Birender Sangwan’s parents wanted him to be a doctor.
For two years, Sangwan even prepared for the medical entrance examinations in India before finally giving up. “I was always scared of hospitals,” he said in an interview at his modest two-room office at New Delhi’s Rohini court complex. “I still get dizzy and feel like vomiting when I go to hospitals.”
But in September 2014, he went to the Metro Hospital in Faridabad, a suburb of Delhi. A friend’s brother needed a coronary stent—wire mesh planted in an artery to open up blood flow—fitted into his heart. The hospital charged his friend more than Rs1 lakh for this, without mentioning the device’s maximum retail price. “I asked the doctor to provide us with the purchase bill for the stent,” Sangwan said. “He refused.”
That refusal is the reason why 37-year-old Sangwan is at the centre of the storm sweeping through India’s Rs6.7 lakh crore ($100 billion) healthcare industry today.
A public interest litigation (PIL) filed by the affable lawyer in 2015 coaxed the Indian government to crack the whip on the country’s Rs3,300 crore ($531 million) coronary stent industry, ending years of rampant profiteering.
In a country where 30 million people suffer from cardiovascular problems and over two million die of heart attacks and strokes each year, stents have become essential. Every year, over 200,000 heart surgeries take place in the country. But this demand has stoked a racket of extraordinary proportions: Government data published last month showed that hospitals in Asia’s third-largest economy could be selling stents at margins of up to 654%.
Not any more, though.
On Feb. 13, the National Pharmaceutical Pricing Authority (NPPA), the primary agency for fixing drug prices, notified a price cap (pdf) of Rs7,260 for bare metal stents (those without any coatings) and Rs29,600 for modern drug eluting stents. The latter have a polymer coating, which gradually releases a drug to ensure that the blockage doesn’t reoccur.
So far, the average retail price for a bare metal stent was Rs45,000, while drug eluting stents were priced at around Rs1.20 lakh.
In a five-page order, the drug pricing authority explained that the move was made after an analysis of pricing data and extensive consultations.
During deliberations, it was found that huge unethical markups are charged at each stage in the supply chain of coronary stents, resulting in irrational, restrictive, and exorbitant prices in a failed market system driven by information asymmetry between the patient and doctors, pushing patients to financial misery; and whereas under such extraordinary circumstances, there is an urgent necessity, in public interest, to fix the ceiling price of coronary stents to bring respite to patients.
Lawyer turned crusader
Born into a middle class family in Kohna, Sangwan grew up in the nondescript Haryana village till he left for the capital to study political science at Delhi University. After graduating in political science, Sangwan turned to study law from Maharshi Dayanand University in Rohtak, Haryana.
In 2007, he enrolled as a lawyer at the Rohini court, where cases from the west and north west districts of Delhi are heard. “For three years, it was a struggle, because I hardly knew anyone and it was tough to find cases. Most of the cases I attended to were criminal ones,” Sangwan said. Three years into the profession, he added civil cases and writ petitions to his repertoire. By 2013, he was handling PILs.
Then, in September 2014, Sangwan witnessed the Metro Hospital episode. “The total bill at the hospital was more than Rs3.2 lakh,” Sangwan said. “That is really expensive for a country like India.”
Soon, he filed a query under the Right to Information Act to find out the number of hospitals in Delhi that performed angioplasty. He found 54 such hospitals and the rates of stents varied across the facilities.
A month later, bothered by what he calls doctors’ brutality, Sangwan filed a complaint with India’s health ministry. In November 2014, Sangwan filed another RTI to see if stents came under the drugs category or metal category.
The crusade had begun.
The government responded in December, informing him that stents came under the Drug and Cosmetic Act, but wasn’t covered under the National List of Essential Medicines (NLEM). This list identifies medicines that must be made affordable for citizens. So, in February 2015, he filed a PIL at the Delhi high court (HC) to get stents included in NLEM. The court asked India’s chemical and fertiliser ministry—under oversees the department of pharmaceuticals—to take action.
There was no response for months. In October 2015, Sangwan filed a contempt notice at the HC citing the government’s laxity.
It was only in July 2016 that the Narendra Modi government notified the addition of stents in the NLEM. Sangwan wasn’t done, though. In December, he filed another PIL seeking a limit on the maximum retail price of stents. This was followed by a HC order asking the government to fix the rates. Finally, on Feb. 13, the government placed the cap.
