Female workers in India: why poor health support is holding them back

Usually, when women work, most nations develop faster. That’s true for India as well.

Although women constitute 49 per cent of the country’s population and make up a significant proportion of the workforce, for years health concerns specific to female workers have largely been ignored by employers. Employers are still not proactive or supportive on women’s health in the workplace.

Fifty-three-year-old Sangeeta (name changed for this article), who works as a senior communications manager in a travel start-up company in Delhi, says she felt compelled to hide the symptoms of the menopause while at work, such as a loss of concentration, crumbling anxiety and debilitating hot flushes. She felt forced to lie to her manager on several occasions about why she needed time off work as she did not feel comfortable or confident speaking to him about menopause symptoms. However, when she needed time off to visit the dentist she had no qualms about telling him so.

Photograph: iStock Credit: gawrav

“I have no problem discussing general health conditions, such as flu, backache and Covid-19, but when it comes to a female-specific illness or condition like menopause, I prefer to suffer in silence at work,” she said. Sangeeta added that she didn’t think her boss would understand health issues specifically affecting women - or recognise the issue as an illness.

However, Sangeeta wishes she was able to break down these barriers and banish the taboos and not feel uncomfortable or embarrassed discussing perfectly normal health concerns. 

Female employment is falling

Although the Union Budget in 2022 put women’s employability (the available pool of employable women) at a healthy 51.44 per cent, according to the World Bank, since the pandemic, female employment in India actually fell by nine per cent in the same year.

It’s worrisome that a huge number of working women in India are facing health challenges related to menstruation and the menopause. Shockingly, over a third of female workers (more than 33 per cent) reported working through pain or symptoms related to menstruation, while almost one in five (18 per cent) worked through menopause symptoms.

Moreover, nearly 25 per cent of women took time off for these reasons but did not disclose it at work. Meanwhile, only 26 per cent said they did disclose menopause as a reason for taking time off and received support from their employer, and only 13 per cent reported disclosing menstruation as a reason for taking time off and receiving support from their employer.

These are the findings of Deloitte’s Women @ Work: A Global Outlook, which surveyed 5,000 women across 10 countries (including 500 in India), across age groups, employment status, sectors and seniority. The survey did find some signs of progress for women in the workplace, but equally, it revealed that some factors have deteriorated since last year.

Younger workers more comfortable talking about mental health

Although levels of stress and burnout continue to be high globally and in India, it’s encouraging that in India, the youngest segment of the workforce is most comfortable talking about mental health in the workplace.

“It’s heartening to see younger generations take charge in having conversations that have traditionally been taboo,” said Saraswathi Kasturirangan, chief happiness officer at Deloitte India. “While top-down interventions and role-model behaviour are important to support mental health, organisations should leverage on this generation to establish strong peer-to-peer networks of mental health champions. The hope is that this cohort will hold on to their openness and progress towards being understanding, humane leaders of the future.”

Compared to older generations, younger female workers today have a lot more confidence, with Millennial and GenZ working women having more advantages and different priorities. As individuals, these Millennial and GenZ women are better educated, financially independent, digitally and financially savvier, career-oriented and outspoken.

However, the Indian Women’s Health Report 2021 – which surveyed 1,000 working women aged between 25 and 55 years, across seven cities – found that about 50 per cent of the women surveyed were not comfortable talking about one or more women’s health issues due to the prevailing societal taboo and stigma associated with them.

The study, conducted by Emcure Pharmaceuticals in association with Ipsos Research Pvt. Ltd (Ipsos India), aimed to gain insight into the social, cultural and medical outlook for career-oriented women – and eventually find solutions involving various stakeholders.

Through the survey, women working in white-collar jobs spoke of the stigma they face with regards to health, and how this adds to social pressures and professional issues.

The research showed that more than 86 per cent of working women have observed their colleagues, relatives or friends drop out of the workforce, 59 per cent of whom cited health issues as the main reason.

Over 67 per cent of working women say that talking about health issues is still considered a taboo in society, the report found.

Irrational taboos

When Emcure Pharmaceuticals launched its YouTube talk show, Uncondition Yourself, in January 2021 focusing on women’s health, the company realised that getting women to come on the show and talk about their health was a big challenge. This led the company to conduct a study and seek to ramp up its initiatives around awareness and diagnosis. “Despite the progress we have made in the corporate world for involving women in the workforce, issues related to women’s health are still associated with irrational taboos,” said Namita Thapar, executive director at Emcure Pharmaceuticals. “The findings of our study reveal the persistence of mis-perceptions and illogical societal taboos related to women’s health issues affecting even India’s white collar women across sectors.”

Stress among working women is an alarming concern as well, and its impact on women’s reproductive and sexual health cannot be ignored, with disorders like Polycystic Ovary Syndrome (PCOS) and endometriosis leading to infertility among working women. Also, studies have shown that commonly occurring illnesses, such as PCOS, breast cancer and endometriosis, are still subject to taboo and stereotypes, reflecting the current poor state of women’s health in India.

Focus on women’s health, businesses told

In its 2022 report, The Reproductive and Sexual Health of Working Women, Plum, an employee health insurance company that focuses on driving ‘inclusion in insurance’ (such as insurance cover that includes maternity benefits for employees), urged businesses to focus on the unspoken aspects of women’s health as this will lead to greater support for working women. Plum argues that in turn, this will lead to a higher percentage of women in the Indian workforce.

According to the Indian Society of Assisted Reproduction, infertility currently impacts 10–14 per cent of the Indian population, with higher rates in urban areas where one in six couples are affected. Commentators argue that the apparent higher rate of infertility among urban couples could be due to a variety of factors, including work-related stress, the later age at which some professional people attempt to start a family, and urban lifestyle factors – such as potentially higher rates of alcohol consumption and smoking, increased junk food intake and a lack of exercise.  

Experts say businesses need to invest in supporting the sexual health and mental wellbeing of their female employees, and insurance companies need to widen the scope of the health and medical support services they offer businesses and their staff to cover these issues. Also, women need to unburden and address their health.

With many hurdles to overcome, it is of little surprise that although the Indian economy has grown more than 10 times since 1990, the female workforce participation rate has fallen from 30 per cent in 1990 to 19 per cent in 2021 – the most recent year for which data is available. The fall was particularly steep in the period 2005 to 2021, when the female labour participation rate dropped from 32 to 19 per cent, according to World Bank data. During that time, the economy nearly quadrupled.

As India overtakes China as the world’s most populous country, one of the country’s biggest challenges is create jobs for all of its workers – including creating the conditions that will allow female workers to take these jobs.

Women activists say businesses and organisations must now take real action to improve the situation and ensure that female workers are treated with compassion at work – and supported to continue working – when they face female-specific health problems.