Breaking the Glass Scalpel: Examining the Barriers and Enablers of Women's Leadership Advancement in Nigeria's Healthcare Sector

This study investigated the structural, cultural, and institutional factors influencing women’s
advancement into leadership roles within Nigeria’s healthcare sector. Employing a cross sectional
survey design the data was collected from 292 female healthcare professionals across primary
healthcare centers and the directorate of health. A structured questionnaire, developed using the
role congruity theory and validated through a pilot study captured participants’ demographic
characteristics, leadership experiences, perceived barriers, and opportunities for advancement.
Descriptive statistics and multiple logistic regression analyses were conducted using SPSS. The
findings revealed that out of the 292 participants only 13.4% had received leadership training,
while 27.1% had held leadership positions, primarily as heads of hospitals and primary healthcare
units (72.2%). Among those with leadership experience, 92.4% evaluated their experience
positively. Nearly half of the participants (45.2%) had observed a female leader in their workplace
and rated the experience positively, with 13.4% reporting a negative experience. More than half
(58.6%) expressed readiness to assume leadership positions. A majority of participants (69.5%)
perceived women as successful leaders, 64.7% supported women in leadership roles, and 80.1%
believed women possess adequate self-confidence for leadership. Most participants (74.6%)
identified leadership training programs as a key opportunity for women to assume leadership
positions. The multivariant analysis showed that postgraduate education [OR=2.74, 95% CI 1.18–
6.35], working in the health directorate [OR=4.96, 95% CI 1.97–12.46], and receiving leadership
training [OR=6.12, 95% CI 2.83–13.23] were independently associated with women taking on
leadership roles. The findings underscore a growing acceptance of female leadership in Nigeria’s
healthcare system, while highlighting the need for structured development programs, institutional
reforms, and gender-sensitive policies. Addressing entrenched social norms and strengthening
professional support mechanisms are critical for breaking the “glass scalpel” and enhancing
women’s representation in executive healthcare leadership.