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Journey amidst Challenges

Women in Indian healthcare workforce and leadership roles have to take on their journey amidst continuing challenges

By: Dr. Vanita Arora

In a country with around 34 births registered every minute, the healthcare force to serve this ever-growing population has never been competitive with other countries. The role of women in all domains of healthcare from leadership roles to being nurses is vital for the healthcare delivery system of modern India to shoulder the constant population growth the country is witnessing. Women from colonial times did not enjoy much liberty in the field of medicine, and traditionally as well, if one goes back in history, rarely does a woman medical practitioner come to mind.

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A research done on women has shown 37% professional women step down from their position voluntarily to fulfil their family duties. The list of bias is long and women are seen as the weaker gender with less ability to be ruthlessly progressive

Women in workforce and leadership roles

Human psyche and evolutionary temperament is such that where there are challenges and limitations, there are those who would break through. And women across the world are famous for possessing the same temperament.
In the past 71 years of Independence, defying all odds, women have not only occupied but claimed their space in Indian health workforce, in various capacities. With over 7.38 lakh females working in the healthcare industry, 38% of all healthcare workers are women. Women dominate the nursing domain, with over 83% of nurses being females.
There have been women inspirational figures, perhaps lesser known to common Indian citizens, who broke all barriers to become a health leader in their own right. From pre-Independence times, Anandibai Joshi and Kadambini Ganguly were the first women Indian doctors obtaining qualification in Western medicine. While crossing over to Independent India from colonial times, Dr. Padmavati Sivaramakrishna Iyer is famous for being the God of Cardiology in India. Past the age of 100 years, she is still active in the field of medicine. Numerous other women such as Manjula Anagani, an Indian gynaecologist and an obstetrician working with underserved and orphan children; Neelam Kler, a pioneer in neonatology; as well as Ketayun Ardeshir Dinshaw, who led the evolution of cancer care in India; have made it to the top of their respective fields.
Healthcare facilities are increasingly led by women doctors and medical practitioners who have dawned the mantle of efficient administrators. Women are also now enjoying the roles of Editors in leading academic journal publications and also conceptualising many such publications from the scratch.
However, despite making in-roads in the medical field and spearheading health revolution in India, women participation is marred with challenges if one looks a little deeply.

Women in workforce: reality check

As one goes up the ranks, which require more financial and time investment, one may find lesser ratio of women participation in healthcare. Of all the female workers, around 17% are doctors. India has only 16.8% women allopathic doctors, while rest being men. There also exists a huge gap between male health worker density against female health worker density per lakh person, with the former being 124.8, the latter is only 76.4. While southern states like Kerala and north-eastern ones like Meghalaya have the highest share of female health workers of around 64%, states with lower literacy rates such as Uttar Pradesh and Bihar has a dismal 19.9% and 22.3% respectively.
The huge investment of time, energy, and money in a patriarchal society as that of India with deeper religious and cultural limitations restrict women to realise their full potential in a demanding field as that of medicine.

The MBBS housewives

At the time of Independence, there were only 20 medical colleges admitting about 1500 students. Today, there are some 350 colleges admitting 45,000 students. In 1886, the first female doctor graduated, and in the last 125 years, Indian women started to outnumber males in the field of medicine. India, in the past 5 years, has produced more than 4,500 more female doctors than males. In India, women comprised 51% of the students joining medical colleges, occupying 23,522 seats in 2014-15 compared with 22,934 seats allocated to men. However, the number of female students pursuing medical studies and the number of them practicing is not the same. The gap between doctors under processing and doctors serving starts from the postgraduate level.
In India, the words "settled in life" is directly associated with marriage. Unfortunately, in a country with abundance of human resources that can be used for overall development of the nation, families still find it suitable to marry their daughters off. Educational qualification is an attribute that increases her marriage worthiness. Giving up career for family is a gender stereotype. Women are expected to be good wives and mothers first rather than being career-oriented good successful professionals. This has been a socially acceptable lifestyle choice for women since ages.
A research done on women has shown 37% professional women step down from their position voluntarily to fulfil their family duties. The list of bias is long and women are seen as the weaker gender with less ability to be ruthlessly progressive.

Greater possibilities for women

Social revolution is a slow process; changing mindset is not going to happen overnight. As India will disassociate itself with the ideology of an "ideal women" and their duties, government must create conducive conditions for the women to thrive shoulder to shoulder with men.
Mindset has a great role to play behind women, despite having equal calibre of men, lagging behind. Discrimination starting from family to workplace has clipped their wings to fly high. While the government policies vouch for women empowerment, society has always seen women as subordinate to men.
Designing a women friendly work culture policy where equality is served. Meanwhile, encouraging female medical students to pursue post-graduation through incentive will be a good way to push them.
Government policies, family support and determination on a personal level will unleash a new horizon for female doctors to serve India better.


About the author

Dr. Vanita Arora is Associate Director & Head, Cardiac Electrophysiology Lab and Arrhythmia Services, Max Super Speciality Hospital, Saket. Dr. Arora is a leading and the first woman cardiac electrophysiologist in India, having dedicated her life to spread awareness on the various matters of heart related to her field of expertise. In a career spanning about two decades, she has to her credit more than 900 Radiofrequency Ablations, 1000 Permanent Pacemaker Implantations, around 400 Biventricular Pacemaker Implantations and 40 3D Mapping Radiofrequency Ablation of the Complex Arrhythmias.