“Our fight isn’t against the stent makers,” said Sangwan, “It is against the distributors and hospitals who have been extorting patients.”
Margin mania
“If you look at a distributor, it is a highly working capital intensive industry for two reason. One is the inventory, the other is the outstanding (payments),” explained Ganesh P Sabat, CEO of Sahajanand Medical Technologies, one of India’s dozen or so domestic stent manufacturers.
The situation, according to Sabat, looks something like this. If a distributor stocks between 120 and 200 stents per hospital, with each device priced at between Rs25,000 and Rs30,000, the working capital requirement is upwards of Rs30 lakh per hospital. It’s obviously a lot more for more expensive stents. On top of that, there’s a possibility of about 10% of the stocked stents become unusable after they cross their expiry date, and approximately 5% of stents have a chance of incurring some damage during transport or storage.
Alongside, there’s the issue of outstanding payments, particularly for government healthcare schemes, where the payout can take anything between six months and a year. All through, the distributor has to pay an interest rate of about 15%.
“Because the distributor makes this substantial investment in the working capital, they end up asking for 30-40% margins,” said Sabat, “And the hospital adds its own margin on top of the distributors.”
Sangwan, too, agrees that it isn’t the manufacturers who are inflating prices. “The manufacturers have been selling at the same price for years,” he said. “The distributors, hospitals, and doctors are hand in glove with each other and they are the ones making the money. The product should come directly from the manufacturers to the patients.”
India’s healthcare service providers cannot deny that such malpractices are rampant. To start with, only about 1% of the hospitals in the country are accredited, the rest are wont to flout norms and rules. Industry leaders, speaking on the condition of anonymity, argue that once accredited, the margins of bona fide healthcare service providers come under pressure because of the cost of following prescribed norms and putting in place the required systems. And with shrinking margins, hospitals come to increasingly rely on pharmacy sales, medical devices, and medical diagnostic testing. The cap on stent pricing, therefore, will hit their balance sheets further, unless it is made up for by increasing the overall cost of cardiac procedures that use such devices.
Industry heartburn
The drastic price revision has rattled India’s stent market, especially multinational medical device manufacturers with expensive offerings.
The Advanced Medical Technology Association (AdvaMed), a Washington DC-based trade association of over 300 medical technology firms, including stent makers Abbott and Boston Scientific, said it was “deeply disappointed” by the NPPA order. In a statement, AdvaMed explained:
While the intent is to cap prices in patient interest, this pricing has the potential to block innovations and limit access to world-class medical care and options to deserving patients. The singular focus on controlling ceiling price of stents, without attempting to address the larger picture and correct inefficiencies in the healthcare ecosystem will not achieve its stated benefit, in the long run.
The decision also disregards the evolution of coronary stents over the last four decades, and blocking innovation may set our healthcare sector back by at least a decade, when there were far lesser options for Indian patients. There is a clear, measurable difference between different types of stents and their benefits. The government should have taken this categorization into consideration before regulating prices.
In the days immediately following the NPPA order, reports suggestedthat Abbott’s bioresorbable stents (which fully dissolves over time), previously priced at Rs1.6 lakh, were withdrawn from a number of Mumbai hospitals. In Kolkata, too, high-end stents suddenly went out of circulation.
The company, however, denied that anything of that sort happened. “Abbott continues to market our full range of coronary stents available in India, per the NPPA order of Feb. 13, 2017,” a spokesperson said. “We have also advised trade partners and hospital partners to abide by the ceiling prices determined by the NPPA order.”
Some part of the setback for multinational stent manufacturers is of their own making, though.
Girdhar J Gyani, director general of the Association of Healthcare Providers, which represents over 400 hospitals nationwide, explained that companies were unable to make a solid case for the use of more expensive, advanced stents, as opposed to older, cheaper variants.
“Unfortunately, our cardiologist friends were not able to produce the validated report which says that the fifth or fourth generation stents will give better outcomes,” said Gyani. “I wanted a very validated report but what I’ve been able to get are reports produced as marketing tools by the stent companies.”
Although the association supports the government’s move to cap some stents, Gyani argued that the NPPA order will make it difficult for patients to get top-of-the-line stents even if they want, and can afford, them. “Our final line is, please keep this option open for the patients who are affluent and who want fourth and fifth generation stents,” he said.
