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Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Research

Exploring the opportunities and challenges of female health leaders in three regional states of Ethiopia: a phenomenological study

Authors: Sualiha Abdulkader Muktar, Binyam Fekadu Desta, Heran Demissie Damte, Wubishet Kebede Heyi, Elias Mamo Gurmamo, Melkamu Getu Abebe, Mestawot Getachew Mesele, Mesele Damte Argaw

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

Gender equity involves fairness in all aspects of life for women and men and is usually determined by social, political, economic, and cultural contexts. The proportion of female leaders in healthcare within the health sector is low. The aim of this study was to explore and describe the experiences, opportunities, and challenges faced by women in their path towards becoming leaders within the health sector.

Methods

This study was conducted using the phenomenological method of qualitative inquiry. The approach was chosen for its merits to narratively explore and describe the lived stories and shared experiences of women leaders in the healthcare system. A purposive sampling technique was used to identify six women leaders. Semi-structured interviews were conducted through telephone by the investigators. The qualitative data analysis was conducted parallel with data collection, using steps of thematic analysis.

Results

This study identified individual, societal, and organizational level opportunities and challenges that had an influence on the career paths of female health leaders in Ethiopia. The leadership positions were an opportunity in the career development of women who had long-term goals, were known for their empathy, and exercised wise use of resources. In addition, women who had the support of close family members and their peers are more likely to compete and rise to leadership positions. Furthermore, women who received organizational support in the form of affirmative action, training, development, and recognition also tended to rise to leadership positions. However, women who assumed leadership positions but whose day-to-day decision-making was influenced by their supervisors, those who had experienced sexual harassment, and those under the influence of societal norms were less likely to attain leadership positions.

