Institutional Patriarchy, Gender Barriers, and Nigeria's Oral Health Workforce.

Abstract

Gender and sexual identity-based inequities remain entrenched within Nigeria's oral health workforce yet remain underexplored in both policy and academic literature. This study explored gender-based disparities and the representation of sexual and gender minority individuals in Africa's oral health workforce, using reanalysis of Nigerian academic interviews and a rapid review of African literature. An inductive analysis of transcripts from in-depth interviews with 54 medical and dental academic researchers in Nigeria was conducted. The analysis explored themes related to gender equity, inclusion, and institutional culture within the oral health workforce. A complementary rapid review was also conducted to assess the representation and roles of sexual and gender minority individuals in oral health care systems across Africa. The findings revealed systemic inequities rooted in patriarchal leadership structures, gendered work-life expectations, limited mentorship, and institutional policies that perpetuate exclusion, particularly for women. While male participants often perceived gender parity as achieved, female respondents reported persistent cultural and institutional barriers. The study also highlights a critical gap: no data or narratives concerning sexual and gender minority individuals within African oral health systems were identified, underscoring their systemic erasure. The study highlights the need for structural transformation to promote gender and sexual diversity within Africa's oral health workforce. It calls for gender-responsive institutional reforms, inclusive policy development, and legal safeguards that address discrimination against marginalized identities, including the urgent need to make visible the experiences of sexual and gender minority individuals within this workforce. A gender-transformative and intersectional approach is essential for achieving equity, fostering representation, and strengthening the resilience of Africa's oral health systems.