Globally, 70% of workers in the health field are female. Nonetheless, despite the increase in the proportion of women in the highest-paying occupations and the recognition of their extraordinary contribution to the delivery of health services, a significant number of women health workers are victims of workplace abuse and harassment.
According to the World Health Organization (WHO), 30% of women worldwide have experienced physical or sexual violence at the hands of spouses or non-partners. Regrettably, domestic violence against women does not end in the home. According to data from joint research by the International Labour Organization, the Lloyd’s Register Foundation (LRF), and the analytics firm Gallup, workplace violence and harassment are still prevalent worldwide.
Women are slightly more likely than men to become victims of workplace violence and harassment during the course of their careers. Moreover, women were more vulnerable to psychological and sexual assault and harassment at work (18.6% and 8.2%, respectively) than men (17.3 percent and 5 percent).
Women in Global Health (WGH) recently produced a policy paper titled “Her Stories: Eliminating Sexual Exploitation, Abuse, and Harassment of Women Health Workers” that examined incidents of sexual exploitation, abuse, and harassment (SEAH) encountered by women in the health sector.
“Beyond the apparent respect shown to the women who provide health services to almost 5 billion people worldwide is a grim reality that is rarely told: large percentages of women health workers face abuse and harassment on the job,” the research stated.
The report noted, “In the absence of comprehensive statistics, Women in Global Health (WGH) developed the #HealthToo platform in 2022 for women in the health sector to anonymously share their experiences with SEAH, shed light on this largely unseen abuse, and promote accountability.”
WGH reviewed a total of 235 SEAH narratives provided by women in the health industry in 10 languages and 40 countries. The accounts explored the pattern of abuse, the types of occurrences recorded, the immediate and long-term trauma reactions of victims, and the reasons why SEAH remains underreported among women health workers.
“The testimonies of the women health professionals under #HealthToo, many of which are horrific to read, match past studies indicating that SEAH is pervasive in the health sector, with women constituting the majority of its victims,” the WGH noted.
The group determined, based on the tales it heard, that women health workers continue to endure work-related SAE, including sexualized verbal abuse, sexual assault, and rape – all of which, the WGH emphasized, were undesired and unprovoked by the victims.
Women in the health industry are subjected to many forms of SEAH from male coworkers, patients, and men in the community. The company also received a claim of sexual harassment from a senior women coworker through the #HealthToo program.
In addition, the data revealed that many male attackers tend to be repeat offenders who are aided by “silent bystanders.” This promotes a patriarchal culture which normalizes, minimizes, and perpetuates SEAH against women. WGH revealed that the experience of SEAH and trauma by women “is minimized and even normalized” in the health profession.
According to the survey, instances of SEAH in the health workforce impede the career advancement and retention of women health workers, which can have a negative influence on morale, mental health, sickness absenteeism, and turnover and can lead to staff shortages.
WGH stated, “SEAH increases career advancement possibilities for men in the health profession by establishing a hazardous workplace and lowering competition from women who may abandon the role or the workforce.”
The stories contributed by women in the global health industry revealed the diversity of SEAH at work. In addition to sexual assault and harassment, SEAH can also take the form of remarks and jokes—specifically, sexist or derogatory remarks towards an individual or a person’s gender “designed to reflect poorly on the individual.”
Sexual comments can often be difficult to distinguish from other forms of harassment. A tale shared by a nurse in Nepal illustrated what SEAH disguised as a joke or remark against women in the health industry looks and sounds like.
“Since I work in the field of sexual and reproductive health and rights and am outspoken about SRHR [sexual and reproductive health and rights] problems, some of my coworkers have told me, ‘I believe you have all the experience necessary for your future husband,'” the nurse explained. Despite the fact that women of all ages can be victims of SEAH, #HealthToo highlighted the fact that many occurrences of workplace violence against women began during their internships or studentships.
“Once, a nurse assistant was massaging my back after I introduced a patient to him. “I felt very awkward and ashamed, but even worse because I had no idea what to do as a resident,” an American doctor told WGH. Threats, retaliation, and power abuse constitute a second form of SEAH in the health workforce. Tales highlighted how senior doctors or sector members exploited female health care workers by utilizing their position of power.
“He informed me that I must introduce him to Nairobi’s nightlife. When I declined, he asked, “How can we work together with your attitude?” It suggests you’re not that interested in your promotion, which I can give you in five minutes.’ “I still said no,” a Kenyan administrator of health care said.
But, a few days later, he informed me that I was ineligible for the position and had done poorly during the prior few months. Abusers can be found outside of the health sector in addition to those who occupy prominent positions in the workplace or have higher social statuses, rendering them superior to the victims.
According to the World Health Organization, women health workers are subject to abuse and harassment by “male senior colleagues, male hospital drivers, male police, male health officers, male international health representatives, male teachers, male interns, male nurses, and male patients.”
In addition, while women are primarily the victims of SEAH perpetrated by men, there are situations in which women misuse their power. According to WGH, gender disparities in the health workforce enhance the risk of SEAH for women, particularly in situations where women are marginalized in leadership, earn less than males on average, and hold less prominent positions.
Statistics revealed that only 25% of senior leadership positions in the health sector are held by women. This facilitates SEAH’s “pattern of men in higher-status positions exploiting power to pressure and push female employees into unwanted sexual contact through a cycle of “grooming,” threats, and retaliation.”
According to a 2019 WHO working paper, the average gender wage gap in the health workforce is approximately 28 percent. If occupation and hours worked are considered, the gender pay gap is 11%.
In addition, it was emphasized that women are less likely to work full-time in the health and social sector than men. “The hierarchical character of medicine, the status discrepancies between professions, and the concentration of women in lower-status, lower-paid, and even unpaid occupations make women more susceptible to abuse,” WGH noted.
“Women’s preponderance in patient-facing jobs, such as community health workers and nursing, brings them into greater contact with patients and their visitors, who can be perpetrators,” the report continued. “Many stories describe sexist behavior that demeans and belittles women, which is driven more by perpetuating power differentials and preconceptions of women’s submissive position than by sexual desire.”