Exploring Women Healthcare Leaders' Perceptions on Barriers to Leadership in Greek Context

Saudi Women's Views on Healthcare Leadership in the Era of Saudi 2030 Health Transformation

Introduction

Saudi Vision 2030 emphasizes women's empowerment and their increased participation in the workforce, particularly in healthcare. This study explores perceptions of Saudi women healthcare practitioners in leadership roles across various healthcare settings.

Methods

A national cross-sectional online survey was conducted, guided by the Leadership Effectiveness Model. It assessed the perceptions of Saudi women health practitioners in leadership positions within the country's healthcare context. Survey questions were adapted from validated surveys. Women classified as "Consultants" by the Saudi Commission for Health Specialties were invited to participate. Descriptive statistics and content analysis were used for analysis. A total of 119 Saudi women consultants participated.

Discussion

Most were physicians (85%) in the Western region (46%) and reported being in leadership roles. Leadership positively impacted their career growth but negatively affected leisure activities. Career progression challenges included further studies (35%) and work-life balance (31%). Leadership commitment to supporting women was seen as crucial (63%). Analysis of responses to Vision 2030 yielded themes like "advancement", "opportunities", and "empowerment". Saudi Vision 2030, combined with evolving organizational cultures and policies, is creating opportunities for women to excel in leadership roles.

Conclusion

National strategies, combined with workplace norm changes and supportive policies, can foster greater representation of qualified women in elite healthcare leadership positions.

Depression is associated with worse health-related quality of life, lower physical activity levels, and inadequate sleep quality in a Greek elderly population

The present study is a cross-sectional study that aimed to investigate the potential associations between depression status, health-related quality of life, physical activity levels and sleep quality in a representative Greek elderly population. Three thousand four hundred five (3405) men and women over 65 years old from 14 different Greek regions were enrolled. Geriatric Depression Scale (GDS) was used to assess depression status, Health-Related Quality of Life (HRQOL) was evaluated using Short Form Health Survey, physical activity levels were assessed via the International Physical Activity Questionnaire (IPAQ) and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A high prevalence of depression and an increased incidence of poor quality of life, low physical activity levels and inadequate sleep quality among the elderly population were recorded. Depression status was independently associated with worse quality of life, poor physical activity, inadequate sleep quality, female gender, BMI and living alone after adjustment for potential confounding factors. Elderly age, low muscle mass, educational and financial status were also identified as indicators of depression; however, their impact on depression status was considerably attenuated after adjusting for confounding factors. In conclusion, depression was associated with worse health-related quality of life, poor physical activity and inadequate sleep quality in a Greek elderly population. Future randomized control trials should be performed to confirm the findings of this cross-sectional study.

Gender Inequalities in Citations of Articles Published in High-Impact General Medical Journals: a Cross-Sectional Study

BACKGROUND

Besides the number of publications, the number of citations is another key metric often used to compare researchers with each other. While women researchers tend to have fewer publications than their men colleagues, the data is scarce for the number of citations. We aimed to determine whether there is a gender gap in citations.

METHODS

We used Web of Science to retrieve the number of citations per year for all research articles and reviews published between January 2015 and December 2019 in fourteen high-impact general medical journals (impact factor > 5). We used Gender API to identify the gender of the first/last authors. We compared the results by gender using multivariable negative binomial regressions (adjusting for intra-cluster correlations within journals).

RESULTS

The gender of the first/last author was determined for 13,218/13,350 (99%) and 11,894/12,026 (99%) articles, respectively. The proportion of women among first/last authors was 40% and 29%, respectively. The median number of citations per year was 5 (IQR = 11.3) for women and 6.8 (IQR = 17.8) for men for first authors (IRR = 1.5 [95% CI = 1.3-1.8], p value < 0.001), and 6 (IQR = 12.4) and 7.5 (IQR = 17.4) for last authors (IRR = 1.3 [95% CI = 1.2-1.5], p value < 0.001). Articles whose first and last authors were women were the least cited and those whose first and last authors were men were the most cited.

CONCLUSION

In this cross-sectional study, we found that articles authored by women were cited less often than those authored by men. Further studies are needed to explore the reasons for these gender differences in article citations.

Using a Modified Delphi Approach and Nominal Group Technique for Organisational Priority Setting of Evidence-Based Interventions That Advance Women in Healthcare Leadership

BACKGROUND

Few studies address how to prioritise organisational interventions that advance women in leadership. We report on the relevance, feasibility and importance of evidence-based interventions for a large healthcare organisation. This study supports the first stage of implementation in a large National Health and Medical Research Council funded initiative seeking to advance women in healthcare leadership.

