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A lot has been discussed and debated about the negative impacts of the Covid-19 pandemic on women but the contribution of women in fighting the pandemic has found very sparing mention. This is despite the fact that women health workers are the beating heart of every healthcare system which is aiding the recovery of Covid patients across the globe.

For several decades, women have played a vital role in the global healthcare workforce as nurses, midwives, community health workers and doctors. In some countries 90% of nurses are women. Although women are still less likely than men to reach senior positions in healthcare professions, recent data shows a trend reversal which ignites some confidence of rising gender parity in the Healthcare sector.

It is heartwarming to note that women represent close to 70% of the global healthcare workforce. Several studies estimate that women in health contribute 5% to global gross domestic product (GDP) (US$ 3 trillion) annually, out of which almost 50% is unrecognized and unpaid.

In 2017, almost half of all doctors in Organization for Economic Cooperation and Development (OECD) countries were women. Thirteen OECD countries exceeded gender parity for doctors in 2017, including Slovenia (63.0%), the Lithuania (69.4%), Estonia (74.0%), and Latvia (74.3%). France (44.5%), Germany (46.6%), the United Kingdom (47.6%), and Sweden (48.0%) were nearing gender parity among physicians. However, women still only made up one in five (21.0%) doctors in Japan. Globally, women represent the majority of nurses and midwives. The Americas (86%), Europe (84%), and the Western Pacific (81%) are regions with the highest proportion of women among nurses.

In Canada, women dominate the health fields in Higher Education. In 2017, women made up more than 78.7% of post-secondary graduates in health and related fields. In the past four decades, women’s share of medical degrees has substantially increased. In contrast to 2017, when only 12% of women earned MD degrees in Canada, there has been a significant spike until 2018 with 54.5% of women achieving the same feat.

In India, women are responsible for 70-80% of all the healthcare services being provided. Women healthcare providers can play an important role in educating society to recognize their health and nutrition needs. Women professionals and empowerment of women at all levels are required for improvement of the health and nutrition structure in India.

In terms of Gender Career Satisfaction, on average, women in healthcare report high satisfaction with their careers (75 percent versus 71 percent of men). They find opportunities aligned with their passions and can adapt their careers over time. Women in healthcare tend to be more happier about their careers compared with men in the same field.

Largely, the gender gap in promotion rates in healthcare, unlike in many other industries, is narrowing. Both women and men report asking for raises at the same rates, but women in healthcare say they are slightly more successful in achieving positive outcomes. Women in healthcare reported receiving more of what they requested in compensation negotiations more often than what men did. Both women and men report asking for raises at the same rates, but women in healthcare say they are slightly more successful in achieving positive outcomes. Women in healthcare reported receiving more of what they requested in compensation negotiations more often than what men did.

According to a research done collaboratively by Lean In and McKinsey, healthcare appears to be one of the best industries for working women on several counts. A broad industry that includes drug and medical-device manufacturers, as well as service providers and payers, healthcare surpasses other industries in female representation.

On the flip side, it is an uncomfortable fact that health systems are currently subsidized by the unpaid work done by women and girls delivering care to family and others in their communities. If only women were able to participate in the economy equally, it would result in nearly an estimated $160 trillion increase in global GDP or a 21.7% increase in human capital wealth.

24 million of the 28.5 million nurses and midwives globally are women. Men, on the other hand, are more likely to be physicians and specialists than women. In addition, more men reach leadership positions, leaving women under-represented in senior, higher-paid roles. However, recent studies reveal an increasing participation of women in highly paid occupations in health, a trend likely to continue over the next 20 years.

The report “Delivered by women, led by men: A gender and equity analysis of the global health and social workforce”, co-produced by WHO and Women in Global Health, confirms that women health workers are concentrated into lower status, lower paid and often, unpaid roles, facing harsh realities of gender bias and harassment.

