Content uploaded by Ruta Aidis
Author content
All content in this area was uploaded by Ruta Aidis on Oct 17, 2019
Content may be subject to copyright.
Healthy Women,
Healthy Economies
A GUIDEBOOK
FOR SMES
December 2018
This publication was produced by Nathan Associates Inc. for review by the United States Agency for International Development.
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 2
DISCLAIMER:
This document is made possible by the support of the American people through the United States Agency for International Development
(USAID). Its contents are the sole responsibility of the author or authors and do not necessarily reflect the views of USAID or the United
States government.
This guidebook was prepared under the APEC Healthy Women, Healthy Economies initiative as part of the US-
APEC Technical Assistance to Advance Regional Integration (US-ATAARI) activity. The principal authors were
Dr. Ruta Aidis and Caroline Rubin, under the guidance of Ann Katsiak. We thank those who provided inputs and
guidance on the report, including Chase Ballinger and Deanne de Lima of the U.S. Department of State, Sashi
Jayatileke of USAID, Erika Elvander of the U.S. Department of Health and Human Services, Chris Watson of the
U.S. Department of Labor, and Patricia Wu of C&M International.
US-ATAARI is a 5 year project funded and managed by USAID/U.S. Department of State that provides capacity
building to strengthen the APEC Secretariat and deliver technical assistance and training aimed at supporting
APEC in achieving its policy objectives, with particular emphasis on developing member economies. The project
is implemented by US-based economics consulting firm, Nathan Associates Inc. For further information,
contact Ann Katsiak, Chief of Party, at AKatsiak@nathaninc.com.
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 1
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 2
Contents
Introduction.................................................................... 3
Why SMEs? .................................................................... 4
Workplace Health and Safety...................................................... 5
Peru: Investing in Employee Health Improves the Work Environment ............... 5
The United States: Developing Professional Protective Gear
Fitted for Women Employees to Reduce Occupational Risks....................... 6
Recommendations and Actionable Steps ...................................... 7
Health Access and Awareness ..................................................... 8
Canada: Providing Maternal Healthcare Attracts Talent .......................... 8
The United States: Providing Support for Returning
Parents through Digital Solutions ............................................ 9
Recommendations and Actionable Steps ...................................... 9
Gender-Based Violence.......................................................... 10
Papua New Guinea: Increasing Productivity of
Female Employees by addressing Family Sexual Violence ........................ 10
Peru: Increasing Incentives for SME Participation in Gender Equality Seal Program....11
Australia: Recognizing SME Commitments through the
Employer of Choice for Gender Equality Program................................11
Recommendations and Actionable Steps ..................................... 12
Work-Life Balance.............................................................. 13
Mexico: Breaking the Traditional Full-Time Employment Paradigm ................ 13
Recommendations and Actionable Steps ..................................... 15
Cross-Cutting Recommendations ................................................. 16
Key Takeaways................................................................. 17
Individuals and Groups Consulted ................................................. 18
Selected Bibliography ........................................................... 19
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 2
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 3
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 2
Introduction
For women to reach their full economic potential, they need
to have access to adequate health care and a workplace free
of safety and gender-based violence issues. In response, the
Asia-Pacific Economic Cooperation (APEC) provides a unique
multi-economy forum to identify and promote policies and
practices that address these concerns. Since 2014, APEC has
promoted programs and policies that foster better health
outcomes for women across the Asia-Pacific region, leading
to their greater economic participation and empowerment,
which in turn, is crucial for economic growth.
The APEC Healthy Women, Healthy Economies (HWHE)
Initiative was launched in 2014 by the United States and the
Philippines in partnership with the private sector to break
down health-related barriers for women to enter, remain,
and advance in the workforce. The initiative looks at five
areas: (1) workplace health and safety, (2) health access
and awareness, (3) gender-based violence, (4) sexual and
reproductive health, and (5) work-life balance.
In 2015, APEC welcomed the HWHE Policy Toolkit. Developed
by an expert group, the toolkit provides a menu of options
and actions across the five areas that economies may
pursue in part, or as a whole, to achieve HWHE objectives.
The following year, the HWHE initiative took the toolkit
from vision to action through a two-day workshop. During
the event, APEC introduced several tools that included
an economic case study for governments and a business
case for the private sector, which were supplemented by
some practical case studies. These tools also included an
evaluation framework to enable implementers to measure
progress. These tools were vital not only for helping
economies and businesses implement the toolkit but also in
providing empirical evidence and examples for why these
policies and programs should be operationalized.
A 2017 workshop offered the opportunity to hear from
implementing governments and businesses on the challenges
faced and progress made towards implementing the toolkit.
Many implementers were at a crossroads – they had made
progress but found that their programs were not reaching as
many smaller companies or women employees as they wanted.
Coming out of the 2017 workshop, participants noted the need
to tailor their programs to different-sized businesses.
In response to this call, this HWHE Guidebook for SMEs
aims to provide both small- and medium-size enterprises
(SME) and policy makers with relevant and tailored actions,
building on the five pillars in the original policy toolkit
adapted specifically for SMEs. Many of the elements in
the original toolkit cut across several issue areas and this
guidebook focuses on those issues that are most prominent
to SMEs. For example, while the sexual and reproductive
health pillar is not examined as a stand-alone pillar within
the guidebook, the applicable elements are captured in other
pillars, including health access and awareness and work-life
balance and are detailed here.
