Access to non-pecuniary benefits: does gender matter? Evidence from six low- and middle-income countries
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RESEARCH
Open Access
Access to non-pecuniary benefits: does gender matter? Evidence from six low- and middleincome countries Neeru Gupta1* and Marco Alfano2
Abstract Background: Gender issues remain a neglected area in most approaches to health workforce policy, planning and research. There is an accumulating body of evidence on gender differences in health workers’ employment patterns and pay, but inequalities in access to non-pecuniary benefits between men and women have received little attention. This study investigates empirically whether gender differences can be observed in health workers’ access to non-pecuniary benefits across six low- and middle-income countries. Methods: The analysis draws on cross-nationally comparable data from health facility surveys conducted in Chad, Côte d’Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. Probit regression models are used to investigate whether female and male physicians, nurses and midwives enjoy the same access to housing allowance, paid vacations, in-service training and other benefits, controlling for other individual and facility-level characteristics. Results: While the analysis did not uncover any consistent pattern of gender imbalance in access to non-monetary benefits, some important differences were revealed. Notably, female nursing and midwifery personnel (the majority of the sample) are found significantly less likely than their male counterparts to have accessed in-service training, identified not only as an incentive to attract and retain workers but also essential for strengthening workforce quality. Conclusion: This study sought to mainstream gender considerations by exploring and documenting sex differences in selected employment indicators across health labour markets. Strengthening the global evidence base about the extent to which gender is independently associated with health workforce performance requires improved generation and dissemination of sex-disaggregated data and research with particular attention to gender dimensions.
Background The importance of an available, competent and motivated health workforce is increasingly recognized for countries to meet their health systems objectives and achieve improved population health outcomes. In many contexts, women comprise the strong majority, often over 75%, of the health workforce [1,2]. At the same time, most health systems worldwide continue to experience occupational clustering by sex, with higher skilled medical personnel usually dominated by men, while nursing, midwifery and other ‘caring’ cadres are typically over-represented by women [3]. Yet gender issues remain * Correspondence: [email protected] 1 Health Workforce Information and Governance, World Health Organization, Geneva, Switzerland Full list of author information is available at the end of the article
a neglected area in most approaches to human resources for health (HRH) policy, planning and management [4]. The evidence base to support policy options for greater gender equality and improved overall productivity of the h
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