Leaning in or taking the helm to lead: A reflection on women’s empowerment and leadership


Mary Ndu, PhD (c) and Elysee Nouvet, Associate Professor
Faculty of Health Sciences


Worldwide, the global burden for disease and death is highest among women due to inequities in access to health, education, and economic empowerment. Over the years, we have seen an increase in the numbers of women in leadership in industry and politics. Specific jurisdictions have developed policies to actively counter the under-representation of women in these domains. In 2018, for example, the U.S. states of California, Washington, and New Jersey passed gender quota laws. On March 2, the Nigerian House of Assembly passed a bill to increase the number of women in parliament to twenty percent.

This is progress worth celebrating. That said, many women still contend with resistance to the idea of women leading. Gillard and Okonjo-Iweala (2022), two great experienced women in leadership, articulate this in their book, Women and Leadership: Real Lives, Real Lessons. They share their personal journey as women in leadership, the barriers they faced, and their struggle to understand the persistent gender bias they witness globally. Reflecting on changes to women in leadership in the last twenty-five years, they find nothing exciting about it. “Given that there are almost four billion women and girls alive today, how can it be that the odds are still so severely stacked against them having a woman lead their nation? In the last twenty-five years the numbers has doubled, which is a progress…somehow it is hard to get enthusiastic…” (p. 21) given the proportion of men versus women in leadership positions.

I agree with Gillard and Okonjo-Iweala that it is hard to be enthusiastic about the changes we have seen with more women in leadership. The ratio of men to women in political positions remains 3:4 (p. 22). This ratio is even lower when we consider women of colour. According to 2021 Mckinsey’s Women in the Workplace in Corporate America, “women of color account for only 4 percent of top executives, a number that has not moved significantly in the past three years.” (Thomas, Cooper & Urban, 2021, p. 8). The 2020 Reykjavík Index found that even though Angela Merkel was the German Chancellor for 21 years, and was widely regarded as effective in her position, 41% of Germans still felt uncomfortable with women in leadership. For us, such statistics indicate that the world is not as progressive as some would like to believe, despite years of campaigns for gender equality.

In discussing leadership, it is essential to acknowledge that access and barriers connect to contextual factors and are geographically specific. The lived experiences of women striving for leadership positions vary within countries, and even within the same institutions, as these experiences intersect with biographical particularities and context-specific social values, norms, and processes. In addition, leadership is a dynamic and slippery concept: what one woman or social context defines as an achievement or evidence of leadership may not correspond to its definition in another time or place. It is vital to highlight that leadership takes many forms and permeates all levels of society. Certainly, women’s experiences of leadership merit distinct analysis and consideration at distinct levels, for specific contexts. Our concerns in this post focus on the ongoing lack of parity regarding women in leadership at the political and corporate decision-making level.

A recent commentary, a people-centred approach to policymaking, provides sound argument for increased equity at the table of health policy making. While focused on women’s health-seeking behaviour, its arguments are relevant here. In non-western countries, we often find men leading policy formulation on issues concerning women, especially health. A people-centered approach to policymaking involves inclusive and equal representation of women and their lived experiences in the policy process. This cannot be achieved without more women having more access to educational and professional opportunities and the confidence of their societies as not only competent, but needed actors in shaping and implementing global health agendas. Women contributing to policy must also be granted recognition for their key work, through equal access to meaningful promotions, invitation to decision-making bodies, and equal levels of remuneration as their male counterparts. Unfortunately, in today’s world, where we speak of equity, diversity, and inclusion, we are still discussing a woman’s ability to perform in male-dominated fields.

On this International Women’s Day, we must reflect on structural patterns that limit women’s role in shaping global, national, and sub-national global health agendas. What will it take to actually level the representation of men vs. women in leadership? In Canada, we often consider ourselves a society with gender equity, but we have had about 15 male provincial ministers in the past 10 years, and only four female provincial ministers. We have had no elected female prime minister.

It is hard not to worry at times about what is not happening below a surface appearance of progress. Is it possible that women such as ourselves advocating for equal representation in leadership may be seen as entitled, when we flag the need for attention to these issues, or insist on gender quotas? Would it be better to ask for equal and fair competition? No woman wants a position handed to her. We want to know we earned our promotions and positions, that we are given opportunities based on our strengths and track record, rather than because we fall into a minority. One finding from the Reykjavík Index could be a signal of future challenges and barriers. It found that 67% of men in the younger demographic were strongly against women taking up leadership positions. Interesting or worrying? Given the number of feminists and womanists raising “feministic men,” we wonder why sentiments such as those reported persist. Maybe we are wrong asking these questions, but it is worth considering that something is not working.

We dare say that while our experiences may differ across context and geographic location, all women must work extra hard to achieve the recognition for her talent, intellect, and knowledge. However, while we discuss the gender differences in leadership and gender equality, it is also important to recognize that while some women want to break the proverbial glass ceiling, some have broken the glass ceiling, and gone beyond it. Yet, at the same time some women may not want to break the glass ceiling or even see the ceiling and that is also perfectly okay. What is important is that we all get the opportunity to choose where we belong.





Gillard, J., & Okonjo-Iweala, N. (2022). Women and leadership: Real lives, Real lessons. MIT Press.

Thomas, R., Cooper, M., & Urban, K. (2021). Women in the workplace 2021.



Artwork by @_Snaps