This guidebook highlights HWHE policies and programs that
are specifically relevant and applicable to both male- and
Workplace
health
and safety
Health
access
and
awareness
Work
/ Life
balance
Sexual and
reproductive
health
Gender-
based
violence
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 4
female-owned SMEs in the formal sector across the APEC
region. Although each APEC economy self-defines SMEs,
small enterprises typically range from 10 to 50, and medium
enterprises typically range from 50 to 499 employees. The
case studies in this guidebook detail examples in which
businesses and governments from across the region have
engaged in these types of programs. Through this guidebook,
SMEs have an opportunity to understand how health-related
programs and policies fit into the context of their businesses,
enabling them to take actions that affect their employees,
recruit higher caliber staff, increase employee retention,
and address critical employee needs. The guidebook will also
inform governments on how to better structure programs
related to HWHE so that SMEs can benefit.
Why SMEs?
SMEs account for over 97 percent of all enterprises and
employ over half of the workforce across APEC economies.
On average, women own 37 percent of SMEs in APEC
economies. SMEs contribute to economic competitiveness
and innovation in addition to contributing significantly to
economic growth, with their share of GDP ranging from
20 percent to 50 percent in most APEC economies. APEC
continues to highlight SMEs as one of its key priorities.
Improving women’s health increases their abilities to
engage and remain in the workforce. These issues are
important for all companies, including SMEs. However, a
number of prevailing attitudes and assumptions inhibit the
implementation of programs and policies to address health-
related barriers for women specifically in the SME sector.
These include attitudes that regard health-related barriers
for women as nonexistent or existing barriers as being
too costly for SMEs to address. Moreover, there is often a
generalized assumption that health-related programs are
burdensome for SMES to implement. These perceptions often
limit SME owners, managers, and staff members from taking
steps to promote the health and wellness of their female
employees above and beyond what is required by law.
The recommendations that follow look at how to address some
of these perceptions. For example, suggested actions indicate
how governments can implement programs and policies while
providing implementation support and clear guidance for
SMEs so that they are not viewed as burdensome.
SMEs work environments differ from those of large
corporations. Some small enterprises are run in a personal,
family-like fashion, while others incorporate more formalized
procedures. However, regardless of their operational
structure, compared to large enterprises, SMEs tend to be
resource-constrained in terms of time, effort, and access to
information. More research is needed to identify how size
and scale differences impact health-related practices for
female employees.
Though limited data exists on SME health-related policies in
APEC, data is being collected on this topic in other regions,
most notably Europe. For example, a 2009 report from the UK
Department of Work and Pensions’ family friendly working
hours taskforce reported that 65% of employers experienced
improved recruitment and higher retention by providing
flexible work benefits and 58% of SMEs experienced increased
productivity by providing these benefits.
Of the data that is available, work-life balance issues are
most often assessed. Research indicates that family-friendly
workplace policies reduce turnover, which reduces costs
since employee turnover is expensive. In the U.S., the average
cost of hiring a single new employee in firms with fewer
than 1,000 employees is US$3,079. However, this cost can
be even greater for replacing an experienced, senior-level
employee. In addition to hiring costs, employers incur costs
for onboarding, training and the impact on employee morale
and higher business error rates. Overall, an abundance of
data exists on women employees at large, multinational
firms and women entrepreneurs, but data on women
employees at SMEs is limited.
Despite the data gaps, the case for implementing HWHE
reforms that impact women SME owners and employees
holds strong.
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 5
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 4
Workplace Health and Safety
Occupational health illnesses and hazards have different
impacts on women and men. Though women are generally
less likely to work in hazardous professions than men, rates
of occupational injury and illness among women employees
are often not clearly known due to lack of awareness and
lack of data. In the APEC region, a large share of women work
in sectors that sometimes have limited occupational health
and safety regulations and controls, such as agriculture,
manufacturing and increasingly construction. The differing
impact on women includes lack of adequate sanitation
facilities, improper and ill-fitting protective gear and clothing,
and lack of awareness of how these issues can be tackled at
the SME level. This results in increased vulnerability of women
for occupational injuries and illnesses.
SMEs in particular can face challenges in meeting health
and safety requirements. In some economies, SMEs are not
inspected regularly for health and safety standards and are
not required to report work-related accidents and injuries.
The impact of work-related accidents and injuries can be
particularly disruptive for SMEs in comparison to other
types of enterprises. Short-term business interruptions
can lead to loss of clients and contracts, which are vital to
operations, and disproportionately affect SMEs compared
with corporations, which tend to have more clients. A
serious incident can lead to business closure owing to the
direct costs of injured employees or the loss of contracts
or customers, or both. Small businesses, especially those in
high-risk industries (such as construction, manufacturing,
warehousing, and health care), need to be actively engaged
in workplace safety to retain employees and successfully
continue their operations. In general, SMEs face several
difficulties in complying with occupational health and safety
regulations owing to fewer resources and less awareness of
the costs of noncompliance in terms of higher risks.
A major impediment to workplace safety for women is the
fact that personal protective equipment and clothing (such
as respirators, gloves, and work boots in the construction
industry) are mostly designed to fit average-sized men.