METHODS

An expert multi-disciplinary panel comprised of health professionals and leaders from a large healthcare network in Australia participated. The initial Delphi survey was administered online and results were presented in a Nominal Group Technique workshop. Here, the group made sense of the survey results, then evaluated findings against a framework on implementation criteria. Two further consensus surveys were conducted during the workshop.

RESULTS

Five priority areas were identified. These included: 1. A committed and supportive leadership team; 2. Improved governance structures; 3. Mentoring opportunities; 4. Leadership training and development; and 5. Flexibility in working. We describe the overall priority setting process in the context of our findings.

CONCLUSIONS

With evidence and expert input, we established priorities for advancing women in healthcare leadership with a partnering healthcare organisation. This approach can be adapted in other settings, seeking to advance women in leadership.

Women's career progression to management positions in Jordan's health sector

PURPOSE

This study aims to identify and explore experiences, perspectives, barriers and enablers to women's career progression to management positions in the health-care sector and to assess women's and men's perceptions of the policies and practices of the health-care system concerning gender equality and nondiscrimination between women and men.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional survey was conducted among health-care professionals in ten selected hospitals, including physicians, registered nurses/midwives and pharmacists with or without managerial positions.

FINDINGS

This study included a total of 2,082 female and 1,100 male health-care professionals. Overall, 70% of women and men reported that opportunities for advancement are based on knowledge and skills in their institution. However, 58.9% of women (p < 0.001) reported that women are more likely to face barriers to career advancement than men do in their workplace. Lack of women in general/line management and discrimination against women by supervisors at the point of promotion were the main barriers to women's career progression, as they were reported by two-thirds of women. The main barrier, as perceived by men (62.3%) was that women have family and domestic responsibilities.

PRACTICAL IMPLICATIONS

To overcome barriers in women's career progression, there is a need to establish a career planning and capacity-building program for women in the health sector.

ORIGINALITY/VALUE

Jordanian female health-care professionals face different barriers that affect their career progression, including inequity and discrimination in the workplace, negative views about women's abilities, lack of qualifications and training, hostile cultural beliefs and family responsibilities.

Diversity among health care leaders in Canada: a cross-sectional study of perceived gender and race

BACKGROUND

Diverse health care leadership teams may improve health care experiences and outcomes for patients. We sought to explore the race and gender of hospital and health ministry executives in Canada and compare their diversity with that of the populations they serve.

METHODS

This cross-sectional study included leaders of Canada's largest hospitals and all provincial and territorial health ministries. We included individuals listed on institutional websites as part of the leadership team if a name and photo were available. Six reviewers coded and analyzed the perceived race and gender of leaders, in duplicate. We compared the proportion of racialized health care leaders with the race demographics of the general population from the 2016 Canadian Census.

RESULTS

We included 3056 leaders from 135 institutions, with reviewer concordance on gender for 3022 leaders and on race for 2946 leaders. Reviewers perceived 37 (47.4%) of 78 health ministry leaders as women, and fewer than 5 (< 7%) of 80 as racialized. In Alberta, Saskatchewan, Prince Edward Island and Nova Scotia, provinces with a centralized hospital executive team, reviewers coded 36 (50.0%) of 72 leaders as women and 5 (7.1%) of 70 as racialized. In British Columbia, New Brunswick and Newfoundland and Labrador, provinces with hospital leadership by region, reviewers perceived 120 (56.1%) of 214 leaders as women and 24 (11.5%) of 209 as racialized. In Manitoba, Ontario and Quebec, where leadership teams exist at each hospital, reviewers perceived 1326 (49.9%) of 2658 leaders as women and 243 (9.2%) of 2633 as racialized. We calculated the representation gap between racialized executives and the racialized population as 14.5% for British Columbia, 27.5% for Manitoba, 20.7% for Ontario, 12.4% for Quebec, 7.6% for New Brunswick, 7.3% for Prince Edward Island and 11.6% for Newfoundland and Labrador.

INTERPRETATION

In a study of more than 3000 health care leaders in Canada, gender parity was present, but racialized executives were substantially under-represented. This work should prompt health care institutions to increase racial diversity in leadership.

Gender Gap in the Leadership of Health Institutions: The Influence of Hospital-Level Factors

Objective: To analyze whether the increased representation of women in the health field is accompanied by a greater presence in leadership positions in the public health system and whether there are differences according to the hospital level.

Methods: A descriptive study of the distribution of leadership positions by sex and type of hospital within the health centers of a regional public health system.

Results: In total, 74.01% of the professionals were women. The representation of women in management positions was 33.1%, and among service chiefs, it was 24.01%. In the service headings, we observed that surgical specialties had a lower representation of women (30.9% in medical specialties vs. 18.1% in surgical specialties, p<0.0001). By type of hospital, no differences were found in the management positions, but there were differences in the medical chiefs, with less female representation in the regional hospitals (28.6% vs. 39.7%, p=0.003).

