Evolution of the presence of women in decision-making bodies of the Spanish national health system

Objective: To examine the presence of women in the organs of the Interterritorial Council of the Spanish National Health System (CISNS). Method: Annual reports of the CISNS from 2005 to 2022 were analyzed. Artificial intelligence was used to assign gender, and percentages of women's participation were calculated. Temporal evolution, vertical segregation, and horizontal segregation were analyzed. Results: Between 2005 and 2022, there were 14,308 participations in 85 organs, with 52% women, rising from 42% in 2005 to 61% in 2022. There was a higher participation of women in propositional organs (54%), followed by executive ones (50%), and plenary sessions (40%). The General State Administration had 61% women compared to 48% in autonomous communities. Women's participation varied by topic, being higher (82%) in gender violence and lower (35%) in inspection. Conclusions: Although there is a slight reduction in the participation gap between women and men, inequalities persist. Women have less presence in higher hierarchical levels (plenary sessions), maintaining vertical segregation. Additionally, women's representation in certain topics remains low, maintaining horizontal segregation. Concrete actions must be taken to continue advancing equality and improving health outcomes in society as a whole. (c) 2024 SESPAS. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).