Strengthening Accountability Systems for Women’s Leadership in the Health Sector

The health sector, despite some progress, remains a landscape where gender equality in leadership is far from realised. One powerful, yet often overlooked, tool to drive change is accountability. Our latest paper, launched as part of a broader five paper Collection in the BMJ, delves into how strengthening systems of accountability can pave the way for greater equality of opportunity for women in leadership roles within the health sector.

Adopting a human rights-based approach, we argue that true accountability hinges on two key pillars: first, a responsible entity that ensures transparent, public reporting on performance progress; and second, an independent body that rigorously monitors and evaluates this progress. Without these, commitments towards gender equality risk being little more than rhetoric.

In this paper, Prof Kent Buse our Co-Founder and Co-CEO, reviews existing gender and health accountability mechanisms at both global and organisational levels, drawing on examples from India and Kenya. The findings are clear—these mechanisms are often fragmented and lack the robustness needed to drive real change. Too many remain voluntary and weak, failing to enforce equality of opportunity in leadership roles across the health sector.

For advocates of women’s rights and leadership in the health workforce, this paper highlights the untapped potential of robust accountability systems. By focusing on this, combined with advocacy efforts, we can make significant strides towards achieving true gender equality in health leadership.

“The paper by Kent Buse and colleagues cuts through much of the rhetoric surrounding the career progression for women in the health care and other sectors and goes straight through to the essence: that of accountability. Not only is the paper conceptually creative, it puts forward what is rarely articulated: well thought out mechanisms of accountability are not only doable but will certainly lead to strengthening equality of opportunity.”

– Ritu Dewan, Professor & Director (R) Mumbai School of Economics & Public Policy, University of Mumbai.

We invite you to read the full paper in the BMJ and explore how these insights can be applied to your own work to improve gender equality. Let’s work together to strengthen the systems that will turn commitments into reality and ensure that women’s leadership in the health sector is not just an aspiration, but a norm.

Read the full paper on the BMJ Website as part of our newly launched Collection on Gender Equality in the Health Workforce.