A World Health Organization regional analysis published on 18 September 2026 finds persistent and substantial pay disparities between women and men across the health and care workforce in Europe. Covering 43 countries, the report shows women make up almost 77% of the sector, yet earn 19% less per hour and 28% less per month than their male colleagues.
Dr Natasha Azzopardi-Muscat, Director of the Division for Health Systems at WHO/Europe, said the gap reflects how the sector values women’s work and has long-term consequences for retirement income and financial security.
"Women make up the majority of the people who keep Europe’s health systems running, yet they’re paid less than their male counterparts, a gap that compounds over a lifelong career," the report quoted Dr Azzopardi-Muscat as saying.
Gaps grow higher up the pay scale
The report finds the pay disparity is not uniform across earnings levels. At the lower end of the pay distribution, women earn about 2% less per hour than men. At the top end, the hourly gap rises to almost 23%. On paper, women’s qualifications and experience would predict slightly higher pay in the best-paid roles, but in practice they earn less — a pattern the authors say points to factors beyond age, education or hours worked.
Managerial roles in health and care—while more likely to employ women than managerial roles in some other sectors—are paid less on average. The report gives the example of managerial pay averaging €22.00 per hour in health and care compared with €24.70 per hour for comparable roles outside the sector.
What explains the gap — and what does not
WHO/Europe adjusted the raw pay differences for several measurable factors: age, education, working hours and whether employment was in the public or private sector. These adjustments reduce the observed hourly pay gap from 19% to 6%, and the monthly pay gap from 28% to 10%. The remaining unexplained difference, the report argues, points to how the sector values work that is predominantly done by women.
- Women account for almost 77% of the health and care workforce in the 43-country analysis.
- Observed hourly pay gap: 19%; observed monthly pay gap: 28%.
- Adjusted (for age, education, hours, sector) hourly gap: 6%; adjusted monthly gap: 10%.
The report highlights a systemic pattern: the more a role is dominated by women, the lower its relative pay tends to be — regardless of skill or responsibility. That raises policy questions about pay-setting, career progression, and occupational segregation within health systems.
Implications for policy and health systems
WHO/Europe frames the pay gap as more than an individual earnings issue. It notes long-term consequences including lower pensions and a greater risk of poverty in older age for women who have spent their careers in care work. For health systems, undervaluing and underpaying women risks staff morale, retention and the diversity of leadership at senior clinical and managerial levels.
The data also touches on how public policy could address inequities. Because adjusting for observable characteristics does not fully close the gap, the report implies that interventions must include structural measures: transparent pay scales, equitable promotion and hiring practices, and attention to how feminised occupations are valued within broader labour markets.
While this analysis focuses on Europe, the findings have resonance for other countries grappling with similar workforce and gender equity challenges. South African policymakers, health employers and unions may find the report a useful comparative reference when reviewing pay structures, leadership diversity and retirement prospects for health workers.
Readers with concerns about workplace pay or career progression should consult their union, employer human resources department or the relevant workplace bargaining council. For health matters, always consult a clinician and your local clinic rather than self-diagnosing.
