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Gender inequality as a global health issue

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Gender inequality. Photo: PEXELS

Reading through Google Stories’ recent article celebrating women’s firsts in anticipation of International Women’s Day, I experienced mixed feeling of inspiration and surprising angst. While excited about the beautiful stories of women conquering new frontiers, I was a little disillusioned with the fact that in 2021, with the dramatic revolution the world has undergone in different areas, we still need to point out first-women positions, as recently as this year for key global decision-making positions.

Concerned that this may be giving the world a false sense of achievement around gender equity, I shared my misgivings with Vivianne Ihekweazu who provided structured perspectives on the celebration of firsts. Vivianne is Managing Director at Nigeria Health Watch, a not-for-profit that uses informed advocacy and communication to influence health policy and seek better health and access to healthcare in Nigeria.
Noting firsts, helping or hurting? Vivianne’s thoughts; “I wish we can come to the place where women have achieved equity and prominence in leadership in all positive developmental aspects of life. Unfortunately, this is 2021 and we are not there yet, so in the meantime, celebrating the firsts helps girls, women and even men the world over know what is possible for girls and women to achieve.”

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I could not agree more as I think of trailblazers like Dr Ngozi Okonjo Iweala who has now taken up almost superhero qualities in the eyes of many. How the world has fresh respect for women and Africans beyond what we look like and ability (or choice) to conceive. It is shocking that even Dr Okonjo-Iweala still faces sexism and gender bias. An example is how one German newspaper chose a headline that attempted to reduce the extensive and excellent pedigree of the legendary Dr Okonjo-Iweala to just maternal. Like the next person, I appreciate the miracle of birth, parenting and longevity of life. However, it was for neither of these reasons that Dr Ngozi Okonjo-Iweala was voted unanimously as the most qualified person to take up the position as the next Director General of the World Trade Organisation (WTO). The article did little to distract attention or diminish Dr Okonjo-Iweala’s achievements or qualifications, something that many women in leadership positions may face today.

Hopefully we get to a place where we have achieved gender equity and extensive global female leadership that girls look beyond being the first to do what men have already done, breaking new frontiers and showing young boys and girls what is possible.

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Gender Inequality as a global health issue
For International Women’s Day 2021, leading women from the Nigerian Chapter of Women in Global Health – whose main goal is to be inclusive by incorporating all genders from all career stages and levels within the healthcare space, to achieve gender transformative leadership – share their recommendations on how to achieve a more gender equal world.

The pyramid structured men-women ratio in the workforce through the ranks is a challenge. According to the team at Women in Global Health, there are many women in the health care workforce; however, too few of these women take up leadership positions. Having more women in key decision-making positions means that better, more evidence-based policies that improve maternal and child health and development will be created and implemented. An example is breastfeeding, Nigeria has struggled with matching the breastfeeding recommendation policy with maternity leave policies. The recommendation is that infants are exclusively breastfed for the first 6 months, however many states struggle to achieve even a 4-month maternity leave period with only a few states in Nigeria practicing a 6-month policy.

Nigeria has one of the highest maternal mortality rates globally, and even newborn mortality and across the globe. A compendium of factors contribute to this statistic, some of which include the systematic suppression of women’s voices expressed in the need for women to take permission before they can access healthcare, reduced access to transportation and ability to move around with ease (this impacts on immunisation rates for children since women are often the primary caregivers who are tasked with taking their children for vaccines), inability or unwillingness to communicate health challenges, thus prolonging or even limiting delivery of health services. The more direct impacts of gender inequity such as female genital mutilation, gender based violence and early marriage have even more dire consequences on Nigeria’s maternal and newborn mortality rate. More female representation is needed in policymaking and advocacy positions, to ensure that the perspectives of women is taken into account when decisions that affect their lives, are made.

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The mental impact gender inequity has on women is especially evident in the workplace where women sometimes have to do twice as much to achieve the same, or even less results and recognition compared to men. For Women in Global Health, more diverse female representation in leadership in the workplace, will mean more policies can be created that take into consideration the peculiarities that women face and develop policies to harness their productivity and wholeness regardless.

What will a gender equitable world look like?
It is important to know what a gender equitable world looks like, so we know how close or how far we are away from progress. It is not often clear yet what such a world might actually look like. Seven Nigerian women leaders in global health share what a gender equal world looks like to them by sharing what they choose to challenge.

For Amaka Momah-Harun, an International Development Professional with the United Nations; a gender equal world is one where women in leadership positions are change agents and create more space with mentorship for other women to grow and thrive.

Vivian Akudo Nwogu, a Registered Nurse and Founder of Nurse Hub Africa, a nursing leadership network; sees a gender equal world as one where women are inspired and empowered enough to pay more attention to critical knowledge to give themselves an edge. She advises that as we work towards gender equality, women use vulnerability as an edge to gain recognition and rise to prominence. “Multi-task strategically. Do a little extra”
Olayinka Umar-Farouk, a public health specialist and Deputy Project Director with USAID Breakthrough ACTION Nigeria, believes that a gender equal world looks like where women can show up, turn up, and just get stuff done. Leadership is at various spaces; women should find their space and strive to make a difference with excellence. We all power to make a difference at the different stages we are.

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For Abisola Oladapo, an innovator and social entrepreneur and is founder of Health-tech company Mumspring; a gender equal world looks like one where a female is empowered enough to take action when something bothers her enough. For her, this is where a person’s passion can lie. She encouraged women and girls even now in the workplace to be problem solvers. Opportunities come to problem solvers.

Favour Anyanwu, Vice president of Public health FUTO and Girl Up Owerri president believes that a gender equal world is where there is limitless space for women in leadership with adequate women mentors.

Adepeju Adeniran – Gender issues are still pervasive it is sad that women 15 years apart in the workplace still face the same issues. However, that something is pervasive does not mean we are helpless against it.
#ChooseToChallenge

Bisola wants to #ChooseToChallenge the fact that every year in Africa, 1million newborns are dying within the first month of being born. She believes that within the next decade we must completely reverse that trend.
Favour wants to #ChooseToChallenge gender inequity in schools and in leadership positions as a young girl.

Olayinka want to #ChooseToChallengethe inadequate rate of women to women mentoring for leadership women. More women need to mentor more women to break the glass ceiling for women in leadership.

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Dr PejuAdeniran, a clinical and public health physician focused on Universal Health Care through the Primary Health Care system and co-chapter lead of women in global health Nigeria; wants to #ChooseToChallenge the infantilisation of women. Women should not need their husband’s permission for something as simple as changing her name or getting a passport.

Vivian wants to #ChooseToChallenge the limited or absent access to health services by women in Nigeria.
ZainabAdesokan, a Public Health Nurse, Researcher and Global Health Advocate wants to #ChooseToChallenge gender discrimination and gender-based violence among health workers in the health care system.

Clearly, a gender equal world can mean many different things to different people, but the underlying factor no person should be treated differently or less because of their gender. This year, I join millions of women in Nigeria and globally and #ChooseToChallenge hidden stereotypes that limit girls and women in any form.
Dear Unkus and auntis, we are way more than mothers, grandmothers and slay queens and you must recognise that there is no table we can’t seat at, no limit to the number of us at that table and no platform we cannot lead, all the while wearing our ‘grandmother’ hat if we (and only if we) so choose.

Ajala-Damisa is a programme manager at Nigeria Health Watch. For International Women’s Day 2021, she spoke to a number of leaders in global health who are female and blazing the trail in Nigeria for other women to be inspired by. This article is based on these conversations.

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