Breaking Barriers, Building Systems: Gender-Transformative Leadership as a Catalyst for Universal Health Coverage in Africa
1
Polio eradication program, Gates Foundation, Maroua, Cameroon
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Achieving Universal Health Coverage (UHC) in Africa requires leadership models that address gendered inequities embedded within health systems. Although women make up more than 70% of the continent’s health workforce, they remain under‑represented in strategic decision‑making roles, limiting the transformative potential of their contributions (World Health Organization, 2021). Gender transformative leadership (GTL) provides a framework for addressing structural and cultural barriers affecting equity and system performance (Mousa et al., 2021). The article examines how GTL can accelerate progress toward UHC by promoting equitable governance, strengthening workforce resilience and enhancing access to essential services.
METHODS:
A narrative, theory‑driven synthesis was conducted using African feminist scholarship (Mama, 2011; Tamale, 2020), leadership theories (Eagly & Carli, 2007; Bass & Riggio, 2006) and empirical studies on gender and health governance in low‑ and middle‑income countries. Illustrative cases from Eastern, Western and Central Africa were reviewed to identify enablers and constraints influencing the implementation of GTL in practice.
RESULTS:
Findings indicate three mechanisms through which GTL supports UHC: (1) redistributing power and strengthening inclusive decision‑making and accountability within institutions; (2) improving workforce motivation and retention, particularly in underserved settings, through equitable and supportive leadership (Anyangwe & Mtonga, 2007); and (3) enhancing quality of care and community trust, as gender‑responsive leadership promotes culturally competent, people‑centred services (Cummings et al., 2018). Persistent barriers include patriarchal norms, weak mentorship systems and limited enforcement of gender‑equitable policies (Ibarra, Ely & Kolb, 2013).
CONCLUSIONS:
Gender transformative leadership serves as a powerful catalyst for advancing UHC in Africa by reshaping gendered power relations that influence health system performance. Strengthening GTL requires investments in leadership development, enforcement of gender‑equitable policies and cultivation of institutional cultures that value diversity and inclusion. Integrating GTL into national UHC strategies can contribute to more resilient, equitable and sustainable health systems.
Achieving Universal Health Coverage (UHC) in Africa requires leadership models that address gendered inequities embedded within health systems. Although women make up more than 70% of the continent’s health workforce, they remain under‑represented in strategic decision‑making roles, limiting the transformative potential of their contributions (World Health Organization, 2021). Gender transformative leadership (GTL) provides a framework for addressing structural and cultural barriers affecting equity and system performance (Mousa et al., 2021). The article examines how GTL can accelerate progress toward UHC by promoting equitable governance, strengthening workforce resilience and enhancing access to essential services.
METHODS:
A narrative, theory‑driven synthesis was conducted using African feminist scholarship (Mama, 2011; Tamale, 2020), leadership theories (Eagly & Carli, 2007; Bass & Riggio, 2006) and empirical studies on gender and health governance in low‑ and middle‑income countries. Illustrative cases from Eastern, Western and Central Africa were reviewed to identify enablers and constraints influencing the implementation of GTL in practice.
RESULTS:
Findings indicate three mechanisms through which GTL supports UHC: (1) redistributing power and strengthening inclusive decision‑making and accountability within institutions; (2) improving workforce motivation and retention, particularly in underserved settings, through equitable and supportive leadership (Anyangwe & Mtonga, 2007); and (3) enhancing quality of care and community trust, as gender‑responsive leadership promotes culturally competent, people‑centred services (Cummings et al., 2018). Persistent barriers include patriarchal norms, weak mentorship systems and limited enforcement of gender‑equitable policies (Ibarra, Ely & Kolb, 2013).
CONCLUSIONS:
Gender transformative leadership serves as a powerful catalyst for advancing UHC in Africa by reshaping gendered power relations that influence health system performance. Strengthening GTL requires investments in leadership development, enforcement of gender‑equitable policies and cultivation of institutional cultures that value diversity and inclusion. Integrating GTL into national UHC strategies can contribute to more resilient, equitable and sustainable health systems.
| eISSN: | 2654-1459 |
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