Empowering Change: A Systematic Review of the Challenges Faced by Female Healthcare Workers in Pakistan

Pakistan's female healthcare force faces numerous challenges compared to their male counterparts that hinder their professional development. These systemic barriers contribute to mental health struggles and high attrition rates among women in the healthcare sector. This systematic review aims to identify and analyse the major difficulties encountered by female healthcare workers in Pakistan, focusing on socio-cultural and institutional factors, and to propose strategies for empowerment. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive literature search was performed across multiple databases, including PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane Library, Europe PubMed Central (Europe PMC), ScienceDirect, Elton B. Stephens Company (EBSCO) Open Dissertations, and ClinicalTrials.gov, from November 22 to December 5, 2024. Ultimately, 14 studies met the inclusion criteria, focusing on workplace and socio-cultural challenges faced by female healthcare workers. Quality appraisal was conducted using the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies and the Joanna Briggs Institute (JBI) critical appraisal checklist for analytical cross-sectional studies. The findings highlight significant barriers such as workplace discrimination and social and cultural expectations that impede the professional growth of female healthcare workers. Women from lower socio-economic backgrounds face compounded obstacles, further entrenching gender disparities. The review also identifies a notable gap in female representation in leadership roles, underscoring the need for targeted interventions, including mentorship programs. Of 1,161 records identified, 14 studies met the inclusion criteria, comprising nine qualitative studies (64.3%) and five cross-sectional studies (35.7%). Professional barriers (workplace discrimination, harassment, lack of mentorship) were reported in 13 studies (92.9%), cultural impediments in five studies (35.7%), familial constraints in seven studies (50%), work-life balance issues in five studies (35.7%), and safety concerns in seven studies (50%). Women from lower socio-economic backgrounds faced compounded obstacles. A notable gap in female representation in leadership roles was identified across multiple studies. Addressing the multifaceted challenges endured by female healthcare workers in Pakistan requires a comprehensive approach that includes policy changes and organisational support. Implementing targeted interventions can foster an inclusive environment that empowers female healthcare professionals, ultimately enhancing the quality of care in Pakistan.