If gloves are too big or if hard hats slide off, it can affect
job performance as well as expose women to accidental
injuries. Correctly fitted safety boots may also be difficult
for female workers to find since a typical woman’s foot is
both shorter and narrower than a typical man’s foot, so a
smaller boot may be the right length but not the right width.
A greater risk for life threatening injuries can occur when
flame resistant clothing or protective fall harnesses are not
properly fitted for women.
Peru: Investing in Employee Health Improves the Work Environment
Ruth Abanto, owner and director of Feel Good Alternative Therapies in Lima provides
workplace oriented physical therapy for employees in small and large companies.
Feel Good is a small company, employing 12 individuals (11 are female). Physical
therapists tend to spend a lot of their time on their feet and can experience high
levels of physical and emotional stress because of their professional demands. Feel
Good invests in the health of its employees by providing them with
• Free personal physical therapy sessions
• Free workshops on how to stay healthy at work, such as strengthening core muscles
and learning beneficial breathing techniques
• Emotional support at work or through a WhatsApp group chat
• Flexible work schedules.
CASE
STUDY
CASE
STUDY
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 6
CASE
STUDY
The United States: Developing Professional Protective Gear Fitted for Women Employees
to Reduce Occupational Risks
Terri Piasecki, owner of Peak Safety Supply in Apex, North Carolina, started her business more than 10 years ago,
selling professional protective gear for women working in construction. Terri still finds a lack of understanding of
the difference between unisex and women-specific options. Women are not just smaller-sized than men, their body
configurations and proportions are different. While unisex safety gear is appropriate for some situations, women require
correctly sized and fitted clothing and equipment especially in more hazardous settings. Large corporations can set
aside the resources to identify and purchase the right size and fit of safety gear for their women employees, but this
process is often perceived as too time-consuming and costly for SMES to undertake. In other cases, employers do not
allow women to procure their own safety equipment. As Terri notes, “I’ll have women place an order, only to have it
cancelled later that day or the next day because their supervisor won’t allow them to purchase or provide their own
safety equipment.”
In addition, it is critical that safety gear, such as fall protection harnesses, pass safety testing on women rather than
being simply adapted to fit women’s bodies more comfortably without actual safety test. In the US, no biomechanic
testing has been conducted on a fall protection harness marketed for women to ensure that it will provide women with
the safety and protection needed.
Recommendations and Actionable Steps
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 6
Australia’s Safe Work
program offers a safety
pack for small businesses
that can be downloaded
from their website.
PAGE 7
WORKPLACE HEALTH AND SAFETY
• If gender-sensitive workplace safety regulations are already
in place and cover SMEs, governments can promote SME
compliance by providing a checklist or easy-to-use guide,
making the implementation of such regulations less
burdensome.
• Australia’s Safe Work program offers a safety pack for
small businesses that can be downloaded from their
website.
• There is a need to raise awareness of the critical
importance for SMEs to provide properly fitted protective
gear for women employees in the construction, health
care, and related industries. Governments and SMEs could
provide a checklist and examples of how to assess a proper
fit for female employees.
• There is a need for collection, analysis, and dissemination
of comparative, sex-disaggregated data on differences in
workplace health and safety requirements for SMEs in the
APEC region.
• While gender-based safety and health data are collected
by the U.S. Bureau of Labor Statistics, they are typically
not analyzed or reported.
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 8
Health Access and Awareness
Access to health services is critical: absenteeism and reduced
productivity are common effects when women face barriers
to medical attention. Yet women often face challenges in
accessing affordable health care and also have different
health needs than men. Women face greater demand
for health care at younger ages than men, mostly due to
reproductive health needs. Moreover, women tend to be more
susceptible to certain types of diseases and illnesses, such
as certain noncommunicable diseases (NCD) including lupus,
osteoarthritis, and thyroid disease. There is a rising need for
women to access quality care and treatment for NCD.
Being able to offer health care for employees is crucial to
attracting and retaining talent as well as to ensuring a
healthy and productive workforce. As a group, SMEs are an
underserved market which can offer a win-win opportunity
for providers to create profitable, tailored solutions to meet
their specific needs. Yet in some economies across the region,
businesses with fewer than 50 employees are not required
to provide health insurance. In many APEC economies, SMEs
also face challenges in finding affordable, comprehensive
healthcare plans for their employees. According to the
Medical Expenditure Panel Survey (MEPS), in 2015, the
average deductible for all U.S. businesses was $423 lower
than for businesses with fewer than 50 employees. SMEs
often face higher administrative and premium costs, making
the provision of healthcare costlier. Thus, the high cost of
health insurance policies sometimes inhibit SMEs from hiring
additional full-time employees and expanding their businesses.
As a major segment of employers across the APEC region,
this impacts whether many women have access to health
insurance, including maternal and reproductive coverage.
For women business owners in particular, lack of access to
affordable healthcare can affect their ability to reinvest
earnings into company growth. Women entrepreneurs and
small business owners experience financial and investment
barriers to a greater extent than male business owners.
Facing steep healthcare costs can further exasperate this
issue for women business owners.
Furthermore, SME owners often lack awareness and information
about the available options of providing health care benefits
for themselves and their employees. SMEs tend to have no or
smaller human resources departments, which hinders their
ability to conduct informed negotiations with healthcare
providers and determine the best health coverage for
employees. Some local and national organizations are involved
in health care issues, such as Women in Public Policy (WIPP) and
Women Construction Owners & Executives (WCOE) in the U.S.
