New Delhi: Only nine of 46 associations under India's largest and oldest professional medical association, the IMA, are currently led by women, suggesting a "negligible" representation in its leadership, according to a study.

Of the 92 individuals who have served as the presidents since the Indian Medical Association's (IMA's) inception in 1928, only one was a woman, said a team of researchers, including those from The George Institute for Global Health, New Delhi.

They looked at the current and past leaderships of the professional medical associations, including the Indian Public Health Association (IPHA) and those of all broad medical and surgical specialities.

Unequal gender representation persists even in the medical associations closely involved in women's health such as obstetrics and gynaecology, pediatrics and neonatology, highlighting a male dominance, the authors said in the study published in the journal PLoS Global Public Health.

"For instance, the National Neonatology Forum has only one woman in its leadership committee and in The Federation of Obstetric and Gynecological Societies of India's 73 years of history, only 15 per cent of past presidents were women," the authors wrote.

Founded in 1928, the IMA is a voluntary organisation of 3.5 lakh doctors practising modern medicine. Along with promoting modern medicine and public health education, it is involved in representing the interest of the doctors and ensuring the well-being of the wider community.

Reacting to the findings, IMA president Dr R. V. Asokan said, "I don't think this is true. These organisations are not under the IMA. They are verticals, speciality organisations. The IMA is three layered and you will find woman presidents and secretaries all across India's local branches, in cities and towns."

The study's authors said that professional medical associations play a crucial role in shaping policy agenda in the health sector, but very little is known about gender diversity in their leadership.

Looking at the IMA's sub-chapters, which are part of local groups or branches across 28 states and four Union Territories, the authors found that "among the 64 individuals currently serving as the presidents and secretaries of 32 sub-chapters of the IMA, only three (4.6 per cent) are women".

"By nature of their work, gynaecologists and paediatricians, who are also housewives, are not able to travel across the country," Dr Asokan said.

The study's authors said the results are in line with those from global studies revealing a 'leaky pipeline' - that even though more women are entering the medical field than ever before, very few reach leadership positions.

Dr Asokan said there is women representation at the top in the IMA headquarters at the state-level.

"There are state presidents. Upto state level, it is easy for them to travel and adjust their professional as well as family work. At the national level, they have their limitations. It's not a limitation of the IMA, it's a limitation in-built in their professional careers," he said.

The researchers cautioned that skewed gender ratio among the professional medical associations is a major concern, as it can lead to an unbalanced agenda inadequate in addressing the health and care needs of women.

They said that concerted efforts to address gender inequities in the medical associations are urgently needed.

They also highlighted that having women-only chapters within associations is insufficient in addressing this issue effectively as only 5.5 per cent of their leadership is women, despite their presence in the IMA.