Women at the last mile: How investments in gender equality have kept health systems running during COVID-19

Even before COVID-19, investments in health systems—and especially female health workers—were too low. In 2019 the world had a gap of 18 million health workers. Two years and fifteen million deaths later, we have at least 26 million fewer health workers than we need. , This leaves us severely underprepared for future pandemics and other major shocks to the health system, including conflict and climate change. We must invest in health systems that don’t just meet the needs of today, but that are also resilient in the face of future shocks.

Pandemic preparedness requires gender equality: equal recognition, support, and fair pay for ALL health workers. Globally, 70% of health workers are women, but half of their work is unpaid. We must do more to support these health workers. The glimmers of success in COVID-19 built on previous investments in women health workers, their skills, and equality in health systems. Pre-existing investments in equality helped systems respond to COVID-19. Increased investments will build better resilience for the crises that come next.

This report highlights case studies and lessons learned from 20 countries during COVID-19. The evidence shows that we must invest in gender equality in health systems to prepare for and respond to the next pandemic. Health worker training is not enough. Focusing only on health workers working within the formal health system is not enough. We need to work for equality.