Feminization of the health workforce in China: exploring gendered composition from 2002 to 2020.

BACKGROUND: Feminization of health workforce has been globally documented, but it has not been investigated in China. This study aims to analyze changes in the gendered composition of health workforce and explore the trend in different types of health workforce, health organizations and majors within China's health system. METHODS: The data were collected from China Health Statistical Yearbook from 2002 to 2020. We focused on health professionals including doctors, nurses, and pharmacists in health organizations. Trend analysis was employed to examine the change in the ratio of female health workforce over 18 years. The estimated average annual percent change (AAPC) was estimated, and the reciprocals of variances for the female ratios were used as weights. RESULTS: In China, health professionals increased from 4.7 million in 2002 to 10.68 million in 2020. Health professionals per 1000 population increased from 3.41 in 2002 to 7.57 in 2020. The ratio of female health professionals significantly increased from 63.85% in 2002 to 72.4% in 2020 (AAPC = 1.04%, 95% CI 0.96-1.11%, P < 0.001). Female doctors and pharmacists increased 4.7 and 7.9 percentage points from 2002 to 2020. Female health workers at township health centers, village clinics, centers for disease control and prevention had higher annual increase rate (AAPC = 1.67%, 2.25% and 1.33%, respectively) than those at hospital (0.70%) and community health center (0.5%). Female doctors in traditional Chinese medicine, dentistry and public health had higher annual increase rate (AAPC = 1.82%, 1.53% and 1.91%, respectively) than female clinical doctor (0.64%). CONCLUSIONS: More women are participating in the healthcare sector in China. However, socially lower-ranked positions have been feminizing faster, which could be due to the inherent and structural gender norms restricting women's career. More collective and comprehensive system-level actions will be needed to foster a gender-equitable environment for health workforce at all levels.

The implications of the feminization of the primary care physician workforce on service supply: a systematic review.

There is a widespread perception that the increasing proportion of female physicians in most developed countries is contributing to a primary care service shortage because females work less and provide less patient care compared with their male counterparts. There has, however, been no comprehensive investigation of the effects of primary care physician (PCP) workforce feminization on service supply. We undertook a systematic review to examine the current evidence that quantifies the effect of feminization on time spent working, intensity and scope of work, and practice characteristics. We searched Medline, Embase, and Web of Science from 1991 to 2013 using variations of the terms 'primary care', 'women', 'manpower', and 'supply and distribution'; screened the abstracts of all articles; and entered those meeting our inclusion criteria into a data abstraction tool. Original research comparing male to female PCPs on measures of years of practice, time spent working, intensity of work, scope of work, or practice characteristics was included. We screened 1,271 unique abstracts and selected 74 studies for full-text review. Of these, 34 met the inclusion criteria. Years of practice, hours of work, intensity of work, scope of work, and practice characteristics featured in 12%, 53%, 42%, 50%, and 21% of studies respectively. Female PCPs self-report fewer hours of work than male PCPs, have fewer patient encounters, and deliver fewer services, but spend longer with their patients during a contact and deal with more separate presenting problems in one visit. They write fewer prescriptions but refer to diagnostic services and specialist physicians more often. The studies included in this review suggest that the feminization of the workforce is likely to have a small negative impact on the availability of primary health care services, and that the drivers of observed differences between male and female PCPs are complex and nuanced. The true scale of the impact of these findings on future effective physician supply is difficult to determine with currently available evidence, given that few studies looked at trends over time, and results from those that did are inconsistent. Additional research examining gender differences in practice patterns and scope of work is warranted.

A feminilização do mercado de trabalho em saúde no Brasil / The feminization in the health job market in Brazil

Este artigo revisita o processo de construção do trabalho feminino. Pretende contribuir para a análise da composição da força de trabalho em saúde quanto ao aspecto gênero, com foco na profissional de saúde, e iniciar um trabalho de verificação, que não se pretende completo, mas um primeiro passo no sentido de desvendar o universo desse imenso contingente de trabalhadoras: em que regiões estão concentradas, qual sua jornada de trabalho, se ocupam postos de trabalho em saúde em zonas rurais e urbanas, indistintamente, entre outras questões. A conclusão reafirma a necessidade de se realizarem mais estudos, pois a efetiva participação da mulher nesse mercado de trabalho ainda é obscura.

This article goes through the historical process of female work construction. It intends to contribute for the analysis of the composition of Brazilian Health Work force concerning the gender aspect focused on the woman as a health professional, initiating a hard work of verification, which is not intended to be complete, but a first step in the direction to unmask the universe of this huge contingent of workers: in which regions they are concentrated, their working hours, if they fill vacancies in agricultural or urban zones, indistinctly, among other questions. It concludes reaffirming the need of more studies as the woman's efective participation in the health work market is still obscure.

La situación de las trabajadoras del sistema público de salud del gobierno de la ciudad de Buenos Aires. Una aproximación cuantitativa / The situation of female workers in the public health system of the Government of the City of Buenos Aires. An approximation quantitative

Existen diversos trabajos que dan cuenta de un proceso de feminización del mercado laboral, tanto en Argentina como en el resto de América Latina. A pesar de que aún en la actualidad hay más varones que mujeres en el mundo del trabajo remunerado, como la tasa de empleo de las mujeres ha aumentado y la de los varones ha disminuido, se suele denominar este proceso como feminización del empleo.