There’s also the fear that the pricing-cap on stents will drive away the lucrative wave of medical tourists who have been coming to Indian hospitals in growing numbers. “If we don’t give them the option, they may not want to come to us,” Gyani added. Well-heeled Indians, too, could fly overseas for treatment if the situation persists.
Indian stent-makers aren’t buying the argument. Their stents, they insist, are just as good as those of their foreign-made counterparts. “We can innovate much faster than them and we have more advanced features,” said Sabat. “With marketing and financial muscle, they try to show that they’re the most advanced.”
In any case, it’s not that multinational stent-makers can ignore India, said the managing director of another Indian firm, speaking on the condition of anonymity. “Can any company neglect this population? No. We have 1.2 billion people,” he said. “Let’s see after a year how many patients really went out of India (for treatment).”
Sangwan, meanwhile, is raring for another fight, this time to bring down the prices of orthopaedic products, including those used in knee and hip replacement surgeries.
“I am also planning to do my PhD in law,” he said. “After all, I must fulfill my parents ambitions of me becoming a doctor.”
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Steve Ovett, the famous British middle-distance athlete, won the 800-metres gold medal at the Moscow Olympics of 1980. Just a few days later, he was about to win a 5,000-metres race at London’s Crystal Palace. Known for his burst of acceleration on the home stretch, he had supreme confidence in his ability to out-sprint rivals. With the final 100 metres remaining,
[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]Ovett waved to the crowd and raised a hand in triumph. But he had celebrated a bit too early. At the finishing line, Ireland’s John Treacy edged past Ovett. For those few moments, Ovett had lost his sense of reality and ignored the possibility of a negative event.
This analogy works well for the India story and our policy failures , including during the ongoing covid pandemic. While we have never been as well prepared or had significant successes in terms of growth stability as Ovett did in his illustrious running career, we tend to celebrate too early. Indeed, we have done so many times before.
It is as if we’re convinced that India is destined for greater heights, come what may, and so we never run through the finish line. Do we and our policymakers suffer from a collective optimism bias, which, as the Nobel Prize winner Daniel Kahneman once wrote, “may well be the most significant of the cognitive biases”? The optimism bias arises from mistaken beliefs which form expectations that are better than the reality. It makes us underestimate chances of a negative outcome and ignore warnings repeatedly.
The Indian economy had a dream run for five years from 2003-04 to 2007-08, with an average annual growth rate of around 9%. Many believed that India was on its way to clocking consistent double-digit growth and comparisons with China were rife. It was conveniently overlooked that this output expansion had come mainly came from a few sectors: automobiles, telecom and business services.
Indians were made to believe that we could sprint without high-quality education, healthcare, infrastructure or banking sectors, which form the backbone of any stable economy. The plan was to build them as we went along, but then in the euphoria of short-term success, it got lost.
India’s exports of goods grew from $20 billion in 1990-91 to over $310 billion in 2019-20. Looking at these absolute figures it would seem as if India has arrived on the world stage. However, India’s share of global trade has moved up only marginally. Even now, the country accounts for less than 2% of the world’s goods exports.
More importantly, hidden behind this performance was the role played by one sector that should have never made it to India’s list of exports—refined petroleum. The share of refined petroleum exports in India’s goods exports increased from 1.4% in 1996-97 to over 18% in 2011-12.
An import-intensive sector with low labour intensity, exports of refined petroleum zoomed because of the then policy regime of a retail price ceiling on petroleum products in the domestic market. While we have done well in the export of services, our share is still less than 4% of world exports.
India seemed to emerge from the 2008 global financial crisis relatively unscathed. But, a temporary demand push had played a role in the revival—the incomes of many households, both rural and urban, had shot up. Fiscal stimulus to the rural economy and implementation of the Sixth Pay Commission scales had led to the salaries of around 20% of organized-sector employees jumping up. We celebrated, but once again, neither did we resolve the crisis brewing elsewhere in India’s banking sector, nor did we improve our capacity for healthcare or quality education.
Employment saw little economy-wide growth in our boom years. Manufacturing jobs, if anything, shrank. But we continued to celebrate. Youth flocked to low-productivity service-sector jobs, such as those in hotels and restaurants, security and other services. The dependence on such jobs on one hand and high-skilled services on the other was bound to make Indian society more unequal.
And then, there is agriculture, an elephant in the room. If and when farm-sector reforms get implemented, celebrations would once again be premature. The vast majority of India’s farmers have small plots of land, and though these farms are at least as productive as larger ones, net absolute incomes from small plots can only be meagre.
