Advancing Women’s Leadership in Thailand’s Health Sector

Thailand illustrates many of the structural issues affecting women’s leadership in the health sector.

While the country has made progress toward gender equality, it remains off track to achieve Sustainable Development Goal 5 by 2030. In the World Economic Forum 2025 Global Gender Gap Index, Thailand ranked 66th with a score of 0.728, meaning 73% of the gender gap had been closed—an improvement from 68% in 2006, though progress has been slow.

Gains in educational attainment, however, have not fully translated into higher earnings, better job quality, and leadership opportunities for women due to structural constraints. Gender gaps persist in economic participation (0.786 = 79%) and in political empowerment (0.148 = 15%), limiting women’s access to decision-making positions.

In Thailand, women spend about three hours a day on unpaid care compared with almost one hour for men (173 minutes versus 56 minutes). This reduces opportunities for career advancements and limits access to leadership roles, including in the health sector.

Expanding access to childcare and eldercare and promoting more equal sharing of family care giving and domestic work are essential to retain women in the workforce, advance women’s leadership, and achieve gender equality.

Statistics from the Office of the Civil Service Commission show that women comprised almost two thirds (59%) of Thailand’s civil servants but held less than a fifth (19%) of high-ranking civil servant roles in 2015. Recent data indicate a slight improvement in the proportion of women in senior executive civil service positions. In 2024, women accounted for about a quarter of Higher Executives (Figure 1), including 16% of Permanent Secretaries, the highest-level officers. In the next tier down, Primary Executives such as Deputy Director General and Deputy Secretary General, women made up less than one third.

Figure 1: Number of Senior Civil Servants in Thailand, 2015-2024 by Gender

Source: Office of the Civil Service Commission

In the health sector, women make up 81% of the Ministry of Public Health staff, including over 90% of nurses and more than half of doctors. However, as of 2025, women accounted for only 9% of Higher Executive and 7% of Primary Executive civil servants in the Ministry of Public Health.

At subnational levels, representation remains limited. Women comprised less than 7% of leadership in the provincial health offices and 23% in the regional and general hospitals. This pattern of a highly female workforce but a largely male leadership is common across health sectors in ASEAN and reflects a missed opportunity to maximize the sector's productivity, responsiveness and impact.

Male-oriented organizational cultures and gendered stereotypes of leadership implicitly disadvantage women.

Women’s high family care burden means they often self-exclude from after-hours meetings and socializing where connections and informal relationships with seniors (typically men) are fostered.

Stereotypes of leadership aligned to typically male characteristics of "strength and decisiveness" rather than stereotypes of women as "soft and detailed" makes women have to work harder to gain recognition and acceptance as leaders.

Merit-based and formally gender-neutral advancement policies treat all equally but are too crude to respond to the lived realities of women and men or counter the implicit biases and gender norms that permeate the system.

Leadership pipelines that preference clinical specialists for executive roles limit the opportunities for nursing, public health, and other allied professionals to advance into sector leadership positions with consequent gender implications.

Thailand’s national policy commitments to gender equality, combined with existing health sector initiatives, provide a strong foundation to advance women’s leadership in health. Existing interventions provide a platform for strengthening women’s leadership, these include:

• Expanding and strengthening leadership development programs. Initiatives such as the Thai Medical Women’s Association’s Medical Women’s Leadership Program can build competencies in leadership skill and organizational influence. Organizational and individual capacity could also be strengthened to support work-life balance and to reach a large number of health professionals.
• Investing in nurse leadership. Targeted training, as advocated by the Nursing Association of Thailand, can support career progression and enable women nurse leaders to attain higher-ranking positions.
• Strengthening organizational support. Reinforcing gender equality objectives and ensuring functioning gender equality mechanisms within the Ministry of Public Health can help create a more enabling environment.

To advance women’s leadership in public health and strengthen national initiatives through the Ministry of Public Health and professional medical and nursing associations, these are the priority areas for action:

• Map pathways to leadership. Analyze how men and women moved into leadership roles, identifying enabling factors and limitations, and highlighting differences in career trajectories. Capture personal leadership journeys. Document experiences, key enablers, and challenges to inform strategies that support women’s movement into senior roles.
• Examine the impact of gendered occupational segregation. Include nursing and its effects on leadership pipelines and opportunities for advancement.
• Evaluate and improve leadership programs. Review existing initiatives, assess effectiveness in increasing women’s representation in leadership positions, and apply lessons to improve program design and impact.
• Strengthen networks and peer support. Empower women’s leadership networks and peer support groups to provide mentorship, guidance, and advocacy.
• Nurture male allyship. Engage male leaders to support gender equality, women’s leadership, and organizational change.

Together, these measures provide evidence-based insights to design effective interventions and support sustainable women’s leadership development in Thailand’s health sector.

Note: This Insight is part of research under the technical assistance on Regional Health Cooperation in the Greater Mekong Subregion. The team appreciates review comments from Claire Charamnac of the Asian Development Bank 's Gender Equality Division (CCGE), Climate Change and Sustainable Development Department (CCSD).

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