Strengthening Legal Frameworks for Women’s Leadership in Health

Despite women making up 67% of the global healthcare workforce, their representation in leadership remains dismally low. Our second feature paper, launched as part of a broader five paper Collection in the BMJ, explores how legal frameworks in India and Kenya are shaping—or hindering—women’s progression into leadership roles in the health sector.

In both India and Kenya, women dominate frontline healthcare roles, yet men overwhelmingly hold senior leadership positions. Our research reveals significant gaps in the legal systems of both countries, particularly in areas critical for women’s career advancement, such as care, family life, and work-life balance.

Building on World Bank’s Women, Business and Law framework and using the “Law Cube” approach, Mireille Evagora-Campbell and Global Health 50/50 colleagues assess the comprehensiveness, accountability, and equity of existing laws. The findings are stark: while India has 12 out of 26 possible good practice provisions in place, and Kenya 19 out of 30, both countries show significant deficiencies in key areas. Notably, laws related to reproductive rights and pay protections are either missing or inadequate, particularly in Kenya.

Accountability is another major concern. In India, 19 out of 27 laws include accountability mechanisms, but in Kenya, only four out of 11 do. Without robust systems to ensure laws are effectively implemented and monitored, these legal provisions risk becoming mere words on paper.

The paper argues that these legislative gaps contribute to the underrepresentation of women in leadership roles within the health sector. Simply increasing women’s participation in formal employment isn’t enough; there must be a focus on addressing systemic inequalities, such as the unequal burden of unpaid domestic labour.

To achieve true gender equality in the health sector, stronger legal frameworks are essential. These frameworks must include robust measures for accountability, equity, and human rights. Governments must commit to regular independent reviews and adhere to international human rights standards to drive real change.

We invite you to explore the full study in BMJ Global Health and explore how these insights can be applied to your work. Together, we can strengthen the legal foundations that ensure women have fair opportunities to lead in the healthcare sector.

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