A new report released by WomenLift Health lays bare a critical but often overlooked barrier to resilient health systems in Southern Africa: a persistent leadership gap for women in the public health sector, despite decades of progressive gender equality policies.
Based on a comprehensive stakeholder analysis across ten countries including Angola, Botswana, Eswatini, Lesotho, Malawi, Mozambique, Namibia, South Africa, Zambia, and Zimbabwe, the Stakeholder Analysis Report reveals that gender policies celebrated at the national level frequently fail to translate into equitable workplace realities. Instead, women face a “glass ceiling in disguise,” where institutional cultures, biased promotion systems, and caregiving expectations quietly limit their rise to leadership.
“What looks like progress on paper is often a façade. Inside health systems, women are still hitting invisible walls. If we are serious about building resilient and effective health systems, we must be serious about intentionally having women being part of the decision-making,” said Akhona Tshangela, Southern Africa Director at WomenLift Health.
Even in countries with notable national progress, such as Namibia, which recently elected its first female president, or South Africa, which has near gender parity in politics, the public health sector tells a different story.
Women remain underrepresented in senior roles, particularly at the district and provincial levels, with Zambia reporting just 13% female district health leaders.
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The report identifies a stark policy-practice gap, where well-intentioned laws lack the enforcement, resources, or institutional will to change workplace dynamics.
Patriarchal norms continue to shape decision-making, limit access to mentorship and keep women from rising through the ranks. Even proven solutions, such as leadership development programs, male allyship, and work-life balance initiatives, are inconsistently applied, often leaving rural and underrepresented women behind.
But the findings aren’t just a diagnosis–they’re a call to action. The report highlights critical interventions aligned with WomenLift Health’s strategy, including investment in leadership journeys for mid-career women, capacity-building for workplace advocacy, and systemic engagement with male allies and senior decision-makers.
“This report validates WomenLift Health’s approach: sustainable change means lifting both the woman and the system she works in,” Tshangela added.
If Southern Africa is to build resilient, equitable health systems, leadership must reflect lived realities, not just policy ideals.
This means elevating those who understand exclusion from the inside and can drive systemic transformation from within.