6
Training and Careers
Improving women’s health requires integrating sex and gender into R&D education and engaging stakeholders. Supporting women’s participation and leadership boosts inclusive research and innovations. Addressing structural inequities in STEMM through harmonized education, training, and policy interventions can strengthen the workforce and advance women’s health outcomes.
Improving women’s health requires an understanding of sex and gender influences on health among those developing, implementing, and monitoring innovation—including researchers, programmers, regulators, and more.
Although the scientific community increasingly recognizes that sex, gender, and their interactions affect health outcomes across most conditions, education programs across health and R&D professions have not systematically incorporated considerations of sex and gender. This deficit constrains researchers’ understanding of and ability to apply sex and gender considerations in patient care, research design, and product development. Integrating sex- and gender considerations into training and curricula at all stages of the learner continuum—and eventually into patient care—requires engaging sex and gender researchers, curriculum developers, leadership, faculty, and learners in developing materials through an inclusive approach.
Beyond strengthening education, support is needed to better enable women’s contributions to R&D. Women’s participation and leadership in R&D-related fields and across the broad biomedical workforce can enhance scientific discovery, and women have historically driven the design and development of innovations that address their health needs, yielding better interventions and improved outcomes. In fact, an analysis of over 1.5 million research papers found a strong positive correlation between women authors and the likelihood of a study including sex and gender analysis—highlighting that support for women’s career development and advancement within R&D fields enables more women-inclusive research and innovation. Another study found that all-female inventor teams are 35 percent more likely than all-male teams to patent women’s health products in the US, suggesting that the gender gap among inventors has resulted in thousands of missing female-focused interventions over the past few decades.
Societal and structural inequities have historically hindered women’s full participation and advancement in their careers.
Women in science, technology, engineering, mathematics, and medicine (STEMM) face persistent challenges, including entrenched bias against women in leadership, sexism, sexual harassment, microaggressions, and unequal promotion rates. Despite a growing proportion of women researchers, women publish fewer papers, are less likely to collaborate internationally, are less likely to be credited with authorship or receive a patent, and hold fewer endowed faculty positions than men. Gender pay inequities are unexplained by factors like seniority, career breaks, and part-time work. Such inequities stem from factors like organizational constraints and culture, the differential impacts of career and family demands, and bias in hiring, promotion, publishing, salary, and funding. For example, women scientists in East Africa face higher burdens of unpaid work and gender-based violence compared to their men colleagues, which affects their individual mental and physical health. Together, these inequities impact women’s well-being and lead to attrition, further reducing workforce diversity.
By supporting harmonized interventions across education, training, and policy, as set out in the opportunities below, stakeholders can strengthen the workforce required to advance innovation that improves women’s health.
Overview Training and Careers
6.1 Resources to educate R&D workforce on sex/gender
Awareness of the impacts of sex and gender on health and disease is limited, partially stemming from limited consideration of these factors in published research. The limited data to support a broader discussion of sex and gender influences on health has led to a lack of emphasis on these topics in health education. In addition, some clinicians and researchers mistakenly believe that sex and gender impacts only matter in reproductive health and assume that education in obstetrics and gynecology covers the topic sufficiently. Even when educators recognize the need to teach the broader impacts of sex and gender, they face challenges like limited faculty resources and development opportunities. Educators also raise concerns on insufficient time in curricula to add additional material on sex and gender, missing the opportunity to weave in sex and gender into existing curricula. Embedding this information into existing curricula can help learners across R&D and healthcare professions to understand that sex and gender are determinants of health across all areas, not separate considerations for certain conditions. Driving change in this area will require engaging faculty, learners, and leaders using both “bottom-up” and a “top-down” approaches.
Progress Assessment
Progress made against Opportunities, from the 2024 Progress Report
Status Moderate Progress
0 % Achievement
Solution Strategies
-
Create new—or amplify existing—educational content that addresses women’s health from a sex and gender perspective that can be adapted and tailored to all healthcare and R&D-related fields and evolve over time.
- Create dynamic materials and instructor guides with links to online resources (videos, exercises, etc.) so that instructors can readily adapt and use the materials for their teaching purposes (including identifying where new faculty or courses are needed). Resources should be updated regularly and readily available to both faculty and learners.
- Equip learners to interrogate the impacts of sex and gender on health topics, especially if these are not included in lectures or other learning materials. With the right resources, learners can help to effect needed change in curricula.
-
Integrate sex- and gender-informed educational content into curricula and training across all healthcare and R&D-related fields and across the continuum of learners and develop metrics to track integration.
- Develop a dissemination and uptake strategy for sex- and gender-informed educational content. Sensitize faculty and educators on the importance of understanding and teaching about sex and gender influences on health and disease, and ensure they are aware of and utilize the developed teaching materials.
- Identify groups and associations engaged in sex and gender research and education or those involved with developing curricula to identify potential areas of collaboration.
-
Identify existing research agendas to which women’s health research can be added and integrate new information into curricular materials.
6.2 Integrating sex/gender into education and training
Sex and gender are infrequently included in health education or training at any level due to a variety of factors, including a lack of awareness that sex and gender differences exist, time constraints in existing curricula, and insufficient teaching or faculty development resources. While students and faculty can advocate for the inclusion of this material, greater integration of sex and gender ultimately requires in the commitment and support of decision-makers within educational institutions to allocate the necessary resources and ensure its incorporation. In addition, the likelihood of integration of sex and gender differences into curricula increases when regional and national accrediting organizations require it. Healthcare professional schools are held to accreditation standards, changes to which have prompted the inclusion of other topics in curricula, but no accreditation standards currently address sex and gender differences.
