Towards gender parity: An analysis of leadership management teams in Tanzania's health sector.

Abstract

Women constitute the majority of the health workforce globally and in Tanzania, yet remain underrepresented in leadership roles, particularly at higher levels. Despite national commitments to gender equality and various supportive policies, analysis of gender representation in health sector leadership in Tanzania is limited. This study presents the analysis of gender representation in leadership across three healthcare levels of Tanzania's health system, Regional Health Management Teams (RHMTs), Council Health Management Teams (CHMTs), and Health Facility Management Teams (HFMTs). This study used secondary data collected by a government ministry in 2022 from 20 out of 26 regions of mainland Tanzania, representing over two-thirds of the country's regions. The analysis examined 9,120 leadership positions. Descriptive statistics were done using Excel. Results show that while gender representation is nearing parity overall for less powerful roles, notable disparities remain based on role and level of seniority. The highest proportion of women is found in HFMTs at 48.9%, followed by a decline at the CHMTs level to 41.5%, and further to 39.5% in the RHMTs. This trend is similarly evident in leadership roles such as Medical Officers In-Charge, where women represent 29.8% at the HFMT level, but their presence drops to 17.6% among District Medical Officers and just 11.1% among Regional Medical Officers. Gender representation also varies geographically and by facility type, with lower-level facilities generally showing more equitable gender distributions. The findings reflect the ongoing need for gender-transformative leadership strategies, including targeted mentorship, equitable promotion practices, and inclusive workplace cultures.