Barriers and facilitators to women's leadership in health in Argentina and Nigeria: survey findings.

Abstract

Introduction: Women represent a significant proportion of the healthcare workforce in low- and middleincome countries (LMICs); however, their participation in leadership positions remains disproportionately low. Our objective was to examine the perceived barriers and facilitators to leadership among women in LMICs.

Materials and methods: Cross-sectional study using a distributed online survey with open-ended questions. Purposive sampling was used to recruit women aged =18 years who held leadership positions in the health sector in LMICs. The responses were analysed using an inductive thematic content analysis approach using ATLAS.ti software.

Results: Sixty-two women in leadership positions in the health sector responded to the survey: 31 were from Argentina, and 31 from Nigeria. The most common barriers to reaching leadership positions included challenges in interpersonal management, professional development, and work-life balance. Others were managing limited resources, staff conflicts, and experiences of gender discrimination. Participants identified conflict resolution, promoting equity, and empowering team members as key leadership responsibilities. Reported facilitators included leadership training, coaching, inclusive organisational cultures, and institutional support as key factors in counteracting persistent gender barriers.

Conclusion: Women in health leadership positions in LMICs face barriers at individual, organisational, and structural levels that go beyond personal capabilities and reflect persistent inequities. The survey data highlight the importance of adopting systemic, forward-looking leadership approaches to advance gender equity in health leadership.