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Women health and education workers

Last edited: July 07, 2020

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Women represent a large proportion of front-line health workers and social care workers. In the health sector, rates of verbal aggression, physical violence and sexual harassment from patients and visitors has reportedly grown in recent years, particularly in the public sector (Public Services International, 2018; WHO, 2002). Health care workers report some of the highest levels of violence in comparison to other industries and sectors (ILO, 2018a, p.171). For example, in Canada, it is estimated that 38 per cent of long-term care workers experience physical violence daily, which is exacerbated by lack of appropriately-trained staff and poor working conditions (Canadian Union of Public Employees, 2013). In a 2016 Eurofound study in the EU, the health care sector raked as the most exposed to violence and harassment (Cited in ILO, 2018a, p.171). Furthermore, reduced budgets, inadequate staffing levels and lack of training can contribute to harassment and abuse of health care workers.[1]

In the education sector, sexual harassment and gender-based violence in universities and colleges often goes unreported (Johnson et al, 2018a). Sexual harassment fuels an organizational culture, resulting in “…significant and costly loss of talent in academic science, engineering and medicine, which has consequences for advancing the nation’s economic and social well-being and its overall public health” (Johnson et al, 2018b). In these environments, several characteristics contribute to high levels of sexual harassment, including: workplaces where men hold positions of power and authority; an organizational tolerance for sexual harassment, such as failing to take complaints seriously or holding perpetrators accountable; relationships that are hierarchical and create dependencies between academic and junior staff or researchers; and isolating environments such as field sites and labs.

Sexual harassment is particularly prevalent in national education systems with low levels of accountability, high levels of poverty and gender inequality, and in institutions that are poorly resourced, where academics are poorly paid and there is a reliance on temporary contracts (ILO, 2018g). Reporting is low, as many women fear victimization. The widespread use of confidentiality clauses and non-disclosure agreements has helped to enable alleged perpetrators to protect their careers, creating a culture of silence where women, and in some cases men, are afraid to make complaints (United Kingdom Parliament, 2018). In the United Kingdom, normalization of violence and harassment against women has made the situation of women workers more vulnerable (Universities and Colleges Union, 2015). In the school sector, gender-based violence is also a growing problem (UN Women and UNESCO, 2016).

Preventing violence and harassment against women health workers

Preventing violence against women health care workers in Democratic Republic of the Congo (Public Services International, 2018)

In the Democratic Republic of the Congo, health care workers are affected by violence, including rape.  The collapse of the health care system and long waiting times have added pressures on nurses and increased the risk factors for third-party violence. Significant efforts have been made by the health care union, Solidarité Syndicale Infirmiers du Congo (SOLSICO), to tackle these high levels of violence at work. The union has drawn up a comprehensive plan to enhance its ability to influence government policy on health and safety issues, especially the issue of workplace violence in the sector. SOLSICO is building a network of civil society to support the union’s demands for a strong health care sector where health workers can provide a quality public service in good working conditions.

Workplace prevention measures negotiated for nurses in Canada (Public Services International, 2018)

The Manitoba Nurses Union in Canada has negotiated additional new workplace prevention measures,[2] in an effort to stem physical and verbal violence against nurses. The union reports that 56 per cent of the union’s members have been physically assaulted, and more than 9,000 have been verbally abused (Manitoba Nurses Union, Undated). A recent change in the law in Manitoba provides that employers are required to draw up a workplace prevention policy and a strategy with procedures to prevent and address cases of violence, provide immediate assistance in cases of violence, and implement a system for reviewing and identifying incidents of violence. The measures cover any third-party - known or not known to a health worker - who perpetrates violence and harassment and can include perpetrators of domestic violence in the workplace, patients, customers or former employees.

Negotiations in the Philippines to stem the rising tide of violence and harassment (Public Services International, 2018)

In the Philippines, violence and harassment, particularly against women in the health sector, has led to decreased morale, absenteeism, high staff turnover and loss of productivity amongst workers. In response, the health care union, the Alliance for Filipino Workers (AFW), negotiated agreements with hospital employers on a range of measures - including training and awareness-raising and new guidelines to tackle third-party violence. The AFW cites the impact of poor work organization and a poor working environment in the public sector as factors leading to co-worker conflict and harassment at work. AFW has given a specific focus to violence and harassment as an occupational safety and health issue. The union was supported by Public Services International (PSI), in order to build awareness of violence at work as a psychosocial hazard, based on international Framework Guidelines for Addressing Workplace Violence in the Health Sector, co-authored by ILO, the International Council of Nurses (ICN), WHO and PSI (ILO et al, 2002). In 2017, the AFW formed the Registered Nurses Task Force which has carried out “listening tours” to provide a space for nurses, union members and non-members alike, to air their grievances and exchange information about violence at work.

Tackling workplace violence in hospitals in Argentina (Public Services International, 2017)

Health care workers in Argentina face growing levels of workplace violence. In one hospital, the health care union, Asociación Sindical de Profesionales de Salud de la Provincia de Buenos Aires (CICOP), carried out violence prevention initiatives to reduce levels of absenteeism at work, and the union has identified further problems related to the lack of job security of many health care workers. CICOP has also negotiated collective agreements on behalf of its members, resulting in the establishment of joint workplace committees on health and security and a Commission on Violence in the Ministry of Health in Buenos Aires. Since 2011, CICOP members have participated in joint health and safety committees in each workplace.

The Lady Health Worker Programme in Pakistan (PSI, 2018)

In Pakistan, women health workers (known as “lady health workers”) face violence and harassment in their work, from male supervisors, families of patients and men in the communities in which they work.  Moreover, they face violence at home, because of the work they do. The All Pakistani Lady Health Workers & Employees Association has helped many women to share “how they survived violence at the hands of their husbands, brothers, brothers-in-law, fathers and fathers-in-law” (PSI, 2018, p. 7).  Male relatives of women health care workers subject them to domestic violence because they feel their interaction with the public brings disgrace to the families. The union provides them a space to talk about cases of economic violence, such as when their husbands took their pay cheques from them and drew their salaries from the bank. The union provides women health care workers with support from fellow workers, helping them break the barriers of silence and isolation that results from domestic violence.

Preventing violence and harassment against education workers

Prevention of school-related gender-based violence and harassment: the role of social partners in Europe

In the education sector, the European Trade Union Committee for Education (ETUCE) and the European Federation of Education Employers (EFEE) have supported education unions and employers to become more proactive in their national social dialogue structures when reducing and preventing third-party violence and harassment, particularly gender-based violence (ETUCE and EFEE, 2012). It has led to treating third-party violence and harassment (from pupils, parents and other third-parties) as a priority in collective agreements in the education sector, and to assisting teachers’ unions and education employers to set up strategies on health and safety for schools. The project has led to increased knowledge of how to tackle the problem amongst unions and employers. Examples of actions taken by national unions include a United Kingdom National Association of Schoolmasters Union of Women Teachers campaign to tackle prejudice-related bullying, including a campaign booklet “Preventing and Tackling Prejudice-Related Bullying.”



[1] According to the ILO, “violence against nurses and midwives, including verbal and physical abuse, has been reported in a number of contexts, both associated with staff shortages and with ‘demands’ from private sector health-care users”. ILO (2018a) Care work and care jobs for the future of decent work (Geneva), page 180.

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