Conclusion

The opinions and experiences of female health leaders revealed that individual behaiour whileassumming a leadership positon, empathy, and wise resource management positivey influence their career development. In addition, female health workers who had support form close family members and peers strived for growth to leadership positions. Furthermore, the presence of organizational support, in the form of affirmative actions, and succession planning were another opportunity for females in their career paths. Conversely, some social norms were found to deter female health workers from advanicing to leadership positions. Therefore, enhancing the leadership capacity of women and improving social and organizational support is recommended. In addition, addressing the low level of self-image among women and patriarchal societal norms at the community level is recommended.
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Literature
1.
go back to reference Boniol M, McIsaac M, Xu L, Wuliji T, Diallo K, Campbell J. Gender equity in the health workforce: analysis of 104 countries: World Health Organization; 2019. Boniol M, McIsaac M, Xu L, Wuliji T, Diallo K, Campbell J. Gender equity in the health workforce: analysis of 104 countries: World Health Organization; 2019.
2.
go back to reference Langer A, Meleis A, Knaul FM, Atun R, Aran M, Arreola-Ornelas H, et al. Women and health: the key for sustainable development. Lancet. 2015;386(9999):1165–210.CrossRef Langer A, Meleis A, Knaul FM, Atun R, Aran M, Arreola-Ornelas H, et al. Women and health: the key for sustainable development. Lancet. 2015;386(9999):1165–210.CrossRef
3.
go back to reference World Health Organization. Delivered by women, led by men: a gender and equity analysis of the global health and social workforce. Geneva: WHO; 2019. World Health Organization. Delivered by women, led by men: a gender and equity analysis of the global health and social workforce. Geneva: WHO; 2019.
4.
go back to reference McDonagh KJ, Bobrowski P, Hoss MA, Paris NM, Schulte M. The leadership gap: ensuring effective healthcare leadership requires inclusion of women at the top. Open J Leadership. 2014;3(2):20–9. McDonagh KJ, Bobrowski P, Hoss MA, Paris NM, Schulte M. The leadership gap: ensuring effective healthcare leadership requires inclusion of women at the top. Open J Leadership. 2014;3(2):20–9.
5.
go back to reference Chisholm-Burns MA, Spivey CA, Hagemann T, Josephson MA. Women in leadership and the bewildering glass ceiling. Am J Health Syst Pharm. 2017;74(5):312–24.CrossRef Chisholm-Burns MA, Spivey CA, Hagemann T, Josephson MA. Women in leadership and the bewildering glass ceiling. Am J Health Syst Pharm. 2017;74(5):312–24.CrossRef
6.
go back to reference Batson A, Gupta GR, Barry M. More women must Lead in Global Health: a focus on strategies to empower women leaders and advance gender equality. Annals of Glob Health. 2021;87(1):67:1–4. Batson A, Gupta GR, Barry M. More women must Lead in Global Health: a focus on strategies to empower women leaders and advance gender equality. Annals of Glob Health. 2021;87(1):67:1–4.
7.
go back to reference Cassells R, Duncan AS. Gender equity insights 2019: breaking through the glass ceilingBankwest Curtin Economics Centre (BCEC), Curtin Business School; 2019. Cassells R, Duncan AS. Gender equity insights 2019: breaking through the glass ceilingBankwest Curtin Economics Centre (BCEC), Curtin Business School; 2019.
8.
go back to reference World Health Organization. Everybody's business--strengthening health systems to improve health outcomes: WHO's framework for action. Geneva: WHO; 2007. World Health Organization. Everybody's business--strengthening health systems to improve health outcomes: WHO's framework for action. Geneva: WHO; 2007.
9.
go back to reference Shung-King M, Gilson L, Mbachu C, Molyneux S, Muraya KW, Uguru N, et al. Leadership experiences and practices of south African health managers: what is the influence of gender?-a qualitative, exploratory study. Int J Equity Health. 2018;17(1):1–2.CrossRef Shung-King M, Gilson L, Mbachu C, Molyneux S, Muraya KW, Uguru N, et al. Leadership experiences and practices of south African health managers: what is the influence of gender?-a qualitative, exploratory study. Int J Equity Health. 2018;17(1):1–2.CrossRef
10.
go back to reference Javadi D, Vega J, Etienne C, Wandira S, Doyle Y, Nishtar S. Women who lead: successes and challenges of five health leaders. Health Syst Reform. 2016;2(3):229–40.CrossRef Javadi D, Vega J, Etienne C, Wandira S, Doyle Y, Nishtar S. Women who lead: successes and challenges of five health leaders. Health Syst Reform. 2016;2(3):229–40.CrossRef
11.
go back to reference Bismark M, Morris J, Thomas L, Loh E, Phelps G, Dickinson H. Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia. BMJ Open. 2015;5(11):e009384.CrossRef Bismark M, Morris J, Thomas L, Loh E, Phelps G, Dickinson H. Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia. BMJ Open. 2015;5(11):e009384.CrossRef
12.
go back to reference Bayeh E. The role of empowering women and achieving gender equality to the sustainable development of Ethiopia. Pac Sci Rev B: Human Soc Sci. 2016;2(1):37–42. Bayeh E. The role of empowering women and achieving gender equality to the sustainable development of Ethiopia. Pac Sci Rev B: Human Soc Sci. 2016;2(1):37–42.
