The study emphasised that even in associations focused on women’s health, men continue to dominate in leadership roles.
Published Aug 14, 2024 | 8:00 AM ⚊ Updated Aug 14, 2024 | 9:40 AM
Women constitute a significant portion of the healthcare workforce, often representing the majority of healthcare providers. However, an Indian study has found that they remain underrepresented in leadership and decision-making roles within the industry.
The study, titled “Examining Representation of Women in Leadership of Professional Medical Associations in India,” published in the journal PLOS Global Public Health, reveals significant gender disparities in the leadership of professional medical associations (PMAs) in India.
PMAs play a critical role in shaping healthcare policies, medical education, and professional standards, making gender representation in their leadership essential for equitable decision-making.
Only 9 out of 46 PMAs (19.5 percent) are currently led by women. Additionally, half of the leadership committees in these associations have less than 20 percent women, and nine PMAs have no women in their central committees.
Among past presidents, less than 20 percent of leadership roles were occupied by women in the 31 associations with available data. Specifically, in the Indian Medical Association (IMA)—the largest doctors’ body in the country—only 4.6 percent of the current presidents and secretaries across its 32 sub-chapters are women.
The study also highlights that even in associations closely related to women’s health, such as obstetrics and gynaecology, paediatrics, and neonatology, unequal representation persists, emphasising male dominance.
“These results demonstrate significant gender disparities in PMA leadership in India, necessitating urgent efforts to promote gender equality. Gender-transformative leadership is crucial to developing gender-sensitive healthcare policies and practices, which can serve as a catalyst for broader societal change,” said the authors of the study.
The primary objective of the study was to evaluate the representation of women in leadership roles across various Professional Medical Associations (PMAs) in India. Specifically, the study aimed to identify the proportion of women holding key leadership positions such as presidents, vice-presidents, secretaries, and committee members.
Additionally, the study explored the historical representation of women in leadership roles within these associations and identified the gaps that persist over time.
The study employed a cross-sectional design, collecting data from 46 PMAs across India. These PMAs were diverse, representing various specialties and subspecialties within medicine. The researchers collected data on the current leadership structure of these PMAs, focusing on the gender of individuals occupying key leadership positions.
Historical data on past presidents were also gathered from 31 associations where this information was available. This historical analysis provided insights into trends in women’s representation over time. According to the study, in India, women constitute 29% of allopathic doctors and 80% of nurses, yet they occupy only around 28% of leadership roles across national health organisations.
“In recent times, the number of women enrolling in medical education has consistently been equal to or higher than that of men, yet the number of women in leadership positions in the health sector remains disproportionately low,” the authors noted.
The study analysed a total of 46 Indian PMAs, representing a mix of general, medical, and surgical specialties, as well as super-specialties.
PMAs have a long history in India, with the Indian Medical Association (IMA) being the oldest at 95 years and the Indian Society of Sports and Exercise Medicine as the youngest at just 4 years. Of the 46 PMAs studied, 24 have been in existence for more than 50 years, with the average age of the included PMAs being 49 years.
“This gender disparity profoundly influences the development, implementation, and allocation of health policies and programs, impacting their equitable distribution among populations. Beyond its impacts on health policy, the lack of gender representation has major implications for systemic discrimination and marginalisation of women within the health workforce,” the authors concluded.
Out of the 46 Professional Medical Associations (PMAs) studied, only 9 (19.5%) are led by women.
“These include the Indian Society of Aerospace Medicine, Anatomical Society of India, Association of Clinical Biochemists of India, Indian Association of Dermatologists, Venereologists, and Leprologists, Indian Association of Medical Microbiology, Indian Association of Pathologists and Microbiologists, Indian Association of Palliative Care, Association of Physiologists of India, and Association of Otolaryngologists of India. None of the PMAs representing the selected super-specialties (surgical or medical) were led by a woman,” the study reported.
The study also found that the composition of leadership committees was predominantly male. Half of the leadership committees within these associations have less than 20 percent women members, and nine PMAs have no women in their central committees at all.