However, there is room for further action on health care and the
challenges SMEs face in providing this employee benefit.
CASE
STUDY
Located in Ottawa, Amika Mobile is one of the few companies in this technology sector to be both led and co-founded by a
woman engineer, Suhayya (Sue) Abu-Hakima, B.Eng., M.Eng., Ph.D. Sue has a Masters and Doctorate in Artificial Intelligence
(AI) and Amika Mobile is her second start-up in AI. As a small business, Amika Mobile has created a female friendly work
culture by taking deliberate steps to ensure a gender balanced workplace and by providing additional maternity and medical
benefits for her employees. As Sue notes: “Our 50/50 male/female employee ratio is unusual for the tech sector and it requires
deliberate interventions to achieve given the shortage of female candidates. Operating in a highly competitive industry,
additional maternity and medical benefits can act as an important differentiator for attracting female talent.” Sue has noticed
that young women seek employers that offer additional medical benefits and are also more likely to take advantage of these
benefits than their male colleagues. In Canada, small business employers are not required to provide their employees with more
health and maternity benefits than what the government provides. Amika Mobile’s employees receive additional coverage and
benefits such as the costs incurred for: medications and pharmaceuticals, specialists, semi-private hospital rooms, physical
therapy, and psychological therapy.
Canada: Providing Maternal Healthcare Attracts Talent
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 8
Recommendations and Actionable Steps
Mednefits’ digital
platform allows
SMEs in Singapore
to pool together to
negotiate affordable
insurance premiums
with healthcare
providers. In the
three years following
its launch, the
digital platform
has facilitated
health insurance
coverage for more
than 15,000 workers
from 180 SMEs in
Singapore.
Maria Health offers
similar services to
more than 60 SMEs
in the Philippines.
• Providers can employ stronger pooling mechanisms for the small employee
group market, where SMEs fall. Governments can implement policies that
provide opportunities for SMEs to pool.
• Mednefits’ digital platform allows SMEs in Singapore to pool together to
negotiate affordable insurance premiums with healthcare providers. In
the three years following its launch, the digital platform has facilitated
health insurance coverage for more than 15,000 workers from 180 SMEs
in Singapore.
• Maria Health offers similar services to more than 60 SMEs in the
Philippines.
• Providers can increase the number of plans available to small- and
medium-size employers.
• Governments can provide or mandate affordable healthcare options for
SME owners and their employees.
• Governments and business associations can conduct information and
communication campaigns on the available health insurance options,
including information on maternal and reproductive services, that SMEs
can offer their employees.
• More data should be collected on differences in the regulatory environment
and on options for health care coverage for SMEs in APEC economies, as
well as on data on the numbers of SMEs that provide health care benefits
to their employees (disaggregated by sex of the owner).
PAGE 9
HEALTH ACCESS AND AWARENESS
CASE
STUDY
The Cleo app provides comprehensive prenatal and postpartum care connecting parents to vetted, experts ranging from
lactation consultants to parenting therapists via digital technologies. Consultations take place in-person or via skype and
can be scheduled through 24/7 text messaging. This innovative app was launched in 2016 by female co-founders Shannon
Spanhake and Chitra Akileswaran. Cleo is currently available in 35 economies, 12 of which are APEC member economies.
Direct business benefits for SMEs providing the Cleo app to their employees include health savings, and attraction and
retention of female employees. BPM, a medium-sized public accounting and advisory firm in the U.S., has realized these
benefits through usage of the app. According to Lisa DeGisi, Benefits & Wellness Specialist at BPM, the retention rate
of new mothers has increased since introducing the app; all new mothers that used the Cleo app have returned to work
after having a child. The app has also increased working fathers’ engagement as parents and helped create a culture of
sensitivity to working parents.
The United States: Providing Support for Returning Parents through
Digital Solutions
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 10
Gender-Based Violence
Sexual harassment and violence, both in and outside the
workplace, has detrimental effects for women, the work
environment, and their employers. Workplace sexual
harassment and intimate partner violence can result in
increased employee absenteeism and reduced productivity, thus
affecting women, businesses, and the economy as a whole.
The perception that sexual harassment is not an issue for
SMEs is a determining factor in whether many businesses
have policies in place. According to a 2016 Manta poll of
594 U.S. small business owners, 67 percent of employers
have no anti-harassment policies or training in place. Also,
41 percent of respondents reported that sexual harassment
policies were unnecessary given their small workforce
and 11 percent responded that sexual harassment policies
were overly politically correct for their business’s culture.
However, workplace sexual harassment is a rampant issue
in businesses of all sizes. In response to a 2012 Australian
Human Rights Commission survey of workers in Australian
SMEs, one-in-five respondents over the age 15 years
reported having experienced sexual harassment in the
workplace during the past five years.
Although this is a widespread issue, regulations around
sexual harassment policies are limited for SMEs. In the U.S.,
harassment is by law a form of discrimination under Title
VII of the Civil Rights Act of 1964, which provides that
workplace harassment is unlawful. This regulation applies
only to businesses with 15 or more employees; moreover, it
does not require companies of any size to have an official
policy on sexual harassment. If employees experience
harassment, they may not know how or where to submit
a complaint or what resources are available especially
at small businesses which tend not to have a dedicated
human resources department. In addition, whereas large
corporations may be able to provide anonymity, it may be
difficult for SMES to ensure.
