Analysis of the Gender Pay Gap in the Nigerian Public Health Sector: Evidence from Cross River State

The gender pay gap in public health services represents a structural inequity that undermines professional motivation among female health workers and reflects broader systemic gender biases within Nigeria's public sector. This study analyses the nature and determinants of the gender pay gap in the public health sector in Cross River State, focusing on registered nurses, pharmacists, and medical officers employed in state health facilities. A quantitative survey design was used, with 240 health workers from 15 facilities completing structured questionnaires supplemented by payroll data analysis from three selected hospitals. Data were analysed using descriptive statistics, independent samples t-tests, and decomposition analysis. Findings reveal that female health workers in the state earn, on average, 17% less than their male counterparts at equivalent grades, with the gap widening at senior professional levels. Differences in allowances, call duty assignment, and promotion rates contribute more to the gap than basic salary structures. Female workers are less frequently assigned to higher-paying specialist units and are underrepresented in management positions that attract additional allowances. Recommendations include a gender audit of health sector remuneration structures, transparent promotion criteria, and mentoring programmes for female health professionals. This study contributes to health workforce gender equity literature in the South South geopolitical zone. Keywords: gender pay gap, public health sector, Cross River State, women, pay equity