It is unfortunate that women lead only 19% of hospitals. When it comes to companies in the healthcare industry, women only hold 13% of CEO roles and 33% of senior leadership positions. However, despite all the roadblocks, some women have made to the top of the ladder with their talent, remarkable contributions and sustained efforts. Some noteworthy names include Emma Walmsley (CEO of GlaxoSmithKline and the first woman to lead a global pharma company), Gail K. Boudreaux (president and CEO of Anthem), and Laura N. Dietch (president and CEO of BioTrace). Frances H. Arnold, who in 2018 became the fifth woman to win the Nobel Prize in Chemistry is yet another example of women in healthcare who have gained worldwide recognition for her achievements. Women are the primary consumers and decision makers in the healthcare market, and they make up almost 50 percent of the workforce: much of their advancement and leadership in the field rests on those facts.

Since women work in the frontline in providing medical care and perform some of the risky jobs, they have an increased risk of contracting infectious diseases. In the United States, the Centers for Disease Control reports that, as of April 2020, 73% of healthcare professionals who tested positive for COVID-19 were women. Exposure to infectious diseases poses a high psychological burden for women healthcare workers. A study of healthcare settings in China during the COVID-19 outbreak found that women workers reported elevated levels of stress, anxiety, and depression.

Despite all the risks taken by women, disparity continues to pervade the industry when it comes to monetary compensation. Women in healthcare are paid Less, on average, than their male counterparts. Women physicians and surgeons made $0.67 to every $1 earned by their male counterparts in 2018. Women in healthcare support occupations, which include home health aides and nursing assistants, made $0.83 for every $1 their male counterparts made in 2018.

Gender equality needs to be looked at holistically in the healthcare sector – Policies, effectiveness of programs initiated by the government, and employee experiences must be taken into consideration to promote diversity and inclusion. While the trends clearly show that significant progress has been made over the last few decades, much remains to be done.

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Boris Johnson, Prime Minister of United Kingdom is all set to promote access to education for girls in Kenya, calling it “is one of the smartest investments we can make”.  Since his time as Foreign Secretary, Mr Johnson has argued that widening access for education for girls is a highly-effective way of driving development in some of world’s poorest countries, in places where girls had often been at risk of missing out on school. The PM will participate in a live study hall connect-up with schoolchildren in Kenya on march 13, 2021 to encourage world pioneers to put resources into training, supporting the UK’s aspiration to get 40 million additional young ladies into school in the following five years. 

He is scheduled to visit a school in the UK with Julia Gillard, previous Australian PM and Seat of the Worldwide Organization for Training, and address President Uhuru Kenyatta at a school in Nairobi as a component of the Associating Homerooms program. This visit comes ahead of the joint UK-Kenya Global Education Summit in London in July, which aims to raise $5 Billion over the next five years for the vial work of Global Partnership for Education (GPE).

The UK reports £55 million for another program to drive essential research into education reforms, , turbocharging endeavours to get young ladies into school and learning. The What Works Hub for Global Education will advise governments across Africa and Asia on the most impactful and financially savvy approaches to reform educational systems and support female enrolment. 

UK’s G7 Presidency has a key part in improving girl’s access to education and is at the heart of global efforts to build back better from the pandemic. Putting resources into schooling helps lift communities out of poverty and shields young girls from early marriage and forced labour. 

Prime Minister Johnson said: 

“Supporting girls to get 12 years of quality education is one of the smartest investments we can make as the world recovers from Covid-19. Otherwise we risk creating a lost pandemic generation. Across the world there is a vast untapped resource – girls whose education has been cut short or denied altogether, who could be leading efforts to pull their communities out of poverty. I’m going to be working throughout the UK’s G7 presidency to ensure leaders invest in those girls and boost children’s life chances around the world.”

Julia Gillard, Chair of the GPE, said: 

“COVID-19 has worsened the global education crisis and hit children in lower-income countries the hardest, with life-changing consequences for millions. Now, we are at a decisive junction. When the world builds back from the pandemic, ensuring that every girl and boy has the opportunity for a quality education is the single best investment we can make for a more sustainable, peaceful and resilient future.”

The Covid-19 pandemic has caused an unprecedented worldwide educational crisis, with 1.6 billion youngsters out of education all around the world at the height of school terminations. It has additionally intensified the hindrances to tutoring that young girls as of now face, including poverty, gender-based violence and child-marriage. 

