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Gendered Leadership, Advancing Systems and Structures (GLASS)

Through Collective Leadership, Networks and Mentorship

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Introduction

Women represent 70% of the global health workforce. They are frequent users of health services through ante-natal and obstetric services, childhood development and vaccination programmes, and through primary caregiving roles for elderly or frail parents. Yet women remain underrepresented in key decisions on resource allocation, health service design and delivery, and have limited voice in health service policies and improvements. They are inadequately represented in governance and leadership in healthcare and scientific disciplines across the world.

More than 80% of the nursing staff in Tanzania are female. While specific figures on women in leadership roles within the Tanzanian healthcare sector are not available (something GLASS aims to address), evidence suggests that women are substantially less represented in leadership than their male colleagues. In a context where the health workforce comprises over 70% women, actions must be taken to address this imbalance and support the advancement of women leaders. 

The primary aim of this project is to implement a package of interventions across 3 regions in Tanzania among the health workforce to address the organisational and individual barriers to the advancement of women to leadership positions, and to evaluate the impact on leadership competencies and career advancement actions of the female health workforce.



Project Outline

Why is GLASS Essential? 

Women represent 70% of the global healthcare workforce but only take up 25% of senior and 5% of top health organization positions. In Tanzania 81.4% of healthcare workers are female; cross-sectoral data reveals that just 17.4% of those in senior and middle management occupations are females. 

Global estimates of gender pay gap shows that women are paid approximately 22% less than men, whilst in Tanzania, the average female mean monthly income is less than males for all types of employment. 

There is proven social and economic return of investing in women and girls, which makes a strong case for prioritising gender equality. It is estimated that achieving gender equality could increase global GDP by US$12 trillion in a decade. 

How does GLASS align with Policy? 

Gender equality is central to the United Nation's Sustainable Development Goals (SDGs).

A Better World—Ireland’s policy for international development—focuses core efforts on specific SDGs and one of these focal points is gender equality.

Tanzanian National Policy on Women Development and Gender (NPWDG) approved the National Sub-Program for Women’s and Gender Advancement as a national strategy. This national strategy which targets women aims to empower them economically, eradicate poverty, enhance their political empowerment, decision-making and legal capacity, and improve access to education, training and employment

What are Aims and Objectives of GLASS? 

The GLASS project endeavours to implement a package of interventions which aim to:

  1. Address the organizational and individual barriers to the advancement of women to leadership positions in the Tanzanian health sector; and 
  2. Evaluate the influence on leadership competencies and career advancement actions of the female health workforce across 3 regions in Tanzania (Kilimanjaro, Mbeya, and Mara)

Specific objectives of GLASS are to: 

  • Undertake a rapid realist review to identify suitable interventions for the advancement of women to leadership positions in the Tanzanian health context 
  • Determine the current characteristics in gender and leadership in healthcare, and barriers for leadership across 3 sites in Tanzania (Kilimanjaro, Mbeya, and Mara)
  • Co-design and implement a mentorship and support programme for women healthcare workers across the 3 sites (Kilimanjaro, Mbeya, and Mara)
  • Document and share programme resources, learning and best practices for supporting women’s leadership in healthcare in Tanzania
  • Engage the GLASS Advisory Board, experts, and stakeholders during various steps of the overall research process to obtain their guidance, knowledge, and feedback to ensure relevance of the research and its cultural appropriateness to the Tanzanian health context

What Tools, Research Methodologies and Knowledge Generation Strategies will GLASS Employ? 

A rapid realist review will look at the interaction between the mechanism, context and outcomes of effective interventions for the advancement of women to leadership positions; the review will also draw from knowledge and experience of stakeholders and content experts to inform the methodology. 

Analysis of human resource data across the Kilimanjaro, Mara and Mbeya regions of Tanzania on gender and leadership. 

Focus group discussions with female nursing staff and administration staff across the Kilimanjaro, Mara and Mbeya regions of Tanzania to explore the perceived organizational and individual barriers to women’s leadership.

A codesign workshop with nurses, academics, government and non-government representatives to inform the design of a leadership intervention for the advancement of women to leadership positions in the Tanzanian health sector.

Health Service Executive (HSE) input on appropriate mentorship strategies to employ with nursing staff, ideal mentorship resources, along with the provision of mentorship from HSE nursing staff to nurses in Tanzania.  

Program evaluation using the REAIM planning and evaluation framework. 

What Impact will GLASS have?

GLASS will impact a wide range of stakeholders and settings which include: 

Nurses who will benefit via improved confidence, morale, leadership, networking, collaboration, career advancement and uptake of leadership positions. 

Health service users who will engage with more accessible and appropriate health services. 

The health sector which is anticipated to experience greater staff retention and shifts in organisational norms leading to more gender equitable workplaces. 

Policy effectiveness due to acceleration towards United Nation's SDGs, Tanzanian policy on gender equity, and Ireland’s strategy for International Development—A Better World.

National and international progression due to increased gross domestic product owing to more gender equitable workplaces and evolution of evidence base on women’s leadership.

Project Team

Professor Eilish McAuliffe

Professor Eilish McAuliffe

Principal Investigator

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Brynne Gilmore

Dr. Brynne Gilmore

Project Co-Applicant

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Professor Henry Mollel

Professor Henry Mollel

Co-Principal Investigator

Associate Professor in the Department of Health Systems Management at Mzumbe University, Tanzania

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Dr Elizabeth Lulu Genda

Dr Elizabeth Lulu Genda

Co-Applicant

Senior lecturer at Mzumbe University, Morogoro, Tanzania

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Dr. Doreen Mucheru

Post-Doctoral Research Fellow

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Anosisye Kesale

Anosisye Kesale

Postdoctoral Researcher

Department of Health Systems Management at Mzumbe University, Tanzania

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Nelson Kisanga

Research Assistant

Noel Otieno

Noel Otieno

Research Assistant

Department of Health Systems Management at Mzumbe University, Tanzania

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Contact the UCD School of Nursing, Midwifery & Health Systems

Health Sciences Centre, University College Dublin, Belfield, Dublin 4
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