abstract: 'This commentary brings together theory, evidence and lessons from 15

  years of gender and HRH analyses conducted in health systems in six WHO

  regions to address selected data-related aspects of WHO''s 2016 Global

  HRH Strategy and 2022 Working for Health Action Plan. It considers

  useful theoretical lenses, multi-country evidence and implications for

  implementation and HRH policy. Systemic, structural gender

  discrimination and inequality encompass widespread but often masked or

  invisible patterns of gendered practices, interactions, relations and

  the social, economic or cultural background conditions that are

  entrenched in the processes and structures of health systems (such as

  health education and employment institutions) that can create or

  perpetuate disadvantage for some members of a marginalized group

  relative to other groups in society or organizations. Context-specific

  sex- and age-disaggregated and gender-descriptive data on HRH systems''

  dysfunctions are needed to enable HRH policy planners and managers to

  anticipate bottlenecks to health workforce entry, flows and exit or

  retention. Multi-method approaches using ethnographic techniques reveal

  rich contextual detail. Accountability requires that gender and HRH

  analyses measure SDGs 3, 4, 5 and 8 targets and indicators. To achieve

  gender equality in paid work, women also need to achieve equality in

  unpaid work, underscoring the importance of SDG target 5.4. HRH policies

  based on principles of substantive equality and nondiscrimination are

  effective in countering gender discrimination and inequality. HRH

  leaders and managers can make the use of gender and HRH evidence a

  priority in developing transformational policy that changes the actual

  conditions and terms of health workers'' lives and work for the better.

  Knowledge translation and intersectoral coalition-building are also

  critical to effectiveness and accountability. These will contribute to

  social progress, equity and the realization of human rights, and expand

  the health care workforce. Global HRH strategy objectives and UHC and

  SDG goals will more likely be realized.'
affiliation: 'Newman, C (Corresponding Author), Univ N Carolina, UNC Gillings Sch
  Global Publ Hlth, Dept Maternal \& Child Hlth, 135 Dauer Dr, Chapel Hill, NC 27599
  USA.

  Newman, Constance, Univ N Carolina, UNC Gillings Sch Global Publ Hlth, Dept Maternal
  \& Child Hlth, 135 Dauer Dr, Chapel Hill, NC 27599 USA.

  Nayebare, Alice, Cordaid Uganda, Nakawa Div, Plot 12B Farady Rd Bugolobi, Kampala,
  Uganda.

  Gacko, Ndeye Mingue Ndiate Ndiaye, Formerly Minist Hlth \& Social Act, Gacko Consulting,
  Fann Residence, Rue Aime Cesaire, Dakar, Senegal.

  Okello, Patrick, Minist Hlth, POB 7272,Plot 6,Lourdel Rd, Kampala, Uganda.

  Gueye, Abdou; Gaye, Sokhna; Gueye, Babacar; Dial, Yankouba, Formerly Intrahlth Int,
  Cite Keur Gorgui,Immeuble Hadji Bara Fall Lot R73, Dakar, Senegal.

  Bijou, Sujata, Intrahlth Int, 6340 Quadrangle Dr,Suite 200, Chapel Hill, NC 27510
  USA.

  Ba, Selly; N''doye, Maimouna, Independent Consultant, Dakar, Senegal.

  Coumba, N''deye, Minist Hlth \& Social Act, Fann Residence, Rue Aime Cesaire, Dakar,
  Senegal.'
article-number: '37'
author: Newman, Constance and Nayebare, Alice and Gacko, Ndeye Mingue Ndiate Ndiaye
  and Okello, Patrick and Gueye, Abdou and Bijou, Sujata and Ba, Selly and Gaye, Sokhna
  and Coumba, N'deye and Gueye, Babacar and Dial, Yankouba and N'doye, Maimouna
author-email: constancenewman88@gmail.com
author_list:
- family: Newman
  given: Constance
- family: Nayebare
  given: Alice
- family: Gacko
  given: Ndeye Mingue Ndiate Ndiaye
- family: Okello
  given: Patrick
- family: Gueye
  given: Abdou
- family: Bijou
  given: Sujata
- family: Ba
  given: Selly
- family: Gaye
  given: Sokhna
- family: Coumba
  given: N'deye
- family: Gueye
  given: Babacar
- family: Dial
  given: Yankouba
- family: N'doye
  given: Maimouna
da: '2023-09-28'
doi: 10.1186/s12960-023-00813-9
eissn: 1478-4491
files: []
journal: HUMAN RESOURCES FOR HEALTH
keywords: 'Systemic structural gender discrimination; Gender inequality; Health

  labor market; Gender transformative policy; Nondiscrimination and

  substantive equality'
keywords-plus: FEMALE; JOBS
language: English
month: MAY 4
number: '1'
number-of-cited-references: '50'
papis_id: 140ec83b64c2c71891857cf42f7f746b
ref: Newman2023systemicstructural
times-cited: '0'
title: 'Systemic structural gender discrimination and inequality in the health workforce:
  theoretical lenses for gender analysis, multi-country evidence and implications
  for implementation and HRH policy'
type: Article
unique-id: WOS:000984871300001
usage-count-last-180-days: '2'
usage-count-since-2013: '2'
volume: '21'
web-of-science-categories: Health Policy \& Services; Industrial Relations \& Labor
year: '2023'