The Global Education Summit this July, co-hosted by the United Kingdom and Kenya, is a critical opportunity to fully fund the Global Partnership for Education and help transform education systems to make them more equitable and effective.

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The imact of the Covid-19 pandemic has not been gender neutral. There has been a differential impact on women, which is cause of serious concern. Emerging data and reports from those on the front lines, have shown that women and girls have been subjugated to all types of violence, especially domestic violence.

If one were to wade through the annals of history, it is noticeable that violence against women tends to increase in any emergency, including epidemics. Immense stress, disruption of social and protective networks, economic vulnerability and dwindling access to services can exacerbate the risk of women being susceptible to violence.

Understandably Covid-19 has dominated the world’s agenda. Especially in the case of COVID-19, prolonged isolation, restricted physical movement and work-from-home measures to contain the spread of the virus have a particularly acute impact on women. The risk of women and their children being exposed to violence has dramatically increased as members of the family spend more time in close contact. Household stress intensifies, and the risk grows even greater when families also have to cope with potential economic uncertainty or job losses.

Closures of schools and child care facilities have increased the burden on parents, especially women. Distance learning or virtual classrooms often requires the supervision of parents or caretakers. Despite the penetration of internet globally, some families still don’t have access to a reliable internet connection, and childcare obligations may fall on friends, neighbors, or family members while parents work or are in search for work. Some occupations are considered essential and physical presence at work is mandatory while others have the freedom to work virtually. The cumulative stress of balancing work, child care, and children’s education has led to a rise in child abuse. Teachers, child care providers, and clinicians are having fewer interactions with children and families which is significantly reducing the opportunity to assess or recognize any signs of child abuse.

“Before the pandemic, 1 in 3 women would already experience gender-based violence in their lifetime. However, the COVID-19 pandemic has exacerbated this already critical issue”, cites an extremely concerned Melissa Alvarado, UN Women Specialist.

A staggering increase in the number of cases of domestic violence have been reported globally including the developed world. Several reports suggest that cases of domestic violence have tripled in countries like France, Cyprus and Singapore. In France, police reported a nationwide spike of about 30 percent in domestic violence. Christophe Castaner, the French interior minister, said he had asked officers to be on the lookout for abuse.

The Eastern Mediterranean Region has the second highest prevalence of violence against women (37%) worldwide. This is due to structural systems that maintain gender inequalities at different levels of society, compounded by political crises and socioeconomic instability in the region. The Covid-19 pandemic has only aggrevated the situation.

In India, where domestic violence has been a perennial problem, there has been a sharp rise in cases ever since the stringent lockdown was announced by the government. National Commission for Women’s (NCW) data showed that domestic violence complaints doubled after the nationwide lockdown was imposed in India. Tamil Nadu Police have reported an increase in domestic violence complaints. They received approximately 25 calls every day during the lockdown period and registered at least 40 such cases. Similarly, Bangalore Police reported a spike in complaints from 10 calls to 25 calls every day from the victims of domestic violence.

In Spain, the emergency number for domestic violence received 18 percent more calls in the first two weeks of lockdown than in the same period a month earlier.

Around 42% of the Australian practitioners noted an increase in first-time family violence reporting by women.

Mahase reported a 60% increase in emergency calls related to violence against women by their intimate partners in Europe.

Similarly, Agüero (2020) found a 48% increase in helpline calls related to domestic violence in Peru.

In China, a Beijing-based NGO dedicated to combating violence against women, Equality, witnessed a a sudden surge in calls to its helpline, when the government locked down cities in Hubei Province, which was the epicenter of the pandemic outbreak.

A study on Ethiopian women found that almost one in four women experienced any form of domestic violence during the COVID-19 pandemic. Housewives aged less than 30 years, and with arrange marriage were at greater odds of experiencing domestic violence

At the heart of it, domestic violence has always been about power and control. Home isolation, however quintessential to prevent the spread of the virus, is giving still more power to the abuser. The isolation has also shattered support networks, making it far more strenuous and sometimes even impossible for victims to get help or escape. Sexual harassment and other forms of violence against women continue to occur on streets, in public spaces and online. Survivors have limited information and awareness about available services and limited access to the much needed support services.

