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How to advance health equity in the digital age

December 12, 2018 by Skye Gilbert

Female laboratory technician logging information in to a computer in the regional hospital laboratory in Thies, Senegal- 23898.jpg

Digitally empowered women are in a unique position to hold the global community accountable for including women in the digital domain. PATH/Gabe Bienczycki

Start by building gender diverse teams.

In global health, we talk a lot about innovations that empower women and girls—and we should. Thanks to many of them, the world is tilting, however slowly, toward a future of health parity between women and men, girls and boys.

Unfortunately, many innovations still don’t reach women and girls. This is especially true in the digital health domain. For example, in the GSMA 2018 report on the gender gap in mobile phone ownership and use, they found that women are 10 percent less likely than men to own a mobile phone in low- and middle-income countries. What’s more, among phone owners, women are also less likely to use the Internet—and the gap is wide. In South Asia, women are 70 percent less likely than men to use the Internet.

If the health systems of the future deliver lifesaving information or medical interventions on digital platforms, billions of women could be excluded—and we risk widening inequities even as we improve the lives of those who have digital access.

This is a complex and formidable challenge. How do we drive health equity through digital innovation? How do we diagnose and treat the root causes of inequitable access to ensure all women have the agency to be as digitally connected as they want to be? How can we ensure that the growing number of digital innovations in health reach the people who stand to benefit?

Microbiology staff, TB diagnostics. Blue Peter Public Health and Research Center, Hyderabad, in the state of Andhra Pradesh, India- 08185_hr.jpg

Building diverse teams allows PATH to face issues of inequitable access without excluding the voices of those we are trying to reach. PATH/Gabe Bienczycki

Across global health and many other sectors, the benefits of gender equity aren’t yet fully realized—meaning less impact, a more limited talent pool, and innovations that don’t always take women into account. It’s for these reasons that PATH’s CEO Steve Davis wrote about the need for better representation of women in leadership positions in global public health.

Our sector is making progress, but there is a lot more we can do. A recent report from Global Health 50/50 highlighted a frustrating statistic: Women account for three-quarters of the global health workforce, but hold less than a fifth of leadership positions. But this wild imbalance isn’t unique to global health. The Women in the Workplace 2018 report, which studies corporate America, determined that only about 20 percent of senior leaders in business are women (for women of color, it drops to 4 percent).

At PATH, our response is to build an appropriately diverse team. We need to reveal our blind spots and biases to inform our strategies. That means we need people with diverse backgrounds and complementary skill sets at the table—and, crucially, we need more women leading the discussion.

So, I am taking this opportunity to share three practices that PATH’s digital health team has adopted to accelerate gender diversity in our work—with the hope that our experience prompts others to evaluate their own progress toward equity in the workplace.

A woman, Marie-Reine Rutagwera, Malaria Surveillance Specialist for MACEPA, and a man, Monde Mathews, Environmental Health Officer for Gwembe district, reviewing malaria surveillance data on a laptop computer-17717.jpg

Marie-Reine Rutagwera, Malaria Surveillance Specialist for Malaria Control and Elimination Partnership in Africa (MACEPA), and Monde Mathews, Environmental Health Officer for Gwembe district, reviewing malaria surveillance data. PATH/Gabe Bienczycki

Number 1: Make women leaders visible

Male allies like my manager and PATH’s CEO promote me as an alternate in conferences and publications—three this year alone. In turn, I promote emerging leaders on my team—both men and women—as my alternates whenever I can. We support each other this way out of mutual respect and trust, but also—we’re learning—because it helps us attract talented people who appreciate our diverse perspectives.

Our willingness to delegate attendance at high-profile events and feature emerging leaders, many of whom are women, builds our reputation in the digital health community as a place where women can grow their careers. Painting a clear career progression and demonstrating a willingness to build a woman’s brand as a leader isn’t easy in the nonprofit space—career progression is often contingent on volatile funding streams and not everyone wants to step back to let an emerging leader shine, but we’ve found huge benefit in doing both. We recruit top-quality candidates who generate higher-quality work, which in turn enables our portfolio to grow and allows our staff to achieve their career goals.

A man and a woman sit side by side at a desk and look at a laptop.

Women account for three-quarters of the global health workforce, but hold less than a fifth of leadership positions, according to Global Health 50/50. Photo: PATH.

Number 2: Showcase women's unique value to the organization

Digitally empowered women are in a unique position to hold the global community accountable for including women in the digital domain. We are better able to access, listen to, and understand women who are digitally invisible, and we can help the global community navigate whether that invisibility is a conscious choice or one that’s out of their control.

Women can also leverage personal experiences with discrimination to generate plausible hypotheses for gender differences in data. For example, a colleague of mine who manages health workforce data came to me with what he perceived as a paradox. Female supply chain officers were, on average, better than men at managing inventory (e.g., more stock counting, less wastage). However, their stockout rates were higher. In addition, the career progression of many of the women in the organization stalled, resulting in less than 10 percent of women in management positions. For me, this wasn’t a paradox. My hypothesis was simply that the majority-male managers responded quicker to orders placed by male officers. And this gave my colleague a new direction for his analysis.

These are just some of the many ways women can add value in global digital health. But the benefits of recognizing and supporting women’s value within organizations cuts across sectors, disciplines, and geographies.

A group of people look at maps on the wall.

Including women in the digital domain is critical for understanding those who are digitally invisible as well as revealing blind spots and bias. Photo: PATH

Number 3: Discuss the risks of double standards

Last year, Harvard Business Review published an article examining Sweden’s venture capital market. The authors were trying to understand why so few women received investment capital despite a third of Swedish businesses being owned by women.

The authors found some striking differences in how males and females were perceived. The venture capitalists were significantly more likely to call men “young and promising” whereas for women, they were more likely to say “young and inexperienced.” Men were “aggressive, but a really good entrepreneur” while women were “enthusiastic, but weak.”

As a young female leader, when I’m put in a leadership role, I may be perceived as having less experience or less value than my male counterparts. This carries risks that aren’t to be taken lightly. It could mean I am less likely to secure project funding or that I am not included in a major decision. And yet, if no one puts women forward, nothing will change.

But I also acknowledge that there are times when the stakes are too high, and having a male ally leading today unlocks opportunities for tomorrow’s female leaders. Part of this journey is knowing what trade-offs to make in pursuit of the long-term goal of equity.

Building toward a more equitable future

Biases and blind spots rooted in gender can have a dramatic impact on innovation in any sector.

A recent profile in Wired of Dr. Fei-Fei Li, a leader in the field of artificial intelligence, reminds us that technology is, after all, built by people. Even the best innovators leave their fingerprints on what they build and why they build it. As Li says, “bias in, bias out.”

But through intentional gender equity and diversity we can avoid the pitfalls and limitations that come with bias. Nowhere is this more important than in the work to serve the world’s most vulnerable people. We must try even harder to account for gender in our work, how that work happens, and who leads it.

The author would like to acknowledge the work of Dr. Rebecca Chaleff and Ms. Martina Welkhoff in the development of this article.

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