The COVID-19 pandemic has generated a global conversation about gender equality and pandemic leadership. Organisations such as UN Women, Women in Global Health and Global Health 50/50 have advocated for greater representation of women in leadership, noting that despite women making up over 70% of healthcare workers, they made up only 24% of COVID-19 task force members. These conversations have been successful in gaining high-profile recognition of the need for greater gender parity in leadership, with the WHO and Women in Global Health coauthoring a report on Closing the Leadership Gap in global health. These discussions have primarily focused on global and national level leadership, as opposed to the health systems leadership directly involved in crisis management. Here, we add this microlevel perspective to these discussions, exploring how women healthcare workers providing direct care perceived and experienced healthcare leadership and crisis management during the COVID-19 pandemic.
More caring forms of leadership might be fostered by replacing, or supplementing, the dominant military traditions and language around crisis response with traditions and language that reflect an ethics of care and caring forms of leadership. This would require commitment from institutions and leaders to incorporate such language into preparedness plans and communications strategies. Concepts, such as Gilligan’s central tenants of the ethics of care (non-violent conflict resolutions, contextual and narrative understandings, the activity of care and networks of relationships and responsibilities) might also be incorporated into crisis management training.
The experiences of women healthcare workers provide several further practical suggestions on how crisis management and leadership might adapt to be more inclusive, empowering and effective. First, pandemic preparedness can include developing systems for consultation that facilitate dynamic communication between front-line providers and decision-makers when crisis occur. Importantly, this requires that the experiences of those at the front-line be valued alongside the expertise of decision-makers. While physical distancing can complicate consultation—as demonstrated during COVID-19 and as is likely in other infectious disease events—the pandemic has also seen a rapid uptake of virtual technologies that can be used to facilitate consultation. Second, addressing the structures that benefit some leaders at the expense of others during a crisis requires action across policy sectors. For example, in BC the lack of childcare that corresponded to shift work disadvantaged women leaders. Accessible, onsite, 24-hour childcare could help rectify this inequity.
Smith J, Purewal S (2023) Towards more caring and consultative crisis management: perspectives and experiences from women healthcare workers during the COVID-19 pandemic, BMJ Leader 2023;7:1-5.