Among the 31 associations that provided historical data, less than 20 percent of past presidents were women, highlighting the long-standing male dominance in PMA leadership. The study emphasised that even in associations focused on women’s health, such as obstetrics and gynaecology, men continue to dominate leadership roles.
“The National Neonatology Forum has only one woman in its leadership committee, and in FOGSI’s 73-year history, only 15% of past presidents were women, underscoring the issue of men occupying leadership positions in fields closely related to women and children’s health. This is not to suggest that leadership in these areas should be exclusively female; rather, we advocate for better gender representation to align leadership with the organisation’s membership and to foster more inclusive, equity-driven decision-making, leveraging the contributions of women leaders in these fields. Current trends in gynaecology indicate that the majority of practising physicians are women,” the study found.
The study also examined leadership representation within various medical specialities. It found that specialities such as obstetrics and gynaecology, which are directly related to women’s health, also have limited female representation in leadership. This is particularly concerning given the importance of female perspectives in these fields.
The Indian Medical Association (IMA), established in 1928 before the country’s independence, boasts a long-standing history as the largest voluntary organisation of modern medicine doctors in India. Its leadership is determined through an election process that appoints leaders for one or two years.
However, the study highlights that the representation of women in leadership roles within the IMA remains negligible. The association is currently led by a man, and of the 18 members of the current governing body, only one is a woman, accounting for just 5.5% representation. “Further, out of the 92 individuals who have served as presidents since its inception, only one was a woman,” the study noted.
The study also pointed out that of the 64 individuals currently serving as presidents and secretaries of the 32 state sub-chapters of the IMA, only three are women. Specifically, the Haryana state chapter has women in both president and secretary positions, while Goa has a woman as secretary. “All the remaining 61 positions are occupied by men. Moreover, as per the IMA website, they have a Women Doctor’s Wing, which exists nationally and at the state chapter level to ‘look after the interests of women doctors,’ but the details are not publicly available, and their role in organisational governance is unclear,” the study added.
“The IMA is the oldest, largest, and most prominent PMA in India, with a history of influencing health policies in the country. The systematic exclusion of women from such associations restricts their voice and excludes their unique perspectives and experiences from the decision-making process,” the study emphasised.
It further stated that the lack of diverse representation could lead to an unbalanced agenda that may not adequately address the health and care needs of women or sufficiently consider gender-specific issues when advocating for or collaborating on particular health policies and programs.
“Moreover, despite the process of electing leadership committees by the members themselves, gender representation continues to remain dismal,” the study pointed out.
The study concluded that having women-only chapters within associations is insufficient to address this issue effectively. Despite their presence in the IMA, only 5.5 percent of its leadership board comprises women.
“This signifies the need to go beyond mere inclusion and implement a gender-transformative leadership approach by including affirmative action policies and initiatives that promote equal opportunities for women and other genders in the medical profession. Strategies such as setting targets and quotas, mentorship programs, and leadership training can foster sensitivity and inclusion, leading to diverse representation in leadership positions,” the study suggested.
The study highlighted that the underrepresentation of women in leadership roles is closely linked to prevalent gender stereotypes, discrimination, and the unconscious favouring of men in decision-making and leadership positions.
“Social and cultural expectations related to parental responsibilities and caregiving—such as the pressure to prioritise family responsibilities over career advancement, limited support for work-life balance, and societal norms that undervalue women’s professional contributions—significantly contribute to the barriers women face in advancing their careers and pursuing leadership opportunities,” the study noted.
The study emphasised that advocating for women’s representation in leadership should not become a mere checkbox activity, as it is only the tip of the iceberg.
“PMAs must adopt an intersectional approach to diversity and inclusion, considering not just gender but also socioeconomic status, the inclusion of marginalised and minority groups, geographic diversity, and more. Wider societal changes are also needed to promote equitable policies, recognizing that achieving more equitable leadership is just one piece of the broader puzzle,” the study concluded.
(Edited by Rosamma Thomas)
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