A further rise in farm productivity and consequent increase in supply, if not matched by a demand rise, especially with access to export markets, would result in downward pressure on market prices for farm produce and a further decline in the net incomes of small farmers.
We should learn from what John Treacy did right. He didn’t give up, and pushed for the finish line like it was his only chance at winning. Treacy had years of long-distance practice. The same goes for our economy. A long grind is required to build up its base before we can win and celebrate. And Ovett did not blame anyone for his loss. We play the blame game. Everyone else, right from China and the US to ‘greedy corporates’, seems to be responsible for our failures.
We have lowered absolute poverty levels and had technology-based successes like Aadhaar and digital access to public services. But there are no short cuts to good quality and adequate healthcare and education services. We must remain optimistic but stay firmly away from the optimism bias.
In the end, it is not about how we start, but how we finish. The disastrous second wave of covid and our inability to manage it is a ghastly reminder of this fact.
On March 31, the World Economic Forum (WEF) released its annual Gender Gap Report 2021. The Global Gender Gap report is an annual report released by the WEF. The gender gap is the difference between women and men as reflected in social, political, intellectual, cultural, or economic attainments or attitudes. The gap between men and women across health, education, politics, and economics widened for the first time since records began in 2006.
[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]No need to remember all the data, only pick out few important ones to use in your answers.
The Global gender gap index aims to measure this gap in four key areas : health, education, economics, and politics. It surveys economies to measure gender disparity by collating and analyzing data that fall under four indices : economic participation and opportunity, educational attainment, health and survival, and political empowerment.
The 2021 Global Gender Gap Index benchmarks 156 countries on their progress towards gender parity. The index aims to serve as a compass to track progress on relative gaps between women and men in health, education, economy, and politics.
Although no country has achieved full gender parity, the top two countries (Iceland and Finland) have closed at least 85% of their gap, and the remaining seven countries (Lithuania, Namibia, New Zealand, Norway, Sweden, Rwanda, and Ireland) have closed at least 80% of their gap. Geographically, the global top 10 continues to be dominated by Nordic countries, with —Iceland, Norway, Finland, and Sweden—in the top five.
The top 10 is completed by one country from Asia Pacific (New Zealand 4th), two Sub-Saharan countries (Namibia, 6th and Rwanda, 7th, one country from Eastern Europe (the new entrant to the top 10, Lithuania, 8th), and another two Western European countries (Ireland, 9th, and Switzerland, 10th, another country in the top-10 for the first time).There is a relatively equitable distribution of available income, resources, and opportunities for men and women in these countries. The tremendous gender gaps are identified primarily in the Middle East, Africa, and South Asia.
Here, we can discuss the overall global gender gap scores across the index’s four main components : Economic Participation and Opportunity, Educational Attainment, Health and Survival, and Political Empowerment.
The indicators of the four main components are
(1) Economic Participation and Opportunity:
o Labour force participation rate,
o wage equality for similar work,
o estimated earned income,
o Legislators, senior officials, and managers,
o Professional and technical workers.
(2) Educational Attainment:
o Literacy rate (%)
o Enrollment in primary education (%)
o Enrollment in secondary education (%)
o Enrollment in tertiary education (%).
(3) Health and Survival:
o Sex ratio at birth (%)
o Healthy life expectancy (years).
(4) Political Empowerment:
o Women in Parliament (%)
o Women in Ministerial positions (%)
o Years with a female head of State (last 50 years)
o The share of tenure years.
The objective is to shed light on which factors are driving the overall average decline in the global gender gap score. The analysis results show that this year’s decline is mainly caused by a reversal in performance on the Political Empowerment gap.
Global Trends and Outcomes:
– Globally, this year, i.e., 2021, the average distance completed to gender parity gap is 68% (This means that the remaining gender gap to close stands at 32%) a step back compared to 2020 (-0.6 percentage points). These figures are mainly driven by a decline in the performance of large countries. On its current trajectory, it will now take 135.6 years to close the gender gap worldwide.
– The gender gap in Political Empowerment remains the largest of the four gaps tracked, with only 22% closed to date, having further widened since the 2020 edition of the report by 2.4 percentage points. Across the 156 countries covered by the index, women represent only 26.1% of some 35,500 Parliament seats and 22.6% of over 3,400 Ministers worldwide. In 81 countries, there has never been a woman head of State as of January 15, 2021. At the current rate of progress, the World Economic Forum estimates that it will take 145.5 years to attain gender parity in politics.
