Women occupy only 18 percent of healthcare leadership positions, earn 34 percent less than men: Dasra report

Women are well-represented in functions such as R&D, nursing, HR, administration, quality assurance, legal, and regulatory affairs, which have limited potential for influence. Image: Shutterstock

The healthcare industry, one of India’s major employers, has experienced significant development and expansion in terms of technology, skills, education, and professional expertise in the past few years. Despite this growth, data analysed by philanthropic organisation Dasra indicates that women within the healthcare sector are predominantly found in the lower-paying frontline roles. 

In India, women make up 29 percent of medical doctors, 80 percent of nursing staff (including midwives), and nearly 100 percent of Accredited Social Health Activists (ASHAs), as per the report. Only 18 percent of leadership positions in healthcare are occupied by women, and persistently earn 34 percent less than their male counterparts.

Shailja Mehta, director at Dasra, says the purpose of the report is to bring about a shift for women in leadership in the healthcare sector, to begin with, as well as influencing other sectors too. “Within our work on gender equality we wanted to focus on the gap area of advancement of women, which needs momentum building and galvanising of resources specifically,” says Mehta.  

Dasra's analysis of available data for the report highlights challenges in the healthcare industry stemming from the lack of standardised and easily accessible information on the representation of women across different roles in small, medium, and large companies, which encompasses entry, mid-level, and senior positions. To address this gap, Dasra conducted a thorough landscape study, collecting primary qualitative data and analysing macro-trends across various sub-sectors of the industry.

According to the report's findings, in the private hospital sector, which constitutes 54 percent of the total healthcare workforce, women occupy approximately 25-30 percent of leadership positions. Within the pharmaceutical and biotech sectors, only 5-10 percent of leadership roles are held by women. The representation of women in sales, marketing, or operations positions is also notably low. While women make up 40-50 percent of entry-level positions, this percentage significantly decreases to 15-20 percent in senior roles.

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In contrast, women are well-represented in functions such as R&D, nursing, HR, administration, quality assurance, legal, and regulatory affairs, which have limited potential for influence. Notably, there is a preferential hiring of women for entry-level HR roles, resulting in a substantial 70-80 percent representation, but this drops to 20-30 percent in leadership positions. The findings of the report have observed a similar pattern in patient service teams, F&B, etc., with women being preferentially recruited at entry levels (40-60 percent), but their advancement to senior administrative levels is limited, reaching 15-20 percent.

The report highlights that the key barriers to women's advancement to leadership roles are the lack of role models, undervaluing of women's work, internalised biases, and the absence of a convincing cultural narrative around gender equality and diversity. As per Mehta, the barriers are multifold. “One is the stereotype that questions whether women are actually effective and are good leaders. Then, there are prevailing norms, behaviours and assumptions that are negative biases against women’s leadership, which are not easy to break away from. Last, diversity in an organisation is not given too much heed as it is falsely assumed that it doesn’t help the bottomline or pay for better business for an organisation.”   

Mehta believes that the conditioning of women also has much to do with their representation in the top leadership positions in the healthcare sector. For example, for many women in India, as per Mehta, limitations are hardwired into their aspirations. They are told their goal should be to become a nurse, and they aren’t being given the opportunity to aspire to be the leader and the manager of a hospital, or the CEO.  “We have conditioned women to believe more in their limitations, and that is one of the biggest barriers.” 

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The study recommends holistic interventions and has identified enablers to address deeply ingrained beliefs and challenges faced by women in healthcare leadership, which can be implemented at both organisational and policy levels. Some of the solutions include facilitating women's retention through measures like re-entry options after career breaks, providing flexible work policies, and prioritising women's representation in historically male-dominated roles.  

According to Mehta, apart from these measures, it is also important to ensure that there are support systems in terms of institutional efforts or collective efforts including advocacy and networking for women. “This fight is not an individual fight for which the burden needs to be only on the woman to say that she needs to fight all odds and survive. Women are working hard to get educated and breaking barriers. But we need to recognise this is an issue for our country to solve as a whole. It's a challenge of the family, the community, the society, the organisation. What we are not realising is, movement on gender equality is a silver bullet that will benefit us all.”