Exploring the perceived impact and influence of women leaders across sub-Saharan Africa on health policy and gender equity.

INTRODUCTION: Women make up a significant portion of the global health workforce but are under-represented in leadership roles. In sub-Saharan Africa (SSA), 70% of the health workforce is women, yet only 38% hold leadership positions in health ministries. This gap can lead to gender biases in health research and policymaking, perpetuating systemic gender biases. Despite these barriers, women leaders are making an impact globally. However, evidence of their impact is lacking. METHODS: We conducted an explanatory sequential mixed-methods study to identify perceptions of women leaders' influence and impact within the fields of reproductive, maternal, child and adolescent health and nutrition and immunisation across SSA. The study included a multicountry online survey with men and women leaders and key informant interviews with a subset of women leaders. Descriptive statistics were computed with SPSS, and thematic analysis was conducted using NVivo. RESULTS: 408 women and men leaders completed at least one section of the survey; 34 women leaders participated in key informant interviews. Women leaders are conducting their leadership differently, using identity-derived power and the power of the collective to influence health policy and programme change. They have unique access to communities and can build trust with marginalised groups. Women leaders also prioritise women-centric and neglected health issues, demonstrating ethical responsibility through transparency, commitment to inclusion, accountability and maximising impact with limited resources. CONCLUSION: The findings from this study underscore the critical role of women leaders in advancing health policy and gender equity across SSA. Women leaders' impact can be amplified and enhanced through targeted investments that strengthen enabling environments, foster allyship, champion gender integration activities implemented by women leaders and support their unique networks. Such investments will benefit women and adolescent girls and contribute to achieving broader public health goals and sustainable development.