Formalization of a workplace sexual harassment policy
is crucial for SMEs to signal to their employees that
sexual harassment is taken seriously. Dissemination and
enforcement are also critical. In addition, it is important to
provide services such as anonymous harassment reporting
hotlines for employees. Formal policies are also imperative
for communicating acceptable behaviors and the clear
consequences for harassment. In addition to addressing
sexual harassment, comprehensive workplace policies
may also include resources and support for employees
experiencing gender-based violence at home.
Papua New Guinea: Increasing Productivity of Female Employees by
addressing Family Sexual Violence
Emanuel Papas is Managing Director at Rhodes PNG, a construction and property development
company. Rhodes PNG is headquartered in Port Moresby and has 50 employees, 12 of
which are women working in nontraditional roles such as a machine operator or as logistics
and procurement clerks. Rhodes PNG has experienced both “on the job” absenteeism and
presenteeism caused by family and sexual violence (FSV), which results in reduced productivity
and disproportionately affects their female employees. Rhodes PNG’s human resources
managers have developed informal practices to address the effects of FSV on employees.
Emanuel feels management has introduced a baseline approach but that it lacks formal,
systemic procedures. Currently, Rhodes PNG is working with the IFC and PNG’s Business
Coalition for Women to formalize their company practices. When SMEs invest time and effort
to formalize measures, this raises the visibility and importance of the issue to their employees
companywide, demonstrating a commitment to tackling these issues.
CASE
STUDY
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 11
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 10
Australia: Recognizing SME Commitments through the Employer of
Choice for Gender Equality Program
In 2014 Australia’s Workplace Gender Equality Agency established the annual Employer
of Choice for Gender Equality program to recognize businesses and organizations that are
committed to achieving gender equality. The program is aligned with the Workplace Gender
Equality Act of 2012 and promotes gender equality as a necessity to a successfully managed
business. The program criterion include flexible working arrangements and other initiatives
aimed at supporting women and men, including those with family or care responsibilities, and
preventing sexual harassment and discrimination. Program targets include improving gender
equality outcomes, among others. It requires that participating companies track and report
progress annually on indicators such as the utilization of flexible work schedules (including
part-time) for women and men by manager and nonmanager categories; both utilization of,
and return from, parental leave (paid and unpaid) by both women and men; and the number
of harassment claims. Although most recipients of this gender equality recognition are large
corporations, several SMEs have received this honor, including First State Super, Gilbert + Tobin,
HESTA, Peoplebank Australia Limited, and PPG Industries Australia Pty Ltd.
CASE
STUDY
Peru: Increasing Incentives for SME Participation in Gender Equality
Seal Program
The Peruvian Ministry for Women and Vulnerable Populations promotes women’s wellness and
safety at work and at home through a voluntary certification process, Sello Empresa Segura
(Gender Equality Seal). To earn this seal, enterprises’ organizational processes and systems are
audited and evaluated for compliance according to five main criteria, one of which stipulates
the eradication of sexual harassment in the workplace. Companies of all sizes have been
certified since its inception in 2013.
Nonetheless, Julia Isabel Laura Jara, owner of Camomille Pijamas and co-founder of the radio
station “Mujeres en Accion” highlighted some difficulties for SMEs to become certified. This
program as well as other seal programs in the region could be strengthened by providing
assistance or capacity building to SMEs for fulfilling the certification requirements. In
addition, the marketing, promotion, and corporate social responsibility benefits are less
apparent for SMEs, which tend to rely less on those benefits than larger corporations. Benefits
such as attracting new clients, raising existing client loyalty, and increasing sales are generally
more impactful to larger corporations. Despite these challenges, two SMEs, Avanza Sostenible
and Reforestadora Amazonica, received the seal in 2017. Hopefully, more enterprises will be
recognized in the future.
CASE
STUDY
Recommendations and Actionable Steps
• Incentive structures for voluntary certification in programs
that address gender-based violence differ depending on
firm size. Government should incentivize the certification of
SMEs by providing tax incentives or allowing certified SMEs
increased access to public procurement contracts.
• Australia’s Workplace Gender Equality Agency requires
that companies submit data annually on several indicators
around harassment, equal pay, flexible work, and more.
Employers that comply with reporting requirements
receive a notice of compliance, which they are required to
provide when bidding on federal government procurement
opportunities of a threshold amount.
• Governments should develop an agreed-upon definition of
workplace sexual harassment that SMEs can look to as a
standard in developing their own policies.
• Governments could aid SMEs themselves by establishing a
clear definition of workplace sexual harassment, providing
policy templates for effectively addressing instances of
sexual harassment including consequences, and helping
with dissemination and enforcement mechanisms and
channels.
• SMEs should expand existing policies to include resources
and support for employees experiencing gender-based
violence outside of work.
• Government programs and resources for reporting
mechanisms and support for survivors of GBV can provide
survivor anonymity that many SMEs cannot offer internally.
SMEs can include these services in their employee
handbooks or human resources policies.
• In some APEC economies (such as Papua New Guinea),
companies including SMEs are required to spend up to
two percent of their annual revenue on training for their
employees. Companies should target some of this toward
GBV/FSV awareness and policies, which could increase the
engagement of the SME sector to address GBV/FSV issues in
the workplace.
