of 10 million healthcare workers globally by 2030with the greatest demand in low- and lower-middle-income countries where the burden of disease is higher.

More recently, recognition of gender pay gap in health of 24% and its impact on the national and regional economy has stimulated more research on the unequal treatment of women, taking into account their specific contexts and locations. Despite efforts to address these problems, progress has been uneven.

Building evidence around gender inequalities in the health workforce, particularly on leadership level highlights the problem of gender bias in health decision-making. Women, who make up 70% of the total health workforce and 90% of frontline staff, continue to be marginalized in leadership, occupying only a quarter of decision-making roles in health.

In addition, the occupational segregation and clustering of women in the low-income workforce and environments further limits their career advancement. Their experiences within the healthcare workforce are further aggravated by various forms of discrimination, such as harassment, violence, abuse and discrimination on several levels.

Gender is not the only factor that comes into play. When health workers migrate from rural and remote areas to well-resourced urban centers, or from developing to developed countries, new forms of obstacles and prejudices emerge in a global context where high-income countries hold most of the socio-economic power.

These include the need to pass resource-intensive accreditation and licensing exams, encountering anti-immigrant sentiment and changing patient-provider dynamics, limited options from smaller job pools, and being affected by global events and geopolitical changes.

This “brain drain” of health workers also has negative consequences for the understaffed health systems they leave behind.

In addition to gender and immigrant status, healthcare workers may also face discrimination based on their race, ethnicity, language and dialect, marital status and sexual orientation, among other factors. These experiences affect the healthcare staff in different ways, resulting in inefficiency, demotivation and burnout at local, national and regional levels.

Health care systems that fail to recognize and address latent discriminatory practices may inadvertently perpetuate these inequities, further exacerbating the biased experiences of health care professionals, despite the need for a diverse health workforce to better serve their diverse populations.

While we talk about zero discrimination, dignity, decent work, fair pay and the importance of supporting diversity and practicing inclusion at the macro level of health systems, we also “see” and “recognize” where this discrimination exists and understand the negative consequences for healthcare professionals and population health? Are we collecting and analyzing data that gives us the whole picture?

More importantly, discrimination in healthcare not only violates the basic human right to be treated with respect and equality, but also severely limits the ability to achieve the SDGs by 2030. The 2017 UN statement succinctly framed this understanding in their call to put an end to discrimination in healthcare.

Equal opportunities and experiences for health and care workers must be ensured at every stage of their careers, including recruitment, promotion, growth and advancement, especially in the era of globalization after COVID.

Gender and race are the primary drivers of inequality around which most of the structural discrimination in health revolves. Therefore, policies and practices must be developed to study and address these discriminations and their underlying drivers, to fully utilize the available talent and potential of the healthcare workforce, and to ensure equitable opportunities for growth and leadership and strategically achieve UHC.

Now more than ever, it is imperative that leaders in global health take bold action by committing to a new social contract that prioritizes the rights of health care workers. This step will not only ensure a more just and equitable health workforce, but also provide better health outcomes for communities worldwide.

Roomi Aziz is the Technical Lead for the Pakistan Chapter, Women in Global Health

IPS UN agency

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© Inter Press Service (2023) — All rights reservedOriginal source: Inter Press Service