Why are women leaders missing in Indian healthcare?

Within the dynamic landscape of Indian healthcare, women seem to be missing in leadership positions, particularly at the executive and board levels, despite them accounting for half of the healthcare workforce. While India has 29% female doctors, 80% are in nursing departments (including midwives), and nearly 100% of Accredited Social Health Activists (ASHAs), there is a significant gender imbalance in India's healthcare sector in senior management roles, according to "An Unbalanced Scale: Exploring the Female Leadership Gap in India's Healthcare Sector" report by Dasra.

Notably, women occupy only 18% of healthcare leadership positions and continue to earn 34% less than their male counterparts. “India’s healthcare sector is affected by the lack of standardised and publicly available data on women’s representation across entry, mid-level, and senior roles in small, medium, and large companies,” says the report. From a global perspective, women occupy only 25% of senior positions and a mere 5% of leadership roles in the healthcare sector.

Currently, within private hospitals—which employ 54% of the total healthcare workforce—women hold about 25-30% of leadership positions. A similarly stark picture is being witnessed in pharmaceutical and biotech sectors, with women occupying only 5-10% of leadership positions.

While generic challenges exist across industries, the report underlines the distinct barriers the healthcare sector presents. A web of obstacles that seem to be affecting women’s career paths include stereotypes regarding women’s commitment and competence, social norms influencing work environments, and the misconception that diversity does not enhance profitability. These can then manifest as stereotyped role assignments, and a lack of flexible work policies.

“The overarching issue is scarcity of qualified women candidates, rooted in systemic issues which hinder their entry, retention, and advancement in healthcare leadership roles,” reveals the report.

As of 2021, only 17% of hospital board members in India were women, despite the majority of healthcare workers in the country being female.

As per the Dasra report, as of 2021, 9.3 million people are employed in India's healthcare sector. Of these, about 85% work in the private sector, which includes sub-sectors like hospitals, pharmacies, biotechnology, financial services, diagnostics, medical equipment and supplies, health technology, etc. The remaining 15% are engaged in the public sector, including public hospitals, financial services, and government bodies like the Ministries of Health and AYUSH.

"Gender equity in healthcare leadership isn’t just a matter of addressing gender imbalance; it’s a paradigm shift towards cultural, structural and normative change. This report serves as our commitment to informed action, advancing our mission to create inclusive spaces and challenging deeply ingrained patriarchal structures," says Neera Nundy from Dasra.

While India’s healthcare sector in 2022 stood at $2.7 billion, and employs more than 9.3 million people across private and public sectors, by 2030, the sector is anticipated to add 8 million employees, generating 40,000 new leadership roles, particularly in private hospitals, pharmaceuticals, biotechnology, and health technology. The increased availability of leadership positions presents a promising opportunity to get more women into these roles.

“The onus is on organisations, particularly within these sub-sectors, to harness this momentum and champion gender-equitable workforces. It is an opportunity for them to be the pioneers in building a diverse and inclusive workforce,” says Manisha Dhawan, advisor, The Udaiti Foundation.