Progress Assessment
Progress made against Opportunities, from the 2024 Progress Report
Status Unchanged Progress
0 % Achievement
Solution Strategies
-
Develop an advocacy toolkit for the integration of women’s health and sex and gender considerations into education and training.
- The toolkit should be free, open source, hosted on a user-friendly source platform, translated into core languages, and ready to be adapted to different settings.
- It should be developed by a multistakeholder group (including academia, accrediting bodies, government, community, etc.) and funded by a collaboration of the private and public sectors.
- The stakeholder group should develop metrics to track the integration of this content in curricula, and these metrics should be included in the toolkit.
-
Implement the toolkit in educational institutions for studying and teaching sex- and gender-based health through a multi-pronged dissemination strategy convening education and institutional policymakers and communities of practice.
- The dissemination and training strategy should include incentives for adapting the tools to different professional sectors, including through accrediting bodies, to underscore its importance. The strategy should address government officials, academic/research institutions, civil society organizations, and NGOs (e.g., UN Women).
-
Measure impact and ensure sustainability of the toolkit by developing an impact measurement strategy, developing incentives for continuing use of the toolkit, and providing guidance for endowments of faculty positions dedicated to sex and gender-based health and acknowledgment of educators who include sex and gender considerations in their teaching materials.
6.3 Barriers and enablers of women’s R&D careers
Structural inequities and challenges have long constrained women’s career participation, progression, and leadership in healthcare and R&D fields and institutions. These inequities affect women worldwide, particularly those from underrepresented backgrounds and those in LMICs. Despite constituting 70 percent of the health workforce globally, delivering healthcare to 5 billion people, and contributing approximately US$3 trillion to global health each year—half in the form of unpaid work—women occupy only 25 percent of health leadership roles. Developing and supporting more women in the R&D workforce (and engaging more men in sex- and gender-based research) are necessary to increase the production of research that is beneficial to women or women’s health.
Progress Assessment
Progress made against Opportunities, from the 2024 Progress Report
Status Moderate Progress
0 % Achievement
Solution Strategies
-
Identify and analyze initiatives and policies that have successfully enabled women’s career participation, progression, and leadership, including what processes and solutions have worked well for them.
- Case studies can be developed of successful networking, mentorship, and sponsorship initiatives, as well as other initiatives that support and encourage women’s participation and career growth at all stages of their careers. Initiatives may span different levels, including organizational, regional, national, and international.
- Success can be measured with metrics like representation of women in leadership positions or satisfaction and well-being of women.
-
Promote a baseline standard for re-entry and family leave policies across countries.
-
Launch campaigns to challenge the traditional division of labor and change stereotypical gender roles that expect girls and women to take on household or family caring responsibilities while sacrificing their training and careers.
6.4 Safeguards for women’s rights
A substantial contributor to women’s inability to fully participate and advance through career fields of their choice is the lack— or poor implementation of— policies to promote gender equity in education and the workplace. Indeed, women enjoy only 77 percent of the legal rights that men do worldwide, and gender equity policies vary considerably across geographic regions. For example, only 20 percent of countries require employers to provide paid breaks and facilities for breastfeeding or expressing milk, and more than half a billion working women worldwide do not have essential maternity protections safeguarded by national law. Policy and regulation are critical instruments that countries can use to close gender gaps in education and industries so that the world does not miss out on the potential women have to offer.
Progress Assessment
Progress made against Opportunities, from the 2024 Progress Report
Status Set-backs Progress
0 % Achievement
Solution Strategies
-
Develop benchmarking standards for laws and regulations that safeguard opportunities for women to pursue STEMM, R&D, and entrepreneurship careers and leadership positions. Develop an inventory with a scorecard of laws and regulations across individual countries to inform the benchmarking.
-
Create new laws supportive of women’s career advancement that are aligned and enforced at national, state, local, institutional, and organizational levels (e.g., following the example of US Title IX), based on gaps identified in the inventorying of laws and regulations.
- In complement, stakeholders should increase public awareness of existing laws, such as laws protecting women from workplace discrimination, determine accountability activities (e.g., enabling environments, safeguarding measures, platforms for reporting), and train individuals on related policies and issues to nurture leaders at all levels, including men, women and girls, gatekeepers, and influencers.
-
Develop milestones and timelines for implementation (e.g., “By 2030, there should be X women in X leadership positions who receive the support needed to succeed and thrive in these positions.”).
6.5 Men’s allyship
Men traditionally hold more power than women in R&D and healthcare settings. Therefore, they are critical partners in dismantling privilege, expanding career opportunities for women, and broadening these fields’ understanding of sex and gender influences. To foster equitable professional environments that empower women to thrive and make full use of their skills, men must understand the effects of implicit and explicit bias, recognize systemic privilege, and be well-versed in practical steps they can take to support women and other underrepresented groups.
Progress Assessment
Progress made against Opportunities, from the 2024 Progress Report
Status Unchanged Progress
0 % Achievement
Solution Strategies
-
Increase the number of men allies by assessing currently available programs around the globe and adapting successful ones to new settings (e.g., The Ohio State University Advocates & Allies for Equity program)
- Develop training and incentives to enable stakeholders at all levels to participate. Organizations can institutionalize required training and provide incentives (e.g., educational grants, prizes, etc.).
-
Programs should be adapted to specific cultural contexts in different countries, engaging grassroots organizations for support.
