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Pathways to leadership: what accounts for women’s (in)equitable career paths in the health sectors in India and Kenya? A scoping review

Saville, Naomi M; Uppal, Radhika; Odunga, Sally Atieno; Kedia, Sapna; Odero, Henry Owoko; Tanaka, Sonja; Kiwuwa-Muyingo, Sylvia; ... Hawkes, Sarah; + view all (2024) Pathways to leadership: what accounts for women’s (in)equitable career paths in the health sectors in India and Kenya? A scoping review. BMJ Global Health , 9 (7) , Article e014745. 10.1136/bmjgh-2023-014745. Green open access

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Abstract

Objectives: We aimed to capture evidence on enablers and barriers to improving equal opportunity and effective organisational interventions that can advance women’s leadership in India and Kenya’s health sectors. // Methods: We systematically searched JSTOR, PubMed, SCOPUS and Web of Science databases, reference lists of selected articles and Google Scholar using string searches. We included studies that were published in English from 2000 to 2022 in peer-reviewed journals or grey literature, focused on paid, formal health professionals in India or Kenya, described factors relating to women’s representation/leadership. // Results: We identified 26 studies, 15 from India and 11 from Kenya. From each country, seven studies focused on nursing. Participants included women and men health sector workers. Seven studies used mixed methods, 11 were qualitative, 5 were quantitative and 3 were commentaries. Factors influencing women’s career progression at individual/interpersonal levels included family support, personal attributes (knowledge/skills) and material resources. Factors at the organisational level included capacity strengthening, networking, organisational policies, gender quotas, work culture and relationships, flexibility, and work burden. Nursing studies identified verbal/sexual harassment and professional hierarchies as barriers to career progression. Structural barriers included a lack of infrastructure (training institutes and acceptable working environments). Normative themes included occupational segregation by gender (particularly in nursing), unpaid care work burden for women and gender norms. Studies of interventions to improve women’s career progression and sex-disaggregated workforce data in India or Kenya were limited, especially on leadership within career pathways. The evidence focuses on enablers and barriers at work, rather than on organisations/systems to support women’s leadership or address gender norms. // Conclusions: Women in India and Kenya’s health sectors face multiple impediments in their careers, which impact their advancement to leadership. This calls for gender-transformative interventions to tackle discrimination/harassment, provide targeted training/mentorship, better parental leave/benefits, flexible/remote working, family/coworker support and equal-opportunity policies/legislation.

Type: Article
Title: Pathways to leadership: what accounts for women’s (in)equitable career paths in the health sectors in India and Kenya? A scoping review
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjgh-2023-014745
Publisher version: https://doi.org/10.1136/bmjgh-2023-014745
Language: English
Additional information: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/ licenses/by/4.0/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10206818
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