Table 1.

Pacific HCW experience of gendered power relations during COVID-19.

Key domain questions	Women	Men, institutions, structures, other/unknown bodies
Who has what?	Specific and highly desirable workplace skills (communication, situational awareness, emotional intelligence, persistence, and endurance) Networks to access information Emancipatory leadership skills Social and cultural capital	Power over work conditions, pay and other benefits. Control over women's access to work and/or other activities (women required to seek permission, or denied permission to work) Demands on women's time, social and cultural capital (family and community caring responsibilities and expectations) Access to knowledge
Who does what?	Most of the patient-facing, clinical work (service-provision, frontline, professional roles), including working overtime Look out for staff; care and protect staff Family and community caring (personal roles) Pregnancy, breastfeeding, maternal care Role modelling for other female staff Effective, ‘on-the ground’ advocacy Take risks and put themselves forward	Higher-level, management work Provide support for some women in some PICTs in leadership roles May or may not recognise women's work and women's leadership Speak on behalf of women
How values are defined	Women shape and confirm values using their social and emotional capital: Women HCWs perceive themselves as well (possibly better) suited to patient-facing roles by virtue of their attention to detail and loving care provision Some PICTs elevated women's cultural capital (‘crowns from home’), and accepted social norms of women's assertiveness (‘being nosey and investigative’) which enabled courageous advocacy and frank speaking from women Women's solidarity assisted with leadership, safety in the workplace and pandemic planning	Common Pacific cultural values (from our data): -Patriarchy (men as head of the family and community) -Respect for elders/hierarchies -Women's domestic centrality -Communitarian Assumption of male leadership and of male speaking opportunities and platforms Women's leadership qualities of inclusivity, persuasion and empowerment not necessarily valued or recognised High value on maternity/motherhood resulting in identification and protection of pregnant HCWs
Who decides?	Group decision-making when in formal leadership roles Informally—women HCWs withdraw their labour if they feel unsafe or the risk/benefit ratio falls towards the family/community rather than the workplace Can enter decision-making roles by default through persistence and advocacy	Men make decisions and speak out on behalf of women or may actively exclude the female voice by nature of male-only leadership Political (almost exclusively male) decisions about pay, overtime allowances and pandemic benefits Institutional decision-making for pregnant HCWs (potentially denying women's autonomy)