Gender Pay Disparity in Healthcare

Source: Frontline
GS I: Role of women, women’s organisations, population and social empowerment; GS II: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources; GS III: Indian Economy and issues relating to planning, mobilization of resources, growth, development and employment

Originally Published : 27 May 2024
Last updated on          : July 2026
Update Note                 : The article has been updated following recent developments reported in July 2026. Link provided Above
What’s New                  : Updated facts and analysis, along with additional infographics for easier understanding.

Overview

1. News in Brief
2. How it helps

Why in the News?

A recent discussion on women’s health and healthcare inequality in India has highlighted how gender discrimination operates not only in access to healthcare but also within the healthcare workforce itself.

News in Brief

• Healthcare is one of the most feminised sectors of employment globally.
• Women are highly represented in nursing, midwifery, community healthcare and caregiving but remain underrepresented in many senior clinical and managerial positions.
• A joint WHO-ILO analysis found a substantial global gender pay gap in the health and care sector.
• The gap reflects not only differences in salaries for similar work but also occupational segregation, motherhood penalties, unequal care responsibilities and lower valuation of female-dominated jobs.
• In India, the issue is especially relevant to nurses, ASHA workers, Anganwadi workers and other frontline care workers.
• Reducing gender-based disparities is essential for Universal Health Coverage, women’s economic empowerment and a stronger health workforce.

What is Gender Pay Disparity?

• Gender pay disparity refers to the difference between the earnings of women and men in the labour market.
• It is broader than a situation in which a woman and a man receive different salaries for exactly the same job.
• A gender pay gap may arise because women and men are:
  • Concentrated in different occupations,
  • Employed at different levels of seniority,
  • Provided unequal opportunities for promotion,
  • Working under different contractual arrangements,
  • Affected differently by caregiving responsibilities, or
  • Rewarded differently despite similar qualifications and responsibilities.

Therefore, the gender pay gap reflects both direct wage discrimination and wider structural inequalities in employment

Gender Pay Disparity in the Healthcare Sector

• Women form the majority of the global health and care workforce.
• But female-dominated occupations frequently receive lower remuneration and weaker employment protection.
• The WHO-ILO global analysis found that women working in health and care earn around 20% less than men on a raw basis.
• After considering factors such as age, education and working time, the estimated gap was around 24 percentage points.
• Importantly, a large portion of this disparity remained unexplained by conventional labour-market characteristics, suggesting that structural inequalities and discrimination may play an important role.

These are global figures, not an India-specific estimate. India needs stronger occupation-wise and gender-disaggregated wage data for its health workforce.

Why is the Healthcare Sector Important for Gender Equality?

• Healthcare generates employment across a wide spectrum, including Doctors, Nurses, Midwives, Pharmacists, Laboratory technicians, Hospital administrators, and public-health professionals
• Because women are strongly represented in the sector, improving wages and working conditions can directly contribute to women’s economic empowerment.
• At the same time, poor remuneration in female-dominated healthcare occupations can reproduce gender inequality across generations..

Causes of Gender Pay Disparity in Healthcare

Occupational Segregation

• Women and men are often concentrated in different parts of the healthcare workforce.
• Women are heavily represented in: Nursing, Midwifery, Community health work, Home-based care, Support services.
• Men may be more strongly represented in certain higher-paying medical specialties, managerial positions and senior decision-making roles.
• This is called horizontal occupational segregation.
• Even within the same profession, women may be less represented at senior levels, producing vertical segregation.
• As a result, the average earnings of women remain lower even when women constitute a majority of the workforce.

Undervaluation of Care Work

• Caregiving has traditionally been associated with women and has often been treated as an extension of domestic responsibilities rather than skilled economic activity.
• WHO has warned that the undervaluation of health and care work is closely connected with social attitudes towards caregiving and reproductive labour.
• The problem is therefore not simply how many women work in healthcare, but how society values the work they perform.

Motherhood Penalty

• Women often experience career interruptions associated with:
  • Pregnancy
  • Childbirth
  • Childcare
  • Elderly care
  • Household responsibilities
• These interruptions can reduce:
  • Work experience
  • Promotion opportunities
  • Earnings growth
  • Professional networking
  • Access to senior positions
• The WHO-ILO analysis also identified evidence of a motherhood gap within the health and care workforce.
• Healthcare professionals may face particular challenges because the sector involves long shifts, night duties and unpredictable working hours.

Unequal Burden of Unpaid Care Work

• Women perform a disproportionate share of unpaid domestic and caregiving work.
• Globally, women undertake approximately 76% of unpaid care activities.
• A woman working in a hospital may therefore complete a full professional shift and still carry most household and caregiving responsibilities at home.
• This creates a double burden, affecting women’s ability to:
  • Work overtime,
  • undertake advanced training,
  • accept transfers,
  • pursue demanding specialisations,
  • take leadership positions.

Leadership Gap

• Women may be well represented among healthcare workers but less visible at the highest levels of:
  • Hospital management
  • Medical institutions
  • Professional organisations
  • Academic medicine
  • Health policymaking
• Fewer women at decision-making levels may also result in workplace policies that inadequately address childcare, maternity support, workplace safety and career progression.

Informal and Contractual Employment

• Many healthcare and care workers are engaged through contractual, incentive-based or informal arrangements.
• Such workers may lack:
  • Regular salaries
  • Social security
  • Paid leave
  • Pension benefits
  • Job security
  • Career progression
• Women are particularly affected because many frontline and community care roles are female-dominated.

Why Addressing the Gap Matters for India

• Reducing gender disparities in healthcare supports multiple national goals.
• It can contribute to:
  • Universal Health Coverage
  • Higher female labour-force participation
  • Better healthcare-worker retention
  • Women’s economic empowerment
  • SDG 3: Good Health and Well-being
  • SDG 5: Gender Equality
  • SDG 8: Decent Work and Economic Growth
  • Reduced socioeconomic inequality

WHO argues that gender-equitable investment in the care economy can simultaneously strengthen healthcare systems and promote inclusive economic growth.

Major Challenges

India faces several obstacles in reducing gender-based disparities in healthcare:

• Lack of detailed gender-disaggregated wage data
• Contractualisation of frontline healthcare jobs
• Inadequate valuation of community care work
• Unequal domestic responsibilities
• Workplace harassment and safety concerns
• Career breaks associated with motherhood
• Lack of childcare support
• Underrepresentation of women in leadership
• Rural and urban disparities in employment opportunities

These factors often interact rather than operate independently.

Key Takeaways

UPSC Mains Practice Question
Women form an important part of the healthcare workforce, yet gender-based disparities in remuneration and career progression persist. Examine the structural causes of gender pay disparity in healthcare and suggest measures to address them.

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