Gender differences in work attendance among health care workers in Northern Nigeria during the COVID-19 pandemic

Modupe Taiwo; Oluwatoyin Oyekenu; Ferdinard Ekeh; Arnab K Dey; Anita Raj

doi:10.1016/j.eclinm.2022.101605

Gender differences in work attendance among health care workers in Northern Nigeria during the COVID-19 pandemic

EClinicalMedicine. 2022 Oct:52:101605. doi: 10.1016/j.eclinm.2022.101605. Epub 2022 Aug 3.

Authors

Modupe Taiwo¹, Oluwatoyin Oyekenu², Ferdinard Ekeh³, Arnab K Dey⁴, Anita Raj^{4

5}

Affiliations

¹ Save the Children, Sierra Leone.
² Global Alliance for Improved Nutrition, Nigeria.
³ Palladium, Nigeria.
⁴ Center on Gender Equity and Health, Department of Medicine, University of California, San Diego, USA.
⁵ Department of Education Studies, Division of Social Sciences, University of California, San Diego, USA.

Abstract

Background: The COVID-19 pandemic has resulted in the overwork of health care workers (HCWs) and greater household burdens for women. This study examines gender differences in HCWs' work attendance under COVID-19 and household burdens as a potential mediator of the gender difference in Northern Nigeria.

Methods: From April to May 2021, we conducted a cross-sectional survey on work and household burdens with a convenience sample of male and female HCWs (N=334) across 16 facilities in the Gombe, Katsina, and Zamfara states in Northern Nigeria. We used a series of multilevel modified Poisson regression models to examine the associations between gender and HCW work attendance. We also tested the mediation effect of household burdens on this observed association.

Findings: Only 2·10% of HCWs reported <5 days of work in a typical week; 35·33% worked 6-7 days a week (i.e., HCW overwork). Males were more likely than females to report HCW overwork (46·33% vs. 22·93%), and females were more likely than males to report an increase in household burden (59·24% vs. 40·68%). Adjusted regression models found that men were more likely than women to report HCW overwork (ARR: 1·76, 95% CI: 1·17-2·66). Increased household burdens mediated 9 percent of the total effect between gender and HCW work attendance.

Interpretation: The COVID-19 pandemic in Northern Nigeria made female HCWs contend with the dual burdens of formal and informal care work. This contributes to lower attendance among female HCWs and overwork for their male counterparts.

Funding: Bill and Melinda Gates Foundation Grant Numbers: OPP1163682 & INV018007.

Keywords: COVID -19; Gender; Health workers; Household burden; Northern nigeria.