Conclusion: Women represent the majority in the public health system. Nonetheless, their representation in positions of greater responsibility and decision-making is very limited, being particularly low in county hospitals. Increasing female representation in these positions is a current challenge for society, and equality policies need to be developed and applied to minimize this gender gap.

Women and men in orthopaedics

PURPOSE

To compare and discuss the gender disparities in the Orthopaedic specialty.

METHODS

We reviewed the literature to find the rates of women applying for an orthopaedic residency, fellowship, and academic career program, to understand the causes of the disparities in women in orthopaedics, and how this relates to orthopaedic surgical practice.

RESULTS

The idea that men and women are different and have different working styles and skills and the belief that males are more dominant and more status-worthy than females leads to gender barriers and stereotypes that restrict women from entering male-dominated specialties. It is important to mention that equivalent barriers restrict men from pursuing female-dominated specialties such as Gynecology. Economic disparities and gender stereotypes that divide medical specialties into masculine and feminine, creating a gender gap in health care are major concerns. However, the number of women in the health sector is expected to increase due to the growing amount of female students that are expected to soon graduate. A leadership gender gap also exists; although women consist of 70% of the health care workforce they occupy only 25% of leadership positions.

CONCLUSION

The existence of gender-based disparities in healthcare is multifactorial. The explanation behind the existence of a so-called gender gap lies in organizational and individual factors. Early development and family relations, the decision between work and life balance, personal choices and interests, as well as working conditions, absence of role models and mentorship and institutional policies make gender disparities even more evident.

Gender gap in medical research: a bibliometric study in Swiss university hospitals

Several studies explored gender inequalities in research, but only limited data are available concerning general internal medicine and family medicine. We aimed to assess the level of gender inequalities in Swiss academic medical research. In this bibliometric study conducted in March 2020, we selected all senior hospital physicians practicing internal medicine or family medicine in the six Swiss university hospitals. The list of these physicians was extracted from the hospitals’ websites. We recorded their socio-demographic characteristics. Then, using Web of Science, we retrieved the number of publications (overall, as first author, per year, per year as first author), the proportion of publications as first author, the number of citations (overall, per year, per publication) and the h-index, and we compared the data by gender. 367 senior physicians were included in the study [female physicians: 172 (47%), internal medicine: 187 (51%)]. Female physicians were four times less likely to be a professor (5% vs. 20%, p value < 0.001) and half as often heads of division or staff physicians (19% vs. 40%, p value < 0.001). The proportion of physicians having published at least one article was lower among women than men (79% vs. 90%, p value 0.003). Finally, all bibliometric indices were associated with male gender (incident rate ratios ranging from 1.9 [(95% CI 1.3–2.8), p value 0.001] for number of citations per publication to 9.3 [(95% CI 5.3–16.2), p value < 0.001] for number of citations), except the proportion of publications as first author that was associated with female gender [odds ratio 1.7 (95% CI 1.2–2.3), p value 0.003). Our data suggest a “leaky pipeline” phenomenon (a lower proportion of women moving up the academic ladder). In addition, with the exception of the proportion of publications as first author, all bibliometric indices were lower for female than male physicians.

Gender gap in research: a bibliometric study of published articles in primary health care and general internal medicine

BACKGROUND

Many studies examined gender inequalities in research, but only a few data are available for general biomedical journals. We assessed the prevalence of female first authorship in general biomedical journals and examined its variations across a number of author, article and journal characteristics.

METHODS

This study was nested within a larger project designed to analyze the bibliometric characteristics of scientific articles. We retrieved 767 randomly selected articles published in 2016 in high impact factor journals of primary healthcare (n = 9) and general internal medicine (n = 9). We extracted the following data: author (gender, number of publications and affiliation of the first author), paper (number of authors, number of participants and study design) and journal characteristics (journal discipline and 2015 impact factor). We compared the proportion of articles authored by women and men using univariate and multivariate logistic regressions adjusted for intra-cluster correlations.

RESULTS

The female authorship proportion was 48% (63% for primary healthcare and 33% for general internal medicine, P-value < 0.001). In multivariate analysis, women published fewer articles (<5 versus >15 publications: OR 1.6 [95% CI 1.1-2.4]), were more often affiliated with institutions in the Western world (OR 2.2 [95% CI 1.2-3.9]), were more likely to publish qualitative studies (versus systematic reviews or experiments: OR 2.7 [95% CI 1.5-4.8]) and to publish in primary healthcare journals (OR 1.7 [95% CI 1.1-2.7]).

CONCLUSIONS

The underrepresentation of women in articles published by general internal medicine journals, in articles from the non-Western world and in systematic reviews and trials should be addressed.