– The gender gap in Economic Participation and Opportunity remains the second-largest of the four key gaps tracked by the index. According to this year’s index results, 58% of this gap has been closed so far. The gap has seen marginal improvement since the 2020 edition of the report, and as a result, we estimate that it will take another 267.6 years to close.
– Gender gaps in Educational Attainment and Health and Survival are nearly closed. In Educational Attainment, 95% of this gender gap has been closed globally, with 37 countries already attaining gender parity. However, the ‘last mile’ of progress is proceeding slowly. The index estimates that it will take another 14.2 years to close this gap on its current trajectory completely.
In Health and Survival, 96% of this gender gap has been closed, registering a marginal decline since last year (not due to COVID-19), and the time to close this gap remains undefined. For both education and health, while progress is higher than economy and politics in the global data, there are important future implications of disruptions due to the pandemic and continued variations in quality across income, geography, race, and ethnicity.
India-Specific Findings:
India had slipped 28 spots to rank 140 out of the 156 countries covered. The pandemic causing a disproportionate impact on women jeopardizes rolling back the little progress made in the last decades-forcing more women to drop off the workforce and leaving them vulnerable to domestic violence.
India’s poor performance on the Global Gender Gap report card hints at a serious wake-up call and learning lessons from the Nordic region for the Government and policy makers.
Within the 156 countries covered, women hold only 26 percent of Parliamentary seats and 22 percent of Ministerial positions. India, in some ways, reflects this widening gap, where the number of Ministers declined from 23.1 percent in 2019 to 9.1 percent in 2021. The number of women in Parliament stands low at 14.4 percent. In India, the gender gap has widened to 62.5 %, down from 66.8% the previous year.
It is mainly due to women’s inadequate representation in politics, technical and leadership roles, a decrease in women’s labor force participation rate, poor healthcare, lagging female to male literacy ratio, and income inequality.
The gap is the widest on the political empowerment dimension, with economic participation and opportunity being next in line. However, the gap on educational attainment and health and survival has been practically bridged.
India is the third-worst performer among South Asian countries, with Pakistan and Afghanistan trailing and Bangladesh being at the top. The report states that the country fared the worst in political empowerment, regressing from 23.9% to 9.1%.
Its ranking on the health and survival dimension is among the five worst performers. The economic participation and opportunity gap saw a decline of 3% compared to 2020, while India’s educational attainment front is in the 114th position.
India has deteriorated to 51st place from 18th place in 2020 on political empowerment. Still, it has slipped to 155th position from 150th position in 2020 on health and survival, 151st place in economic participation and opportunity from 149th place, and 114th place for educational attainment from 112th.
In 2020 reports, among the 153 countries studied, India is the only country where the economic gender gap of 64.6% is larger than the political gender gap of 58.9%. In 2021 report, among the 156 countries, the economic gender gap of India is 67.4%, 3.8% gender gap in education, 6.3% gap in health and survival, and 72.4% gender gap in political empowerment. In health and survival, the gender gap of the sex ratio at birth is above 9.1%, and healthy life expectancy is almost the same.
Discrimination against women has also been reflected in Health and Survival subindex statistics. With 93.7% of this gap closed to date, India ranks among the bottom five countries in this subindex. The wide sex ratio at birth gaps is due to the high incidence of gender-based sex-selective practices. Besides, more than one in four women has faced intimate violence in her lifetime.The gender gap in the literacy rate is above 20.1%.
Yet, gender gaps persist in literacy : one-third of women are illiterate (34.2%) than 17.6% of men. In political empowerment, globally, women in Parliament is at 128th position and gender gap of 83.2%, and 90% gap in a Ministerial position. The gap in wages equality for similar work is above 51.8%. On health and survival, four large countries Pakistan, India, Vietnam, and China, fare poorly, with millions of women there not getting the same access to health as men.
The pandemic has only slowed down in its tracks the progress India was making towards achieving gender parity. The country urgently needs to focus on “health and survival,” which points towards a skewed sex ratio because of the high incidence of gender-based sex-selective practices and women’s economic participation. Women’s labour force participation rate and the share of women in technical roles declined in 2020, reducing the estimated earned income of women, one-fifth of men.
