Delivered by women, led by men
Because gender equality in healthcare is not a mere formality, but a matter of quality – and because ICMED has chosen to demonstrate this through its own example
There is a phrase that sums up, better than any table, the contradiction running through global healthcare: ‘delivered by women, led by men’. Delivered by women, led by men.
It is not a slogan. It is a snapshot of reality. According to the World Health Organisation, women account for around 70 per cent of the global workforce in the health and social care sector, but hold only 25 per cent of senior leadership roles and a mere 5 per cent of top positions in healthcare organisations. They are the beating heart of wards, corridors, laboratories and community services; they are far less common in the rooms where policies, budgets and research priorities are decided.
This power imbalance is accompanied by an economic one. The WHO also estimates that, globally, women in the health sector are paid on average around 24 per cent less than men – a gap that persists even when the data is adjusted for age, educational qualifications and experience. The pandemic has made all this even more evident: it was mainly women on the front line, but when it came to leading the national task forces, the leadership remained largely male.
The situation in Italy: same story
Italy is no exception. Women make up the majority of those employed in healthcare and care professions, yet the gender pay gap is also evident within the National Health Service and, according to the most recent analyses, is particularly pronounced among younger doctors. A significant proportion of the country’s overall gender pay gap – estimated at around a quarter of the total – can be explained precisely by the concentration of women in sectors that are structurally lower-paid, including care, healthcare and education.
The legislature has begun to take action. Law 162/2021 on equal pay has strengthened the Equal Opportunities Code (Legislative Decree 198/2006); since 2022, gender equality certification has been in place, based on the UNI/PdR reference standard
125:2022; and the new EU Directive on pay transparency introduces a game-changing principle: when a pay gap of more than 5 per cent emerges that cannot be justified by objective criteria, there is an obligation to analyse and rectify it. No more good intentions: obligations, evidence, consequences – including exclusion from public tenders and reputational damage for those who fall behind.
It is not (just) a matter of ethics. It’s about quality.
This is the point that matters most to us at ICMED, because it lies at the heart of what we do. Gender equality is often dismissed as a ‘values issue’. It is, of course. But it is also, and above all, a factor in the quality of the system.
When leadership does not reflect either the workforce or the population it serves, something breaks down in the accountability mechanism: perspectives are missing, needs go unmet, and risks go unnoticed. Several international studies show that a greater presence of women in top management is associated with better resource allocation, a healthier organisational culture and a greater capacity for innovation. Translated into the language of the management systems that ICMED builds every day: gender equality is a process control, not a mere ornament. An organisation that upholds it is an organisation that functions better, makes fewer mistakes and trusts more.
It is exactly the same logic that governs JACIE accreditation, ISO 15189 or ISO/IEC 27001: measure, document, improve.
ICMED: quality is demonstrated by applying it to oneself
And here comes the part of which we are, quite frankly, proud.
Can you be a quality consultant whilst preaching one thing and practising another? We don’t think so. That is why ICMED has chosen to be the first to embark, on its , the entire journey towards gender equality, by establishing its own Management System compliant with UNI/PdR 125:2022.
The result is not merely a statement of intent, but a living, measurable system:
• A comprehensive body of documentation – gender-neutral HR procedures, harassment prevention, inclusive communication, internal audits – integrated into a single company policy that brings together Quality, Information Security and Gender Equality. Not three separate worlds: a single way of working.
• Monitoring of indicators is handled by our proprietary IAAPP platform, which tracks 27 KPIs in real time, organised according to the 6 areas of the standard, with an automatic compliance score calculator. The quality of equality, quite literally, on the dashboard.
• A compliance score which, against a minimum threshold of 60 per cent, exceeds 90 per cent at ICMED. In other words: we haven’t just opened the door a crack – we’ve thrown it wide open.
• An organisation where women make up the majority of the workforce and hold the majority of leadership roles (over 60%), with no pay gap for the same role, a dedicated Steering Committee, a point of contact for the prevention of harassment, systematic remote working and work-life balance policies that go beyond the National Collective Labour Agreement.
Let’s say it without false modesty: in a sector where equality is much talked about but rarely measured, ICMED puts it in black and white, quantifies it and certifies it. It is the difference between those who talk about quality and those who demonstrate it with data.
Consistency as a method
For ICMED, all this is not a separate chapter, but the natural extension of a way of working. The same discipline we apply every day in laboratories, transplant programmes, blood transfusion services and assisted reproduction centres – measuring, documenting, improving – we have applied to ourselves in the field of equality. Not because a client asked us to, but because we believe that the credibility of those involved in quality is measured first and foremost within our own organisation.
Because the best healthcare is not just the one that treats best. It is the one that, at last, gives the women who keep it running every day an equal say in the decision-making rooms.
And on this point, we have no intention of waiting for anyone’s permission.
Sources of the data cited:
World Health Organisation (WHO) and Women in Global Health (healthcare workforce and leadership; global pay gap); INPS, Confcommercio and the World Economic Forum’s Global Gender Gap Report (Italian and European context); UNI/PdR 125:2022; Law 162/2021 and the EU Pay Transparency Directive.
