Why Women Leaders Are Crucial for Driving Change in India’s Healthcare Sector

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Walk into any hospital or clinic in India, and you'll notice something almost instantly-women are everywhere. They're the ones caring for patients, running wards, managing communities, and holding the system together in ways that often go unnoticed. And yet, when it comes to who's making the big decisions, their presence suddenly fades.

At a time when India's healthcare system is evolving rapidly with new technologies, policies, and pressures, the voices shaping its future don't always reflect the people who sustain it every day. That gap isn't just about representation; it quietly influences how care is delivered, what gets prioritised, and who gets left behind.

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While the sector employs more than 7.5 million people, senior roles remain largely male-dominated, a gap that merits closer attention as India works towards building a more responsive and effective healthcare system. We spoke to Dr Sabine Kapasi, CEO, Enira Consulting, Founder of ROPAN Healthcare Pvt Ltd, and UN advisor, who shared her insights on why women's leadership is key to building a more inclusive and effective healthcare system in India.

Women as the Backbone of Healthcare Delivery

Women are in charge of most frontline jobs. "They make up 29% of doctors, more than 80% of nurses and midwives, and over 100% of ASHA workers. This strong presence at the bottom does not mean increased authority at the top of the pyramid. Structural hurdles and ingrained biases hinder advancement into more senior, higher-paying positions," said Dr Kapasi.

Dasra's report, "An Unbalanced Scale," puts numbers to what many already sense. Women are still missing from the top in healthcare; just 18% make it into leadership roles. Even when they do, they are often paid less-about a third lower than men doing the same job. Globally, women hold about a quarter of senior positions in healthcare and only 5% of leadership roles overall. India reflects this imbalance, but the impact runs deeper here because so much of the system depends on women at the community level.

Representation Matters in a Digital Future

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When only men make most of the decisions, some important issues get ignored. Women leaders often raise points about maternal health, menstrual care, and mental health, areas that still do not get enough support.

"This gap assumes greater significance as India moves rapidly towards digital healthcare. The market, valued at over ₹75,000 crore in 2024, is projected to expand more than fivefold by 2033. Flagship initiatives such as Ayushman Bharat, which has created 73 crore health accounts, and Tele MANAS, which has handled 17.6 lakh mental health calls by January 2025, illustrate how technology is steadily reshaping access to care," added Dr Kapasi.

But here's the issue, which is that too few women are in charge of designing most of these systems. This means that people don't often ask questions, for instance, whether teleconsultations protect the privacy of rural women. "Moreover, there will be 2.7 to 3.5 million new jobs in digital healthcare, so it's not just fair to have more women involved in shaping these systems; it's also important to make sure that technology works for everyone, not just some," added Dr Kapasi.

Policies and Goals

Budget constraints add another layer. The Economic Survey 2024-25 indicates that public health spending is expected to decline from 2.5% of GDP in FY25 to 1.9% in FY26. In a resource-constrained environment, how each rupee is prioritised becomes especially important. The Union Budget for FY26 has set aside Rs 9,406 crore (US$1.08 billion) for PMJAY, which is 28.8% more than the previous year. But how effectively this spending is utilised depends on who decides what is most important.

Women leaders are more likely to talk about preventative care, nutrition, sanitation, and community health. These are issues that are often left out of conversations that focus on tertiary hospitals and building more infrastructure. Their presence at the top can change policy such that it focuses on actions that will improve public health as a whole.

Bottomline

Dr Kapasi concluded, "Women make up a large part of India's healthcare workforce, yet they are rarely in charge. This gap is not about appearances. It affects the quality of patient care, the way policies are designed, and the strength of the workforce itself. As healthcare expands with technology, new insurance models, and private investment, those leading it should reflect the people who keep it running."

"The next phase of healthcare cannot be built by leaving women out of the decisions that shape it. A fairer, more responsive, and more effective system is possible when women have a seat at the table. Their leadership is not an add-on. It is what will make the sector stronger for everyone," she added.