Learning from the Nordic region, noteworthy participation of women in politics, institutions, and public life is the catalyst for transformational change. Women need to be equal participants in the labour force to pioneer the societal changes the world needs in this integral period of transition.
Every effort must be directed towards achieving gender parallelism by facilitating women in leadership and decision-making positions. Social protection programmes should be gender-responsive and account for the differential needs of women and girls. Research and scientific literature also provide unequivocal evidence that countries led by women are dealing with the pandemic more effectively than many others.
Gendered inequality, thereby, is a global concern. India should focus on targeted policies and earmarked public and private investments in care and equalized access. Women are not ready to wait for another century for equality. It’s time India accelerates its efforts and fight for an inclusive, equal, global recovery.
India will not fully develop unless both women and men are equally supported to reach their full potential. There are risks, violations, and vulnerabilities women face just because they are women. Most of these risks are directly linked to women’s economic, political, social, and cultural disadvantages in their daily lives. It becomes acute during crises and disasters.
With the prevalence of gender discrimination, and social norms and practices, women become exposed to the possibility of child marriage, teenage pregnancy, child domestic work, poor education and health, sexual abuse, exploitation, and violence. Many of these manifestations will not change unless women are valued more.
[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]2021 WEF Global Gender Gap report, which confirmed its 2016 finding of a decline in worldwide progress towards gender parity.
Over 2.8 billion women are legally restricted from having the same choice of jobs as men. As many as 104 countries still have laws preventing women from working in specific jobs, 59 countries have no laws on sexual harassment in the workplace, and it is astonishing that a handful of countries still allow husbands to legally stop their wives from working.
Globally, women’s participation in the labour force is estimated at 63% (as against 94% of men who participate), but India’s is at a dismal 25% or so currently. Most women are in informal and vulnerable employment—domestic help, agriculture, etc—and are always paid less than men.
Recent reports from Assam suggest that women workers in plantations are paid much less than men and never promoted to supervisory roles. The gender wage gap is about 24% globally, and women have lost far more jobs than men during lockdowns.
The problem of gender disparity is compounded by hurdles put up by governments, society and businesses: unequal access to social security schemes, banking services, education, digital services and so on, even as a glass ceiling has kept leadership roles out of women’s reach.
Yes, many governments and businesses had been working on parity before the pandemic struck. But the global gender gap, defined by differences reflected in the social, political, intellectual, cultural and economic attainments or attitudes of men and women, will not narrow in the near future without all major stakeholders working together on a clear agenda—that of economic growth by inclusion.
The WEF report estimates 135 years to close the gap at our current rate of progress based on four pillars: educational attainment, health, economic participation and political empowerment.
India has slipped from rank 112 to 140 in a single year, confirming how hard women were hit by the pandemic. Pakistan and Afghanistan are the only two Asian countries that fared worse.
Here are a few things we must do:
One, frame policies for equal-opportunity employment. Use technology and artificial intelligence to eliminate biases of gender, caste, etc, and select candidates at all levels on merit. Numerous surveys indicate that women in general have a better chance of landing jobs if their gender is not known to recruiters.
Two, foster a culture of gender sensitivity. Take a review of current policies and move from gender-neutral to gender-sensitive. Encourage and insist on diversity and inclusion at all levels, and promote more women internally to leadership roles. Demolish silos to let women grab potential opportunities in hitherto male-dominant roles. Work-from-home has taught us how efficiently women can manage flex-timings and productivity.
Three, deploy corporate social responsibility (CSR) funds for the education and skilling of women and girls at the bottom of the pyramid. CSR allocations to toilet building, the PM-Cares fund and firms’ own trusts could be re-channelled for this.
Four, get more women into research and development (R&D) roles. A study of over 4,000 companies found that more women in R&D jobs resulted in radical innovation. It appears women score far higher than men in championing change. If you seek growth from affordable products and services for low-income groups, women often have the best ideas.
Five, break barriers to allow progress. Cultural and structural issues must be fixed. Unconscious biases and discrimination are rampant even in highly-esteemed organizations. Establish fair and transparent human resource policies.
Six, get involved in local communities to engage them. As Michael Porter said, it is not possible for businesses to sustain long-term shareholder value without ensuring the welfare of the communities they exist in. It is in the best interest of enterprises to engage with local communities to understand and work towards lowering cultural and other barriers in society. It will also help connect with potential customers, employees and special interest groups driving the gender-equity agenda and achieve better diversity.