Submission ID 118474
| Issue/Objective | The COVID-19 pandemic posed unprecedented challenges to global health systems, severely affecting health care providers, especially in low- and middle-income countries (LMICs) like Kenya. Women providers, who comprise 70-90% of the health workforce faced disproportionate economic and social burdens, including increased unpaid care and domestic labour. Despite their crucial role in healthcare delivery, health systems rarely addressed their gender specific needs. The Women in Health and their Economic, Equity and Livelihood Statuses during Emergency Preparedness and Response (WHEELER) study, funded by IDRC through the Women Rise initiative, explored these gendered disparities among paid and unpaid healthcare providers (HCPs) in Coastal Kenya |
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| Methodology/Approach | WHEELER study was conducted in Kilifi and Mombasa Counties, Kenya, from September 2022 to March 2025. It used a participatory mixed-methods approach guided by human-centered design, gender-based analysis plus, and equity frameworks. It involved academic partners from Kenya and Canada, with government policy-makers as co-principal investigators. Two advisory groups, the Community Research Advisory Group (CRAG) and Local Advisory Board (LAB), supported the process. Quantitative data were collected through structured surveys, while qualitative data came from in-depth and key informant interviews. Analysis included descriptive statistics for quantitative findings and thematic organization for qualitative insights. |
| Results | The study involved 2,526 respondents (76% women, 56% unpaid workers) and revealed that COVID-19 severely impacted livelihoods, especially for unpaid HCPs (58% reported extreme impact). Women were more likely to be unpaid and earn less than men, with unpaid female HCPs earning a median of approx. 32 CAD and the men 64 CAD. Most women reported increased unpaid care work. While more paid female HCPs outsourced unpaid care work, qualitative interviews with 82 HCPs and managers highlighted double burden for unpaid female HCPs of unpaid care work on domestic and health systems sides. Policy gaps emerged in gender-responsive planning, recognition of unpaid care work, and social protection for female HCPs. |
| Discussion/Conclusion | WHEELER highlights gendered disparities among HCPs, with women disproportionately impacted. In line with Kenya's 2023 Care Policy recognizing unpaid care, the findings from the WHEELER study point to the need to champion gender-responsive policies and strengthen global health systems for resilience against future outbreaks. |
| Presenters and affiliations | Bilali Mazoya Kilifi County Government, Kenya Evaline Lang'at Aga Khan University Lisa Avery University of Manitoba Ahmed Adam Mombasa County Government, Kenya |