In some countries, resources and efforts have been diverted from violence against women response to immediate COVID-19 relief, thus compounding the problem.

One interesting study reveals that the stricter the lockdown, the greater the risks of domestic violence. The most stringent lockdown was enforced in South Africa. Amongst other bans, liqour and cigarettes were strictly banned during the country-wide lockdown. One study claims that this has adversely affected the mental health of men and the incidences of domestic violence has increased significantly in South Africa. The magnitute of the problem is so significant that women are having to leave their homes along with their children to nearby shelter homes and distress centers. However, the fear of getting infected with the Covid-19 virus at these centers is dissuading others to tolerate the abuse and abuser at home.

Some advocates have raised concerns about a potential increase in intimate partner violence (IPV) ever since people were confined to their homes and personal movement was limited. Stay-at-home orders, even though rightly intended to protect the public and prevent widespread infection, has left many IPV victims trapped with their abusers. One in 4 women and one in 10 men experience IPV, and violence can take various forms: it can be physical, emotional, sexual, or psychological. Studies show that people of all races, cultures, genders, sexual orientations, socioeconomic classes, and religions experience IPV.

A Glimmer of Hope:

Not all seems to be lost though. Women are being creative about how they seek support. In some places women are going to Pharmacies and grocery stores to reach out for help. In some countries they are setting up pop-up crisis centers at pharmacies and grocery stores to help women subject to harrassment reach out for the much needed help. This is especially helpful when the abuser has confiscated the victims’ phone and other forms of communication are not accessible.

UN Women, the United Nations entity dedicated to gender equality and the empowerment of women, has launched the Shadow Pandemic public awareness campaign, focusing on the global increase in domestic violence amid the COVID-19 health crisis.

The French Government has allocated 20,000 hotel rooms for abused women. Additional Control rooms have been setup by the French Police to distress calls.

Dr. Kemi DaSilvaIbru, a qualified physician with more than 15 years of experience in private practice, dedicates her time to addressing the needs of girls and women. Her unmitigated passion for women’s rights and protection led her to found Women at Risk International Foundation (WARIF) in Nigeria. The foundation addresses the prevalence of rape and gender-based violence through intervention and treatment for girls and women and by providing effective educational and community-based initiatives. She has been helping women and children who have been subjected to physical and sexual abuse during the pandemic.

Community gatekeepers who are at the forefront of rescuing abused women and children opine that the perpetrators get moved to the shed instead of the survivor. This indeed is a wise suggestion. Why should the abused person bear the brunt of shifting to a different location while the abuser gets away with the crime.

Despite all these praiseworthy initiatives during these precarious times, women subject to domestic violence are trapped at home with their abusers and the perpetrators are at a ear-shock distance. Phones and other assets of the victims have been confiscated making it very hard for them to seek support or help. The abusers are using the stringent lockdowns as an excuse to prevent their victims from moving out of their homes.

Ironically, since the pandemic erupted, it is heartwrenching to know that home is no longer the safe place for women, the true homemakers.

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By Dr. ELSA LYCIAS JOEL

From time immemorial women have been considered to be better caretakers. Nothing unusual about it. History has provided us with many examples of women as nurses and their contributions to our communities. Be it the lady with the lamp or the angel of the battlefield or sojourner truth or the first black woman general of USA or the first lady of nursing, there is no dearth of inspiration. All of us, at least when pandemics hit us come to know what the word ‘nurse’ stands for. The word is derived from the fifth-century post-Classical Latin nutrice a wet-nurse hired to provide an infant with breast milk when the infant’s mother would not or could not do so. Etymologically it is related to our modern word nourish.