PAGE 12
GENDER-BASED VIOLENCE
Australia’s Workplace Gender
Equality Agency requires
that companies submit data
annually on several indicators
around harassment, equal
pay, flexible work, and more.
Employers that comply with
reporting requirements receive
a notice of compliance,
which they are required
to provide when bidding
on federal government
procurement opportunities of
a threshold amount.
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 13
Work-Life Balance
It is common in many cultures for women to be expected to
serve as the main caregiver of a household and to balance
this role with employment. Programs that address pregnancy
discrimination, family care options, breastfeeding, flexible
schedules, paid sick and holiday leave, and parental leave can
help women balance family and other responsibilities while
not only remaining, but also advancing, in the workforce.
In general, corporations are more likely than SMEs to
provide formal work-family balance policies. However, this
varies across APEC economies: U.S. companies with 50 to
99 employees are more likely than companies with 1,000 or
more employees to provide flexible working hours, telework,
and paid leave.
SMEs are less likely to be required by law to provide work-
family balance policies. Although many economies have
family policy protections in place, in numerous cases,
SMEs are exempt, or the policies are applied differently.
One example is Japan, where small firms are exempt from
legal requirements regarding flexible schedules following
childbirth. Another example is the United States: the Family
and Medical Leave Act applies only to companies with more
than 50 employees. This act requires these companies to
provide unpaid, job-protected leave for family and medical
reasons with continuation of group health insurance under
the same terms and conditions as if the employee had not
taken leave. Even in economies where regulations exist,
discrimination against pregnant women is somewhat
common among small businesses.
Often, there is an assumption that flexible workplace policies
are too expensive for SMEs to implement. However, studies
show that small businesses that offer these policies experience
lower rates of employee turnover and absenteeism and,
therefore, lower costs for employee replacement and paid
CASE
STUDY
Mexico: Breaking the Traditional Full-Time
Employment Paradigm
Ana Lucia Cepeda started her online business, Bolsa Rosa, in 2014,
after witnessing the large numbers of educated women forced to
leave their jobs because companies in Mexico were unwilling to
offer flexible working arrangements to support work/life balance
for mothers. Even though Mexican labor laws allow for part-time
and flex-time work, most companies only offer traditional full-time
employment options. Bolsa Rosa provides mothers with a job board
for permanent flexi-work positions. The company also works with
businesses to shift company culture and introduce permanent “flex
time” positions. The focus is on evaluating work performance in terms
of results and deliverables instead of hours spent working at the office.
Most of Bolsa Rosa’s clientele are SMEs because human resources
policies at most larger companies in Mexico are not yet equipped to
accommodate permanent, flex-time workers.
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 14
sick leave. A case from the United States demonstrates that
it can be costly not to address these issues: one study of
small businesses found that employee stress over balancing
of work and family obligations was associated with increased
absenteeism, resulting in costs of $496 to $1,984 per
employee per year. In many cases, SMEs lack an understanding
of how the benefit of flexible work schedules is a beneficial
investment that can increase productivity. Instead, flexible
work is often viewed narrowly as freelance or part-time work,
a perception that acts as a disincentive for companies to hire
women who require it.
SMEs owners and managers cite concerns over workload
coverage when female employees take family leave. With
fewer employees to cover colleague’s tasks while on leave,
this labor shortage can be daunting. SMEs are also less likely
to replace staff when they take family leave; instead, they
depend on reorganization of existing staff and tasks. SME
staff must continually cultivate their capabilities through
informal knowledge sharing across employees so that
coverage for others is practical.
Childcare was one of the key barriers to women’s economic
participation highlighted in the APEC SME survey
completed in March 2017. Because women are more likely
than men to shoulder childcare responsibilities, public or
privately provided childcare is crucial to enabling women’s
employment opportunities. There is a widely held view
that maternity, paternity, and parental leave policies are
too expensive for SMEs to provide. However, a recent
International Finance Corporation study demonstrates
that the returns, at minimum for larger companies, are
greater than the cost to implement. With provision of
childcare benefits, companies experience better talent
recruitment and retention, increased employee motivation
and productivity, and reduced absenteeism. Although there
is a need to address the issue of childcare, it is important
to acknowledge the adverse effects that are seen in some
economies that require companies with a certain number of
female employees to provide childcare. Many SMEs view this
as an incentive not to hire women, thus leading to hiring
discrimination. This issue is mitigated in economies that
offer government-provided childcare. More than half of APEC
economies have some form of public childcare services that
are partially or fully funded by the government. However, it
is unclear to what extent, SMEs are able to access and fully
benefit from these services.
Recommendations and Actionable Steps
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 14
Article 203 of the Labor
Code of Chile explicitly
allows employers to
provide childcare jointly
and offsite.
• Raise awareness of the benefits of flexible schedules.
Governments and the private sector can help raise
awareness through communication campaigns or matching
programs, such as Bolsa Rosa in Mexico.
• Policymakers can expand government-provided childcare
services to reach SMEs and ensure that there is uptake by
SME employees.
• Once childcare provision policies are in place, governments
can provide guidelines and implementation support to help
businesses comply with such laws.
• Instead of taking on the costs of onsite childcare alone, SMEs can partner with other SMEs in
the same geographic location to share a centrally located childcare center.
• Article 203 of the Labor Code of Chile explicitly allows employers to provide childcare jointly
and offsite.