13.
go back to reference Kalaitzi S, Czabanowska K, Fowler-Davis S, Brand H. Women leadership barriers in healthcare, academia and business. Equal Divers Inclusion. 2017;36(5):457–74. Kalaitzi S, Czabanowska K, Fowler-Davis S, Brand H. Women leadership barriers in healthcare, academia and business. Equal Divers Inclusion. 2017;36(5):457–74.
14.
go back to reference ALobaid AM, Gosling CM, Khasawneh E, McKenna L, Williams B. Challenges faced by female healthcare professionals in the workforce: a scoping review. J Multidiscip Healthc. 2020;13:681.CrossRef ALobaid AM, Gosling CM, Khasawneh E, McKenna L, Williams B. Challenges faced by female healthcare professionals in the workforce: a scoping review. J Multidiscip Healthc. 2020;13:681.CrossRef
15.
go back to reference Adisa TA, Mordi C, Mordi T. The challenges and realities of work-family balance among Nigerian female doctors and nurses. Econ Insights-Trends Challenges. 2014;66(3):23–37. Adisa TA, Mordi C, Mordi T. The challenges and realities of work-family balance among Nigerian female doctors and nurses. Econ Insights-Trends Challenges. 2014;66(3):23–37.
16.
go back to reference Farahat FM. Challenges facing female physicians in Egypt. Arch Environ Occup Health. 2009;64(2):121–8.CrossRef Farahat FM. Challenges facing female physicians in Egypt. Arch Environ Occup Health. 2009;64(2):121–8.CrossRef
17.
go back to reference Teede HJ. Advancing women in medical leadership. Med J Aust. 2019;211(9):392–4.CrossRef Teede HJ. Advancing women in medical leadership. Med J Aust. 2019;211(9):392–4.CrossRef
18.
go back to reference Newman CJ, Stilwell B, Rick S, Peterson KM. Investing in the power of nurse leadership: what will it take? IntraHealth internationalNursing Now, Johnson & Johnson; 2019. Newman CJ, Stilwell B, Rick S, Peterson KM. Investing in the power of nurse leadership: what will it take? IntraHealth internationalNursing Now, Johnson & Johnson; 2019.
19.
go back to reference Akhtar M. Female and gender leadership: under representation of female leaders; 2008. Akhtar M. Female and gender leadership: under representation of female leaders; 2008.
20.
go back to reference Vong S, Ros B, Morgan R, Theobald S. Why are fewer women rising to the top? A life history gender analysis of Cambodia’s health workforce. BMC Health Serv Res. 2019;19(1):1–9.CrossRef Vong S, Ros B, Morgan R, Theobald S. Why are fewer women rising to the top? A life history gender analysis of Cambodia’s health workforce. BMC Health Serv Res. 2019;19(1):1–9.CrossRef
21.
go back to reference Tlaiss HA. Women in healthcare: barriers and enablers from a developing country perspective. Int J Health Policy Manag. 2013;1(1):23.CrossRef Tlaiss HA. Women in healthcare: barriers and enablers from a developing country perspective. Int J Health Policy Manag. 2013;1(1):23.CrossRef
22.
go back to reference Mousa M, Boyle J, Skouteris H, Mullins AK, Currie G, Riach K, et al. Advancing women in healthcare leadership: a systematic review and meta-synthesis of multi-sector evidence on organisational interventions. EClinicalMedicine. 2021;39:101084.CrossRef Mousa M, Boyle J, Skouteris H, Mullins AK, Currie G, Riach K, et al. Advancing women in healthcare leadership: a systematic review and meta-synthesis of multi-sector evidence on organisational interventions. EClinicalMedicine. 2021;39:101084.CrossRef
23.
go back to reference Moustakas C. Phenomenological research methods: Sage publications; 1994. Moustakas C. Phenomenological research methods: Sage publications; 1994.
24.
go back to reference Morrow R, Rodriguez A, King N. Colaizzi’s descriptive phenomenological method. Psychologist. 2015;28(8):643–4. Morrow R, Rodriguez A, King N. Colaizzi’s descriptive phenomenological method. Psychologist. 2015;28(8):643–4.
25.
go back to reference Groenewald T. A phenomenological research design illustrated. Int J Qual Methods. 2004;3(1):42–55.CrossRef Groenewald T. A phenomenological research design illustrated. Int J Qual Methods. 2004;3(1):42–55.CrossRef
26.
go back to reference Ethiopian Ministry of Health (MOH). Health sector transformation plan 2015/16-2019/20Ministry of Health Addis Ababa Ethiopia; 2015. Ethiopian Ministry of Health (MOH). Health sector transformation plan 2015/16-2019/20Ministry of Health Addis Ababa Ethiopia; 2015.
27.
go back to reference Boyd CO. Phenomenology the method. In: Munhall PL, editor. Nursing research: a qualitative perspective, vol. 3; 2001. p. 93–122. Boyd CO. Phenomenology the method. In: Munhall PL, editor. Nursing research: a qualitative perspective, vol. 3; 2001. p. 93–122.
28.
go back to reference Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006;27(2):237–46.CrossRef Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006;27(2):237–46.CrossRef
29.
go back to reference Tolley EE, Ulin PR, Mack N, Robinson ET, Succop SM. Qualitative methods in public health: a field guide for applied research: Wiley; 2016. Tolley EE, Ulin PR, Mack N, Robinson ET, Succop SM. Qualitative methods in public health: a field guide for applied research: Wiley; 2016.
30.
go back to reference Guba EG, Lincoln YS. Fourth generation evaluation: Sage Publications, Inc.; 1989. Guba EG, Lincoln YS. Fourth generation evaluation: Sage Publications, Inc.; 1989.
31.