As Britain prepares to celebrate Florence Nightingale’s 200th birthday on May 12, the whole world cling to nurses as their saviours and would not let go of them. In today’s scenario, despite intensive care many die. That doesn’t stop anyone from believing that nurses are a courageous lot under the most adverse conditions. Uncomplaining resilience and calm professionalism displayed by them make known that they should be considered essential elements of all societies, at all times. With a long history, they are everywhere as members of the largest health care profession in diverse settings and fields. Stories of army nurses have reinforced the fact that they do their best withstanding hardships at the front and have been awardees of ‘The Purple Heart’. We all know how vulnerable they are under the present circumstances as a vital link between the patient and the rest of the healthcare system. Raincoats and helmets in lieu of coveralls and masks, claps and clanging pots instead of PPEs and a pay raise, it’s a struggle day in and day out. Being around critically ill patients even when the surge hits is an act of self-denial. A listening ear and a calming touch even as they keep their senses alert for one small subtle change to determine what or who needs to be called reflects their flexibility, innovativeness, patience and adaptability.

Severe shortages of nurses characterizing  the current and post pandemic periods is a result of governments’ lethargy and unpreparedness of governments in addition to an uneven battle with the deadly virus in turn threatening the delivery of health services to the public. Though nursing’s image takes on an heroic cast during pandemics and wars,  the reality for most nurses is that the work is incredibly demanding with few financial rewards and poor working conditions. Nursing fails to keep up economically with other occupations. For the sake of four words – Humanity, Fortitude, Devotion and Sacrifice which describe this profession the best and for these words to ring true, the cracks in the current edifice of healthcare safety should not continually grow. For those thousands who died on duty leaving their colleagues and families shaken, their contributions are acknowledged as essential to victory against this evil called COVID19. If we think, nurses report for work in the most challenging of circumstances anyway, because that is their job we should rethink. Well, it’s also because they believe that respect for the inherent dignity and of human lives is a fundamental principle of their profession.

While nurses are looked upon as those holding the fort and expected to go on and on their psychosocial well-being is a concern. At these times, even behind a mask the nurses are not wholly successful in altering their outward demeanour and the presentation of what they see as their ‘detached’ face does not serve to mask feelings of exhaustion, demoralisation, anger or sorrow. Recently, with too many failings and deaths to handle, however, nurses find themselves having to perform a different kind of emotion management than that prescribed by their profession. They have to present the detached face of the professional career as fear of losing grips them. Next moment, they also have to handle intense joy on liberating someone from a ventilator, when another one stabilises and could breathe on her/his own again. ‘Smiling happiest faces’ also means they have to work hard on their emotions especially with families of patients whose expectations of a quality service have been raised beyond anything better than the best. An impending doom or an existing gloom, the overall effect is physically and psychologically palpable. Wobble rooms are indeed “rainbow rooms” that offer peace and quiet plus a space to have a safe conversation. Above all, nurses need not go home thinking, ‘I could have been the kindest to so and so’.

If we think nurses’ experience alternate between periods of intense activity, sleep and anxiety, we are wrong. It’s much more than that. Underpaid, under- resourced and overworked, they are barely holding it together. Patients who arrive in severe shock, others very sick demanding a high level of nursing care and many others on the verge of death needing a kind look or words of comfort, surrender themselves with ‘that’ look in their eyes. ‘Stoicism’ is the ruling word in times of profound upheaval, risk, and strain. Is there anything more traumatic than seeing the one you cared for in the previous shift with lot of hopes and prayers, in a body bag hours later? These soldiers who display courage in the face of duty are more than deserving of a ‘Maidstone Medal’ or “The Christiane Reimann Prize”. What’s more, they put the wellness of others before their own, and many accept their fate with incredible dignity.  Bold voices clearly articulate ethical positions with an astute understanding of human rights, careful discernment of human rights violations and bold acceptance of professional responsibility.  When push comes to shove, many expose racism despite knowing the ordeals ahead with their livelihood at stake, as more than life savers who are willing to advocate for victims and to collaborate with right thinking people in finding solutions to ethical and racial issues. Whatever, deafening sounds of oxygen will accompany them for years to come.