• Rather than providing onsite childcare, SMEs can provide vouchers to their employees to
utilize external, nearby childcare centers.
• SMEs can create strategic coverage plans so that an employee taking maternity, paternity, or
parental leave is feasible from a workload perspective.
• Greater collection of data on the applicability of existing laws to SMEs is needed. Current
data predominantly focuses on flexible work arrangements and family leave policies. In terms
of legal protections, there is a fair amount of reporting on family care policies and pregnancy
discrimination, but limited data exists on how these policies are applied to SMEs, which
policies SMEs are exempt from, and how these policies impact SMEs.
PAGE 15
WORK-LIFE BALANCE
Cross-Cutting Recommendations
Although the previous recommendations target specific areas
of the HWHE Policy Toolkit, many of these cross-cutting
recommendations address barriers that are connected and
require governments and businesses to take approaches that
address their interrelated nature. The recommendations below
apply to programs and policies across all areas of the HWHE
Policy Toolkit.
• Governments can expand and modify existing health-
related programs to include SMEs. Although it may
not be fitting to expand existing programs to smaller
businesses, economies can modify eligibility and
evaluation criteria for SMEs specifically.
• Where feasible, SMEs can extend benefits to hourly wage workers rather than outsourcing
these positions, a situation which typically does not provide benefits.
• For the several APEC economies that have existing social insurance and healthcare programs,
this structure supports the employer in providing flexible work environments and leave
benefits. As such, the employer does not have to shoulder the burden. These economies should
extend this level of support to SMEs.
• Researchers should disaggregate data based on business size. Many studies on issues of
workplace violence and work-life balance do not differentiate between business size, making
it difficult to determine which issues are most impactful for SMEs.
• Small business associations can partner with service providers to offer programs to companies
in their associations. This can be helpful for those cases in which SMEs do not have the
resources to develop their own services.
• The Papua New Guinea Business Coalition for Women partners with Femili PNG to provide
family and sexual violence services to employees of coalition member companies.
• Certain unions provide maternity and healthcare benefits for their members, including the
International Association of Bridge, Structural, Ornamental and Reinforcing Iron Workers,
which operates in the U.S. and Canada.
• Governments can create an inventory of domestic associations and organizations for SMES
that support health-related programs through training, certifications, or other mechanisms.
• Government or the private sector should conduct an inventory of existing regulations to
identify where SMEs are exempt or included in HWHE related policies.
PAGE 16
The Papua New Guinea Business
Coalition for Women partners
with Femili PNG to provide family
and sexual violence services
to employees of the coalition
members.
Key Takeaways
Certain unions provide maternity
and healthcare benefits for its
union members, including the
International Association of
Bridge, Structural, Ornamental and
Reinforcing Iron Workers, which
operates in the U.S. and Canada.
PAGE 17
• Governments must be aware that firm size matters
when developing programs for businesses!
• Though less visible, SMEs play an important role as
employers of women in APEC economies. Adapting
accessible policies and practices to promote and
support the implementation of practices (health,
workplaces free of sexual harassment, support for GBV
victims, and work-life balance) for SMEs will facilitate
improvements for women employees, critical for
fostering sustained economic growth and productivity
in the SME sector.
• Gendered data at the economy level is needed to better
understand the prevailing conditions in the SME sector
for women employees. Governments could collect this
data through representative domestic surveys and
coordinate with supporting organizations to compile
case study and sector-specific information.
For more information on the APEC Healthy Women, Healthy
Economies Initiative, see http://healthywomen.apec.org/.
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 18
Individuals and Groups Consulted
Ruth Abanto
Elizabeth Asigau
Laura Berry
Anna Lucia Cepeda
Jenny Fang
Shabnam Hameed
Shalaka Joshi
Theresa Kern
Avia Koisen
Linda van Leeuwen
Julia Isabel Laura Jara
Virginia Littlejohn
Amy Luinstra
Rita Mariella Maltese
Luz Maria de la Mora
Janice McDonald
Susil Nelson-Kongoi
Emanuel Papas
Terri Piasecki
Laura Thomas-Lung
Richelle Tickle
Yolanda Torriani
Sarah Twigg
Pam Woo
Business Coalition for Women (BCFW), Papua New Guinea
Chamber of Commerce of Lima, Peru
International Finance Cooperation (IFC), Multilateral
National Association of Women Business Owners, USA
Women Construction Owners and Executives (WCOE), USA
Women Impacting Public Policy (WIPP), United States
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 19
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 18
Selected Bibliography
Adams, L., M. Winterbotham, K. Oldfield, J. McLeish, A. Large, A. Stuart,
L. Murphy, H. Rossiter, and S. Selner. 2016. Pregnancy and Maternity-
Related Discrimination and Disadvantage: Experiences of Mothers. London:
Department for Business, Innovation and Skills/Equality and Human
Rights Commission, Government of the United Kingdom. https://www.
gov.uk/government/publications/pregnancy-and-maternity-related-
discrimination-and-disadvantage-final-reports
APEC Secretariat, APEC Policy Support Unit. 2016. Gender-related
Constraints Faced by Women-owned SMEs. Singapore: APEC. https://www.
apec.org/Publications/2016/06/Gender-related-Constraints-Faced-by-
Women-owned-SMEs
Cabrera, Marishka. 2017. “Philippine Health Start-up Seeks to Expand
Presence with Fresh Funding.” Inc. Southeast Asia (blog). December 4.
