I am delighted to join Vanessa, and 11 amazing change-agents, table-shakers and thought-leaders committed to reigniting the road to equity in global health for all. Your steps; our strides, are a timely jolt as we come together in choosing to challenge and improve the timeless journey for female healthcare workers worldwide.
This year’s International Women’s Day is a marvellous opportunity at a precarious time yet a hopeful one. During this annual, global moment dedicated to recognising and celebrating the social, cultural, economic and political achievements of women, this year, as we take stock of the events which preceded this very day, we are reminded of the unique challenges faced by women and girls around the world – and their continued commitment to undoing and overcoming them all.
Last week, I joined the WHO PMNCH Partnership for Maternal Newborn and Child Health and United Nations Women’s Fund in welcoming, and rendering commitments to the Gender Equal Health and Care Workforce Initiative of the Government of France, WHO, and Women In Global Health – to increase visibility, advocacy, dialogue, technical output, and commitment to action on improving gender equity in the health and care workforce alongside the UN Women Generation Equality Campaign to accelerate gender equality actions.
To date, policies have attempted to fit women into inequitable systems that do not seek to serve their commitments, capacity or level of innate caring abilities. Because of COVID-19, 4x as many women dropped out of the labor force in 2020 as men worldwide. The onus is on each member of society to identify and recalibrate existing systems, policies and work environments, in order to create a culture of work for women that promotes and provides the ability for them to thrive, and closes gender gaps in leadership and pay.
Recognised as the main providers of health, women deliver care to around 5 billion people globally, and creating safe and enabling environments where we can work to our full potential is critical to achieving health for all and improving the well-being of our own personal communities. Today, Women make up 70% of the global healthcare workforce, yet occupy less than 25% of influential leadership positions. We contribute $3 trillion to health care globally, however nearly half of the care we commit to facilitating is unpaid. This must change, and a bottom up approach is a strong, authentic and powerful place to begin this reposition.
Thought-leaders and policymakers will continue to gather throughout March to identify, celebrate and increase the visibility of women’s achievements; they help forge equality through strategic collaborations based on shared purpose, trust and the appreciation of impacting positive change for women. We are boldly choosing to challenge gender bias and discrimination in order to accelerate gender parity in the health and care workforce, meticulously marching on towards a decade of delivery for the sustainable development goals, and a gender equal world by 2030.
As a worthy precursor to this very day, and in this Year of the of the Health and Care Worker, I have endorsed the clarion call for a Gender Equal Health and Care Workforce, to further recognise and reinforce the capacities and impact of nurses, midwives and community health and care workers at the forefront of providing essential services around the world. The report of the UN High Level Commission on Health Employment and Economic Growth concluded that investments in education and job creation in the health and social sectors result in a triple return of improved health outcomes, global health security, and inclusive economic growth.
When we look at the progress made through upskilling Nigeria’s healthcare professionals in previous years, the importance of accredited and assessed evidence-based practice and care facilitation has been a central and vital component. It has not only strengthened the promise of career progression, but affords and assures the safety and provision of an uncompromised work environment for the health and care giver, and for their family when it comes time for ‘clocking off.’
Taking a deep-dive into case studies such as the successful eradication of the wild polio virus in Nigeria, we have seen that females on the frontline have been instrumental in building trust within communities, and thus, successfully facilitating uptake of vaccinations and immunisations. I urge the wider world to glean from such successes, while acknowledging this and many other components as evidence for the increase.
My WBFA’s Mamacare360 Antenatal and Postnatal Education program remains committed to administering care and informing evidence-based counsel to women and families, and more recently, the height of the pandemic served as a ready and powerful example of the purpose equity has in promoting gender leadership – in care, in counsel and in community. Our success in delivering a quality continuum of maternity, newborn and child health care serves as proof and support for increased investments in the direction of upskilling and responsibilities.
With the core goal of empowering health-workers to propel safer births and healthy futures for all, since 2016, my Wellbeing Foundation Africa has partnered the Liverpool School of Tropical Medicine, supported by Johnson and Johnson Global Health to improve the availability and quality of emergency obstetric and newborn care in Nigeria, deploying pre and post-service anatomically correct simulation models training, and the results are clear: an immediate and sustained 22% drop in mortality and morbidity, improved task shifting between doctors, midwives and nurses, and swift appropriate responses to obstetric and newborn emergencies, cascading into better decision making and leadership and a truly multi-disciplinary approach to care. For our targeted pioneer state, Kwara, in North Central Nigeria, we have achieved the lowest maternal newborn and child mortality, and highest commensurate survival, repeatedly, for the last 4 years, in Nigeria.
This is what the global frontline requires, and desires to have access to. The determined and skilled professional community health-worker even in the most rural parts of sub-saharan Africa for example, dreams of inner-city impact beyond leveraging the locality they begin with. This will only be made possible by way of up-skilling, adequate and equal remuneration, and qualifying him or her as a vibrant and accredited professional healthcare practitioner. Increasing investments from the start of a CHW’s journey, and dream in the direction of impact, is therefore vital.
Midwives, nurses and the community health workers who aspire to follow in their footsteps are more commonly women, and have proven to be effective in facilitating better maternal and child health outcomes, essential newborn care, effective SRH education and the promotion of breastfeeding and immunisation, and we must ensure that our healthcare policies reflect that of equal remuneration and equal access to facilities – truly personifying the front in frontline.
In the 2020 Year of the Nurse and Midwife, I was pleased to crown the conclusion of my second term and 6 years of service as the Inaugural Global Goodwill Ambassador to the International Confederation of Midwives in leading my Wellbeing Foundation Africa to join Member States and Non-State Actors at the 73rd WHO World Health Assembly, in unison, speaking to the critical role of health and care workers in ensuring our health and prosperity. We emphasized the urgency and made it imperative to address persistent health worker challenges.
Ahead of this year’s 74th World Health Assembly, recognising the need to advocate for a gender equal health and care workforce, the Wellbeing Foundation Africa which had launched its own Women Girls and Gender Development Targets in November 2020 wholeheartedly endorses and supports actions in the health and care sectors in the 4 identified areas:
From the community healthcare worker aspiring to facilitate life’s first cry, to the autonomous and multi-skilled practitioner working to ensure the promise of optimal care, the priority must remain; to provide the appropriate health facilities whole-system support infrastructure to welcome, protect and preserve life from cradle to age. In choosing to challenge and strengthen the primary health frontline where lives are won, the Wellbeing Foundation Africa has developed, and invested in improving primary health centres, evolving a uniquely unprecedented comprehensive community care model to maternity referral standard, as our Wellsprings Universal Health Coverage Centres to be expanded across Nigeria, throughout this Decade of Action.
The Wellbeing Foundation Africa is committed to tackling health, gender and global development together, as we prioritise equity, facilitate decent work conditions and increase investments in the direction of upskilling in a bid to position the doctor, the midwife, the nurse, and all female healthcare workers, towards a gender equal health workforce, truly leading at the front of the frontline.
Making our commitments to the ethical principles and practices of the WHO Global Code of Practice on the International Recruitment of Health Personnel (Code), we continue to urge prioritization of support and safeguards for the countries with the greatest vulnerability, including greater investment, and endorsed the call to action for WHO and development partners to strengthen its financing, implementation and monitoring and moving purposefully beyond applauding the contributions of the frontline health workforce, to deliberate and intentional investments in health, health systems and in health and care workers.
We must now, at our global, national and subnational frontlines, ensure that this key consensus necessarily unites, includes and integrates a gender equal approach to capitalise female leadership in the global health workforce.
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