Forget Covid19 for a moment. In normal circumstances, to smooth the often turbulent path of interaction between patient and an overworked health specialist, nurses become able to tolerate differences, willingly keep aside potential perceptions and whole heartedly contribute to shared care plans even when multiple patient handoffs play foul in establishing a trusting and collegial relationship. Nurses must re-define stressful situations, carry on and do their job in any situation with or without resources. There seems to be no recognition anymore of the collective goodwill involved in providing a service, many a time selfless one. A bad job is definitely not excusable, but others involved with nurses ought to understand and appreciate the struggles or shortcomings. At the end of the day, they don’t feel like heroes but rush back home as a daughter, wife, mother, lover or a friend to feel belonged, to care and be cared for. 

Still, everybody fights, nobody quits. 

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The Covid-19 pandemic is disproportionately affecting women and leaving them far behind when compared to their male counterparts. The massive gains made in the last few decades in upliftment of women and gender equality is now being neutralised by the pandemic.

The continued global lockdowns and the ensuing layoffs by several companies big and small is pushing women back into traditional roles. ILO has estimated that full or partial lockdown measures now affect almost 2.7 billion workers, representing around 81% of the world’s workforce, while the IMF projects a significant contraction of global output in 2020. COVID-19 is lurching the world

economy towards a global recession, which will be strikingly different from past recessions.

Emerging evidence on the impact of COVID-19 suggests that women’s economic and productive lives will be affected disproportionately and differently from men. Across the globe, women earn less, save less, hold less secure jobs, are more likely to be employed in the informal sector. They have less access to social protections and are the majority of single-parent households. Their capacity to absorb economic shocks is therefore less than that of men.

Women spend 3x as many hours as men in unpaid care and domestic work, limiting their access to decent work. More men between the ages of 25 to 54 are in the labor force than women. The global gender gap is stuck at 16% with women paid up to 35% less than men in some countries. Since women are paid lesser than their male counterparts, family compulsions are making women quit their jobs to run the households while men find it more prudent to cling on to theirs.

740 million women globally work in the informal economy. They have been augmenting the family income and are more vulnerable to losing their jobs. Studies reveal that Women aged 25 to 34 globally are 25% more likely than men to live in extreme poverty

As women take on greater care demands at home, their jobs will also be disproportionately affected by cuts and lay-offs. Such impacts risk rolling back the already fragile gains made in female labor force participation, limiting women’s ability to support themselves and their families, especially for female-headed households.

Women spent more than twice as much time as men on their children’s home schooling and development during the UK’s coronavirus lockdown, according to the first academic study to measure how parents responded while schools and nurseries were closed to most families. The surveys conducted by researchers at University College London (UCL) found that women across several age groups bore the brunt of childcare and home schooling, while those with primary school-aged children “were considerably more likely” to have given up working than fathers with children of the same age.

Among parents of primary school-aged children, mothers spent on average five hours each day on home schooling, while fathers spent just two hours each day. Women were also spending more than three hours a day on developmental activities – such as doing puzzles, reading or playing games – compared with just under two hours a day for fathers,the researchers at UCL’s Centre for Longitudinal Studies concluded.

From past experience and emerging data, it is possible to project that the impacts of the COVID-19 global recession will result in a prolonged dip in women’s incomes and labor force participation, with compounded impacts for women already living in poverty. For those who, as a result of recent economic growth managed to escape from extreme poverty, they are likely to fall back into this most vulnerable of situations once again.

COVID-19 is not only a challenge for global healthcare systems, but also a test of our indomitable human spirit. The challenge however is that recovery must lead to a more equal world that is more resilient to future crises. Fiscal stimulus packages and emergency measures need to address public health gaps to mitigate the impacts of COVID-19. It is crucial that all policy decisions should place women and girls, their inclusive representation, their rights, social and economic outcomes, equality and protection at their centre if they are to have the intended impacts.

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The Womb is an e-platform to bring together a community of people who are passionate about women rights and gender justice. It hopes to create space for women issues in the media which are oft neglected and mostly negative. For our boys and girls to grow up in a world where everyone has equal opportunity irrespective of gender, it is important to create this space for women issues and women stories, to offset the patriarchal tilt in our mainstream media and society.

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