go back to reference Korstjens I, Moser A. Series: practical guidance to qualitative research. Part 4: trustworthiness and publishing. Eur J Gen Pract. 2018;24(1):120–4.CrossRef Korstjens I, Moser A. Series: practical guidance to qualitative research. Part 4: trustworthiness and publishing. Eur J Gen Pract. 2018;24(1):120–4.CrossRef
33.
go back to reference Spears LC. Character and servant leadership: ten characteristics of effective, caring leaders. J Virtues Leadership. 2010;1(1):25–30. Spears LC. Character and servant leadership: ten characteristics of effective, caring leaders. J Virtues Leadership. 2010;1(1):25–30.
34.
go back to reference Jyoti J, Dev M. The impact of transformational leadership on employee creativity: the role of learning orientation. J Asia Bus Stud. 2015;9(1):78–98. Jyoti J, Dev M. The impact of transformational leadership on employee creativity: the role of learning orientation. J Asia Bus Stud. 2015;9(1):78–98.
35.
go back to reference Folke O, Rickne J, Tanaka S, Tateishi Y. Sexual harassment of women leaders. Daedalus. 2020;149(1):180–97.CrossRef Folke O, Rickne J, Tanaka S, Tateishi Y. Sexual harassment of women leaders. Daedalus. 2020;149(1):180–97.CrossRef
36.
go back to reference Bahiru B, Mengistu AB. The challenges of women leaders of business organizations in Addis Ababa, Ethiopia, in balancing work-family responsibilities. J Int Women's Stud. 2018;19(2):140–58. Bahiru B, Mengistu AB. The challenges of women leaders of business organizations in Addis Ababa, Ethiopia, in balancing work-family responsibilities. J Int Women's Stud. 2018;19(2):140–58.
37.
go back to reference Ely RJ, Ibarra H, Kolb DM. Taking gender into account: theory and design for women's leadership development programs. Acad Manag Learn Educ. 2011;10(3):474–93.CrossRef Ely RJ, Ibarra H, Kolb DM. Taking gender into account: theory and design for women's leadership development programs. Acad Manag Learn Educ. 2011;10(3):474–93.CrossRef
38.
go back to reference Argaw MD, Desta BF, Muktar SA, Tewfik N, Tefera BB, Abera WS, et al. Effectiveness of leadership, management, and governance competencies for performance improvements at primary health care entities in Ethiopia: a before and after study. J Human Resour Sustain Stud. 2021;9(2):250–75. Argaw MD, Desta BF, Muktar SA, Tewfik N, Tefera BB, Abera WS, et al. Effectiveness of leadership, management, and governance competencies for performance improvements at primary health care entities in Ethiopia: a before and after study. J Human Resour Sustain Stud. 2021;9(2):250–75.
39.
go back to reference Argaw MD, Desta BF, Muktar SA, et al. Comparison of maternal and child health service performances following a leadership, management, and governance intervention in Ethiopia: a propensity score matched analysis. BMC Health Serv Res. 2021;21:862.CrossRef Argaw MD, Desta BF, Muktar SA, et al. Comparison of maternal and child health service performances following a leadership, management, and governance intervention in Ethiopia: a propensity score matched analysis. BMC Health Serv Res. 2021;21:862.CrossRef
40.
go back to reference Desta BF, Abitew A, Beshir IA, Argaw MD, Abdlkader S. Leadership, governance, and management for improving district capacity and performance: the case of USAID transform: primary health care. BMC Fam Pract. 2020;21(1):252.CrossRef Desta BF, Abitew A, Beshir IA, Argaw MD, Abdlkader S. Leadership, governance, and management for improving district capacity and performance: the case of USAID transform: primary health care. BMC Fam Pract. 2020;21(1):252.CrossRef
41.
go back to reference Kuhlmann E, Ovseiko PV, Kurmeyer C, Gutiérrez-Lobos K, Steinböck S, von Knorring M, et al. Closing the gender leadership gap: a multi-Centre cross-country comparison of women in management and leadership in academic health centres in the European Union. Hum Resour Health. 2017;15(1):1–7.CrossRef Kuhlmann E, Ovseiko PV, Kurmeyer C, Gutiérrez-Lobos K, Steinböck S, von Knorring M, et al. Closing the gender leadership gap: a multi-Centre cross-country comparison of women in management and leadership in academic health centres in the European Union. Hum Resour Health. 2017;15(1):1–7.CrossRef
43.
go back to reference Dea M. The prospectus, challenges and causes of gender disparity and its implication for Ethiopia's development: qualitative inquiry. J Educ Pract. 2016;7(4):24–37. Dea M. The prospectus, challenges and causes of gender disparity and its implication for Ethiopia's development: qualitative inquiry. J Educ Pract. 2016;7(4):24–37.
44.
go back to reference Eriksson T, Smith N, Smith V. Gender stereotyping and self-stereotyping attitudes: a large field study of managers; 2017. Discussion Paper Series. Germany Eriksson T, Smith N, Smith V. Gender stereotyping and self-stereotyping attitudes: a large field study of managers; 2017. Discussion Paper Series. Germany
Metadata
Title
Exploring the opportunities and challenges of female health leaders in three regional states of Ethiopia: a phenomenological study
Authors
Sualiha Abdulkader Muktar
Binyam Fekadu Desta
Heran Demissie Damte
Wubishet Kebede Heyi
Elias Mamo Gurmamo
Melkamu Getu Abebe
Mestawot Getachew Mesele
Mesele Damte Argaw
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-13871-w

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