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Observational Study
. 2020 May 29;18(1):40.
doi: 10.1186/s12960-020-00481-z.

Gender inequality in the health workforce in the midst of achieving universal health coverage in Mexico

Julio César Montañez-Hernández  1 , Jacqueline Elizabeth Alcalde-Rabanal  2 , Gustavo Humberto Nigenda-López  3 , Gladis Patricia Aristizábal-Hoyos  4 , Lorena Dini  5
Affiliations
Observational Study

Gender inequality in the health workforce in the midst of achieving universal health coverage in Mexico

Julio César Montañez-Hernández et al. Hum Resour Health. .

Erratum in

Abstract
in English, Spanish

Background: The third Sustainable Development Goal aims to ensure healthy lives and to promote well-being for all at all ages. The health system plays a key role in achieving these goals and must have sufficient human resources in order to provide care to the population according to their needs and expectations.

Methods: This paper explores the issues of unemployment, underemployment, and labor wastage in physicians and nurses in Mexico, all of which serve as barriers to achieving universal health coverage. We conducted a descriptive, observational, and longitudinal study to analyze the rates of employment, underemployment, unemployment, and labor wastage during the period 2005-2017 by gender. We used data from the National Occupation and Employment Survey. Calculating the average annual rates (AAR) for the period, we describe trends of the calculated rates. In addition, for 2017, we calculated health workforce densities for each of the 32 Mexican states and estimated the gaps with respect to the threshold of 4.45 health workers per 1000 inhabitants, as proposed in the Global Strategy on Human Resources for Health.

Results: The AAR of employed female physicians was lower than men, and the AARs of qualitative underemployment, unemployment, and labor wastage for female physicians are higher than those of men. Female nurses, however, had a higher AAR in employment than male nurses and a lower AAR of qualitative underemployment and unemployment rates. Both female physicians and nurses showed a higher AAR in labor wastage rates than men. The density of health workers per 1000 inhabitants employed in the health sector was 4.20, and the estimated deficit of workers needed to match the threshold proposed in the Global Strategy is 70 161 workers distributed among the 16 states that do not reach the threshold.

Conclusions: We provide evidence of the existence of gender gaps among physicians and nurses in the labor market with evident disadvantages for female physicians, particularly in labor wastage. In addition, our results suggest that the lack of physicians and nurses working in the health sector contributes to the inability to reach the health worker density threshold proposed by the Global Strategy.

Antecedentes: El tercer Objetivo de Desarrollo Sostenible busca alcalzar vidas saludables y promover el bienestar para todos en todas las edades. Por lo cual, el sistema de salud es clave para lograr estos objetivos, y debe tener suficientes recursos humanos para brindar atención a la población de acuerdo con sus necesidades y expectativas.

Métodos: Exploramos el desempleo, subempleo y desperdicio laboral en médicos y enfermeras en México como barreras para lograr la Cobertura Universal de Salud. Realizamos un estudio descriptivo, observacional y longitudinal para analizar las tasas de empleo, subempleo, desempleo y desperdicio laboral en el período 2005-2017, por género en ambas profesiones. Utilizamos la Encuesta Nacional de Ocupación y Empleo. Calculamos tasas anuales promedio (TAP) para el período para describir las tendencias. Además, para 2017 calculamos las densidades de la fuerza laboral para todos los 32 estados, y estimamos sus brechas con respecto al umbral de 4.45 propuesto en la Estrategia Global sobre Recursos Humanos para la Salud.

Resultados: La TAP de las médicas empleadas era más bajo que el de los médicos, y la TAP del subempleo, el desempleo y el despilfarro laboral para las médicas eran más altas que en los hombres. Las enfermeras tienen una TAP más alta en el empleo que los enfermeros y una TAP más baja de subempleo y desempleo. Tanto las médicas como las enfermeras muestran unas TAP más altas en las tasas de desperdicio laboral. La densidad de trabajadores por cada 1,000 habitantes empleados en el sector de la salud fue de 4.2, y el déficit estimado para alcanzar el umbral propuesto en la Estrategia Global es de 70,161 trabajadores. Hipotéticamente, si todos los desempleados, subempleados y aquellos dedicados a las actividades del hogar estuvieran empleados en el sector de la salud, la densidad sería de 7.16.

Conclusiones: Encontramos evidencia sobre la existencia de brechas de género entre médicos y enfermeras en el mercado laboral con desventajas evidentes para las médicas, y particularmente en el desperdicio laboral. Además, mostramos la falta de médicos y enfermeras trabajando en el sector de la salud para alcanzar el umbral propuesto en la Estrategia Global.

Keywords: Employment; Gender inequality; Labor wastage; Nurses; Physicians.

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Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
Rates of employment and labor wastage in physicians and nurses. ENOE TrimIII-2017
Fig. 2
Fig. 2
Deficit in the number of health workers from 4.45 threshold. ENOE TrimIII-2017
See this image and copyright information in PMC

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