The gender pay gap in the health and care sector: A global analysis in the time of COVID-19


This report was developed by the International Labour Organization (ILO) and the World Health Organization (WHO). It was released on July 13, 2022, and is the first-ever global and sector-wide report that provides an analysis of the gender pay gap in the health and care sector. The report uses representative survey data from salaried workers from 54 countries categorised into four groups – Africa and the Eastern Mediterranean regions; South-East Asia and Western Pacific regions; the Americas; and Europe. 

The report finds that the health and care sector is highly feminised across all countries, that is, women account for the majority of the people employed. Despite this, globally women earn 20 per cent less compared to men engaged in this sector. The report highlights that gender pay gaps in the health and care sector tend to be wider than in other sectors. Additionally, pay equality saw only small improvements between January 2019 and December 2020 despite the crucial role of health workers during the Covid-19 pandemic. 

The 160-page report is divided into eight sections: Introduction (Section 1); The health workforce across the world (Section 2); The gender pay gap in the health and care sector (Section 3); Factors driving the gender pay gap in the health and care sector (Section 4); Decomposing the gender pay gap in the health and care sector (Section 5); Employment characteristics and the gender pay gap over time in the health and care sector (Section 6); The effect of Covid-19 on employment and earnings in the health and care sector (Section 7); and The way forward towards reducing gender pay inequalities in the health and care sector (Section 8).


  1. The report defines gender pay gap in the health and care sector as “the difference in average wages between men and women who are engaged in paid employment in the sector”. In the case of median hourly wages, the pay gap is around 15 per cent. Calculated according to mean monthly earnings, the pay gap rises to 24 per cent.

  2. More women work in the lower paid health and care occupations (cleaners, support and personal health care workers) and the pay gap here is smaller, the report states. On the other hand, the pay gap is larger in higher paid health and care jobs – such as medical doctors – where women are underrepresented.

  3. Women account for 67 per cent of the total employment in the health and care sector worldwide. The percentage is higher in high-income countries (75.3 per cent) than in low- and middle-income countries (63.8 per cent).

  4. Except for four countries - Bangladesh, Jordan, Nepal and Pakistan, in all other countries, the share of men working in the sector is significantly smaller than that of women, the report notes.

  5. In low- and middle-income countries, there is significant informal employment in the health and care sector. Additionally, compared to men, women are more likely to occupy such informal jobs in this area.

  6. In 18 of the 54 countries reviewed, the mean hourly pay gap in the health and care sector is at least twice as high than in other sectors of the economy. These countries include Bangladesh (14.8 per cent compared to 6.9 per cent), Brazil (41 per cent compared to 12.3 per cent) and Vietnam (15.9 per cent compared to 9.3 per cent).

  7. The report highlights two important factors which contribute to the gender pay gap. One of these is that highly feminised sectors, on average, have lower wages. The second factor is the ‘motherhood gap’ (the pay gap between mothers and non-mothers holding all other factors constant) that has an adverse effect on women’s careers in the health sector.

  8. In many countries, the proportion of women part-time workers in the health sector rises dramatically around the child-rearing age. The report notes that having to balance work hours with unpaid caregiving responsibilities affects the wage women make working in the health sector.

  9. The report suggests periodic collection of sector-specific wage data in the health and care sector to assess the situation of the workforce. This would also include gathering data on the pay gap between men and women workers.

  10. Another recommendation in the report outlines investing in the sector to ensure better working conditions including formalisation of informal jobs. It also suggests that women should be provided equal opportunities and training for undertaking higher-level jobs or jobs that require specialised skills. The report also calls for pay transparency, establishment of legal measures against discrimination in payment and effective education towards changing gender norms.

    Focus and Factoids by Gautami Kulkarni.


Michelle McIsaac (WHO), Rosalia Vazquez-Alvarez (ILO) and Silas Amo-Agyei (University of Lausanne)


World Health Organization and the International Labour Organization


13 Jul, 2022