Driving Change: Women in Policy and the Path to Equitable Healthcare

Santushti Tyagi

Background: Women as Leaders

Women in leadership roles, research, and policymaking spaces play a pivotal role in revolutionizing India’s economic, social, and political prosperity. The realization of equal participation of women and men in political and public decision-making leads to better and more efficient policymaking through the redefinition of political priorities and the placement of new issues on the political agenda (Ministry of Statistics and Program Implementation, n.d.). India has come a long way since independence, from Sucheta Kriplani singing our national song at the independence session in the Constituent Assembly to witnessing leading women figures across various sectors, chief ministers, presidents, and even a prime minister. But women’s representation in leadership roles still continues to be abysmal.

If we tend to compare the gaps between the opportunity and representation of men and women in different spheres like education, employment, legal rights, etc., political leadership is the area where it has been the least. Comparing the representation of women in the first cabinet of independent India to their leadership in the year 2025, after seventy-five years of independence, there has not been a remarkable success at the top-tier representation. Despite increasing participation at the local level, there continues to be a huge gap as we move up the political ladder at top-level governance and policy making.

Another facet to this issue is demonstrated by the fact that in India, the Ministry of Health and Women and Child Development has been led by women cabinet ministers who demonstrate gender equality through their positions at the highest level. However, the majority of representatives in these ministries remain male despite female leadership in the Ministry of Health and Women and Child Development. The gap shows that women’s leadership exists in particular domains yet fails to extend to equally important policy-making positions.

The 73rd and 74th Amendment Acts, passed by P.V. Narsimha Rao in 1992, were a significant step towards increasing women’s representation at the local government level. Today, India’s local-level representation of women is among the highest in the world, but it remains behind in the top echelon (Fig. 1 & 1.1).

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(Fig & 1.1)

There is an urgent need to understand and advance women’s leadership in India, primarily in the healthcare sector. This article aims to evaluate the critical role of women in driving equitable healthcare for all. The beneficiaries include women, marginalized communities, and healthcare systems globally.

Functioning: Advancing Women’s Leadership in the Healthcare Sector

A gender-equal democracy requires greater political participation of women (STATUS OF WOMEN IN INDIA, 2022, 14). Participation, more than just a ‘token gesture’ or women’s participation being ‘only for show,’ is the need of the current system. Building truly gender-equal democracies requires more than just adding women to the mix. (Brechenmacher, 2020). The health sector, being one of the most important players in the socio-economic progress of a developing nation like ours, needs more inclusivity and gender equity to ensure efficiency in progress towards the Sustainable Development Goals as well as the Viksit Bharat Agenda @2047.

Problems of gender equity occur in health leadership around the world. Women make up over 75% of the health workforce in most countries, especially as a proportion of the allied health workforce and lower-status health occupations. However, the percentage of women health workers declines moving up the hierarchy and pay grade of the workforce, with disproportionately more men filling managerial and leadership positions (Addressing Leadership Competency Gaps and Gender Disparities in India’s Medical Workforce: A Call to Action, 2023, 1). Women are often considered better leaders, more altruistic, and more considerate about women’s issues in general. Therefore, their role in the policymaking space at top-tier decision-making continues to be pivotal.

A study in India, conducted after the 1993 amendment that created randomization across villages in assigning female leaders as heads of village councils, showed that women leaders tended to invest more in initiatives linked to women’s concerns, such as water and sanitation (Health Systems & Reform, 2016, 230). The critical role that women play in addressing and shaping healthcare policies can be well understood by the noticeable progress made at local levels when issues like water, sanitation, cooking fuel, stoves, dowry, sale of liquor, etc., that men often tend to overlook but women brought into focus (First Post, 2024) (Fig. 2).

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(Fig. 2)

The reason to be advocating for more women at the top tier of administration, primarily in the healthcare sector, is (Fig. 2.1):

  • More women leaders lead to better accessibility among beneficiaries.
  • It leads to equity in the sector.
  • Maximizes the value of the female workforce
  • Helps in incorporating subtleties of our social fabric into policies
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(Fig. 2.1)

Challenges and barriers in women’s health leadership are as follows (Fig 2.3):

  • Lack of mentors for guidance, primarily female mentors
  • Patriarchal Culture and Sexism at the Workplace
  • Family Responsibilities
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(Fig. 2.3)

Performance: Leadership roles and persistent challenges Data Analysis

Despite nearly 43% of STEM graduates in India being women, they occupy only 14% of these jobs, highlighting a significant gap between education and workforce representation (Forbes India, 2021). This reflects systemic challenges that hinder women’s advancement in STEM fields (Fig. 3.1).

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(Fig. 3.1)

Twenty-three National Health Committees were identified between 1923 and 2020 with available reports. There were Twenty-five chairpersons and 316 members. All except three chairpersons were men. Among members, only 11% were women (Aggarwal et al., 2024, 1) (Fig. 3.2).

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(Fig. 3.2)

In India, 77.8% of legal frameworks promoting gender equality are in place, which indirectly supports women’s participation in policymaking (World Health Organization, 2025) (Fig. 3.3).

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(Fig 3.3)

Women policymakers have contributed to reducing maternal mortality rates from 167 deaths per 100,000 live births in 2011-13 to 113 in 2016-18 (Socio Health, 2024) (Fig. 3.4).

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(Fig. 3.4)

Impact: Consequences of better representation of women at top-tier health sector leadership

Increasing women’s representation in the healthcare sector helps uncover untapped potential and bring diverse ideas and visions to implementation. Bashing the taboos of ‘Pradhan Pati,’ often noticed in rural local bodies, and the ‘instrumentalism’ seen during the initial politics of the country, there have been efforts to let women rise up the ladder and take charge. More representation of women in healthcare sector jobs and policymaking roles has been a priority for various organizations, improving results and contributing to better overall health of the population.

At CIPACA, the nursing teams for each ICU comprise 2-3 doctors and 8-10 nurses, with 95% of the nursing staff being women. Women also hold critical management and administrative positions, with 3 out of 4 regional team leaders being women (Cipaca Paves Way for Women-Led Healthcare With Equitable Policies).

Tackling issues like gender-based discrimination at the workplace can improve women’s leadership and foster an environment of women-led policymaking.

Way Forward: Breaking the cycle of ‘token representation’ (Fig. 4)

  • Strengthening representation of women and advocating for leadership roles across STEM fields to have professionals and learned representatives in the top-tier healthcare sector can help revolutionize the path to equitable healthcare.
  • Cross-sector collaboration and partnerships across local levels, NGOs, and even globally can help access new ideas and technologies and gain support in achieving faster and more equitable healthcare leadership.
  • Introducing legislative reforms and laws that mandate women’s representation in healthcare policy formulation and governance.
  • Capacity building and stakeholder collaboration among experienced leaders and emerging professionals in the industry.
  • Monitor and evaluate policies and existing frameworks regularly to ensure sustained impact.
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(Fig. 4)

References

About the Contributors

Santushti Tyagi is a final year undergraduate at the University of Delhi and a Public Policy Qualitative Action Research Fellow-Cohort 5.0 at IMPRI.

Acknowledgements

The author extends sincere gratitude to Impact and Policy Research Institute India team for reviewing the article and for providing the opportunity to write the article.

Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.

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