In Ethiopia, women make up the majority of the health workforce, particularly in frontline and community-based roles. Yet, they remain starkly underrepresented in senior leadership positions within the health sector. This disconnect between representation and leadership is more than a question of fairness; it is a question of system performance, sustainability, and equity.
According to recent data compiled by the chapter, less than one-third of executive and director-level roles in Ethiopia’s public health institutions are held by women. This is despite the fact that the great majority of the workforce is composed of women. The picture is even more sobering at the regional level, where patriarchal norms and institutional barriers converge to stifle women’s progression to leadership.
This is not just an Ethiopian challenge. Globally, women make up 70% of the health and social care workforce, but occupy only 25% of senior roles. However, Ethiopia is uniquely positioned to lead by example in Africa, given its health sector reforms and political commitment to gender equity. What remains is the hard work of structural change.
When women lead, health systems benefit. Research has shown that female leadership in health is associated with more inclusive, equitable, and people-centred policies. Diverse leadership teams are better at responding to crises, addressing the social determinants of health, and advocating for vulnerable populations.
Moreover, leadership diversity directly impacts health outcomes. A study published in The Lancet found that women leaders were more likely to champion issues like maternal health, reproductive rights, and gender-based violence, areas that disproportionately affect women and girls. In contexts like Ethiopia, where maternal mortality remains high and gender-based violence persists, these perspectives are essential.
Women in the health sector face a combination of visible and invisible barriers. These include:
- Patriarchal institutional cultures that undervalue women’s voices in decision-making.
- Limited mentorship and sponsorship opportunities for young women professionals.
- Work-life balance expectations.
- Inadequate gender-responsive policies, including in recruitment, promotion, and retention.
Addressing these challenges requires more than individual effort; it demands systemic transformation.
The Government of Ethiopia has taken important steps toward gender equality. The Health Sector Gender Mainstreaming Manual and the establishment of Gender Focal Persons in major institutions are commendable. However, progress remains uneven and often dependent on the will of individual leaders rather than institutionalized mechanisms.
WGH Ethiopia advocates for a more coordinated, data-driven, and action-oriented approach. This includes:
- Gender-disaggregated leadership tracking across all health institutions to benchmark progress.
- Mandatory gender equity targets in leadership appointments, supported by legislation or regulatory guidance.
- Mentorship and leadership development pipelines tailored for women across regions and cadres.
- Safe and enabling work environments that protect against harassment and discrimination.
- Budget allocations for gender-transformative leadership programs embedded in national health strategies.
Change, however, cannot fall solely on women. Male allies, institutional champions, donors, and policymakers must be part of the equation. Gender equity is not a women’s issue; it is a leadership and governance imperative.
At WGH Ethiopia, we are building a movement. We are working with public sector agencies, academic institutions, civil society, and communities to reshape how leadership is defined, recognized, and developed.
As Ethiopia looks to the future, towards attaining UHC, resilient systems, and equitable health outcomes, it must confront a fundamental truth: no health system can achieve its goals if the majority of its workforce is excluded from decision-making.
Ultimately, promoting women’s leadership is not about ticking equity boxes. It is about unlocking the full potential of our health system. It is about ensuring that policies reflect the lived realities of all Ethiopians.
Let us move from dialogue to action, from intent to accountability. The health of our nation depends on it.