Health workers earn less if they’re women

New WHO analysis finds a 28% monthly pay gap across Europe

Copenhagen, 18 September 2026

Women make up almost 77% of the health and care workforce across the WHO European Region but earn 19% less per hour than men and 28% less a month, according to a new WHO/Europe report published today covering 43 countries.

“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,” said Dr Natasha Azzopardi-Muscat, Director, Division for Health Systems, WHO/Europe. “It means lower pensions, less financial security in older age, and a higher risk of poverty for women who've spent their working lives caring for others. This isn't a coincidence, and it isn't about qualifications. Women are being paid less for the same work and passed over for the roles that pay more.”

A gap that widens the higher you go

The pay gap widens sharply across the earnings distribution. At the bottom of the pay scale, women earn about 2% less than men per hour, but at the top, the pay gap reaches almost 23%. On paper, women's own qualifications and experience would see them earning slightly more than men in the best-paid roles, yet in practice they are earning less.

That pattern points to something other than differences in age, education or working hours. Managerial jobs in health and care employ more women than management roles in other sectors do and pay less for it: €22.00 per hour on average, against €24.70 in comparable roles elsewhere. The more a role in the sector is dominated by women, the report finds, the lower it tends to be paid, regardless of the skills or responsibilities it requires.

What explains the gap, and what doesn't

“Most of this gap isn't down to women working fewer hours, being younger, or working in different parts of the sector,” Dr Azzopardi Muscat explained. “It comes down to how the sector values women's work. Age, education, working hours and public versus private sector employment only helps explain some of it.”

Adjusting for those four factors brings the hourly pay gap down from 19% to 6%, and the monthly pay gap from 28% to 10%. The remaining pay gap can’t be explained by anything measured in the data, and it's worst exactly where it matters most: at the top of the pay scale, where it accounts for almost the entire difference between what women and men earn.

The analysis found that much of the gender pay gap remains unexplained even after accounting for factors such as age, education, working hours and sector, and that the gap widens further up the pay scale.

It also points to a clear pattern of undervaluation: the more a health and care role is dominated by women, the less it tends to pay, even compared with similar work in other sectors.

These findings suggest that the disparity cannot be explained by differences in qualifications alone but reflects how work predominantly carried out by women is valued and rewarded.

Why this matters

The health and care sector is the region's fourth-largest employer, accounting for roughly 10% of everyone employed, and the biggest single source of paid caregiving jobs in the region, ahead of education and domestic work.

It's an especially important source of work for women. The sector makes up almost 17% of all women's employment in the region, against just 5% for men. In Belgium, Denmark and Norway, 1 in 4 employed women works in health and care. In France, Germany, Ireland, the Netherlands and Switzerland, it’s 1 in 5. In the Russian Federation, it's about 1 in 7, and in Kyrgyzstan, around 1 in 10. In Estonia, Lithuania and Poland, women make up nearly 90% of the sector's workforce.

Unequal pay in a sector this size affects recruitment, retention, and how many women reach senior and leadership roles, with knock-on effects for the health systems that depend on them.

Call to Action

WHO/Europe is calling on Member States to act on five fronts, all of them achievable:

• Make gender pay gap reporting mandatory, so pay gaps are visible and can be tracked over time.
• Close the data gaps. Collect and publish pay data disaggregated by gender, profession, race and ethnicity, not just age and sector.
• Strengthen equal pay legislation and back it with real enforcement and monitoring.
• Remove the structural barriers, such as limited mentorship and unequal caregiving expectations, that keep women out of senior, better-paid roles.
• Revalue health and care work itself, so pay reflects the skills and responsibility the job demands, rather than who has traditionally done it.

“This isn't a complicated problem to fix, it's a question of will,” concluded Dr Azzopardi-Muscat. “We know how to close the pay gap: transparency, enforcement, and removing the barriers that keep women out of senior roles. Every Member State in this Region can start today.”

ENDS

Note to editors

• The report combines 2023 data from 32 countries with earlier data (2017-2019) from 11 more, covering 43 of the WHO European Region's 53 Member States in total[i]. Data weren't available for the remaining 10 countries. It is the first region-specific update to the 2022 ILO-WHO global report on gender pay gaps in health and care, and it shows the sector, one of the most female-dominated in Europe, hasn't translated women's numbers into equal pay.
• “Raw” gender pay gap figures compare what women and men actually earn, with no adjustment for other factors. “Factor-weighted” (adjusted) figures control for age, education, employment sector (public/private) and full-time/part-time status.
• The full evidence brief, Gender pay gap in the health and care sector in the WHO European Region, is available here.

Media contacts

Ramy Srour, srourr@who.int

Bhanu Bhatnagar, bbhatnagar@who.int