Gender Equity and Decent Work in the Health Workforce in Nepal: Insights From Community Health Volunteers, Nurses, and Doctors

Gender equity in the health workforce is crucial for achieving the Sustainable Development Goals. However, persistent inequities undermine workers' well-being, service delivery, and health system sustainability. This study examines how gender norms and hierarchical structures shape working conditions across Nepal's healthcare workforce. Drawing on 66 qualitative interviews and three stakeholder meetings with Female Community Health Volunteers (FCHVs), nurses, and doctors working in decentralized and centralized settings, we demonstrate how feminization, undervaluation, and the care-cure divide produce inequities in recognition, pay, autonomy, and career progression. FCHVs provide essential community health services for minimal remuneration. Nurses face high workloads and constrained advancement, and women physicians encounter gendered barriers to leadership and decision-making. Reconceptualizing decent work as a continuum ranging from unpaid to professional roles, we argue that health workforce equity is fundamental to broader health equity by shaping service quality, equitable access, and sustainable care. Gender-transformative and equity-oriented labor policies are required to strengthen health systems and advance SDG 3 (health), SDG 5 (gender equality), and SDG 8 (decent work).