http://inc-asean.com/editor-picks/philippine-health-start-seeks-expand-
presence-fresh-funding/
Caramela, Sammi. 2018. “A Small Business Guide to Addressing Workplace
Sexual Harassment.” Business News Daily. February 26. https://www.
businessnewsdaily.com/9352-small-business-harassment-policies.html
Corporate Voices for Working Families. After School Toolkit: Business to
Community. Washington, DC: Corporate Voices for Working Families.
http://www.afterschoolalliance.org/AS2booklet.pdf
David Cegarra Leiva, M. Eugenia Sánchez Vidal, and Juan Gabriel Cegarra
Navarro. 2012. “Understanding the Link between Work Life Balance
Practices and Organisational Outcomes in SMEs: The Mediating Effect
of a Supportive Culture.” Personnel Review 41(3): 359–79. https://doi.
org/10.1108/00483481211212986
Dex, Shirley, and Fiona Scheibl. 2002. “Flexible and Family Friendly
Working Arrangements in UK Based SMEs: Business Cases.” BJIR 39 (3):
411–31. https://doi.org/10.1111/1467-8543.00207
Dodds, Scott. 2013. “Why SMEs Should Implement Flexible Working
Hours.” The Guardian. February 21. https://www.theguardian.com/small-
business-network/2013/feb/21/remote-working-cloud-computing
Dunkelberg, William. 2016. “The Cost of Health Insurance Is a Big Problem
for Small Business.” Forbes (online). September 22, 2016. https://www.
forbes.com/sites/williamdunkelberg/2016/09/22/the-cost-of-health-
insurance-is-a-big-big-problem-for-small-business/#52980f7c25d9
French, Kitty. 2016. “Are Sexual Harassment Rules Too PC for Small
Businesses?” Manta Trends. August 8. https://www.manta.com/resources/
small-business-trends/sexual-harassment-rules-pc-small-businesses/
Hancock, Trent. 2018. “Sexual Harassment at Work: How Small to Medium
Businesses Can Deal with Allegations.” Dynamic Business. January
24. https://www.dynamicbusiness.com.au/small-business-resources/
employment-legislation-hr-and-staff/sexual-harassment-at-work-how-
small-to-medium-businesses-can-deal-with-allegations.html
IFC (International Finance Corporation). 2017. Tackling Childcare: The
Business Case for Employer-Supported Childcare. Washington, DC: IFC.
https://www.ifc.org/wps/wcm/connect/2ec7e545-437e-43bb-8d2a-
c929229c6ce6/Tackling+Childcare+Report+Final+October+2017.
pdf?MOD=AJPERES
IFC (International Finance Corporation). 2011. Strengthening
Access to Finance for Women-Owned SMEs in Developing Countries.
Washington, DC: IFC. https://www.ifc.org/wps/wcm/connect/
a4774a004a3f66539f0f9f8969adcc27/G20_Women_Report.
pdf?MOD=AJPERES
Lewis, Suzan, Bianca Stumbitz, Lilian Miles and Julia Rouse, with Laura
Addati, Marian Baird, Wendy Banfield, Michael Brookes, Sara Calvo,
Richard Croucher, Hafiz Khan, Ian Roper. 2014. Maternity Protection in
SMEs: An International Review. Geneva: International Labour Organization.
http://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/@publ/
documents/publication/wcms_312783.pdf
Matos, Kenneth, and Ellen Galinsky. 2014. 2014 National Study of
Employers. New York: Families and Work Institute. http://familiesandwork.
org/downloads/2014NationalStudyOfEmployers.pdf
Singapore MCI (Ministry of Communications and Information). 2018.
“#SMETowkay: Making Affordable Healthcare for SMEs a Reality.”
Medium. February 7. https://medium.com/sgmci/smetowkay-making-
affordable-healthcare-for-smes-a-reality-ec06d31ce44f
NIOSH (The National Institute for Occupational Safety and Health).
1999. “Providing Safety and Health Protection for a Diverse Construction
Workforce: Issues and Ideas.” Page last updated: June 6, 2014. https://
www.cdc.gov/niosh/docs/99-140/
Pacific Women. 2017. “Femili PNG and BCFW: Taking Care of Business.”
Pacific Women Shaping Pacific Development. March 1, 2017. https://
pacificwomen.org/news/femili-png-and-bcfw-taking-care-of-business/
Rand, John, and Finn Tarp. 2011. “Does Gender Influence the Provision of
Fringe Benefits? Evidence From Vietnamese SMEs.” Feminist Economics 17
(1): 59–87. https://doi.org/10.1080/13545701.2010.542003
The Royal Institute of International Affairs, Chatham House. 2017. Gender-
smart Procurement Policies for Driving Change. London: Chatham House.
https://www.chathamhouse.org/sites/default/files/publications/research/
Gender-smart%20Procurement%20-%2020.12.2017.pdf
SafeWork NSW (Government of New South Wales, Australia). “Small
Business Safety Packet.” http://www.safework.nsw.gov.au/media/
publications/health-and-safety/small-business-safety-pack
The SEEP Network. 2018. “Tackling Childcare - Webinar.” April 19. https://
seepnetwork.org/Webinar-Post/Tackling-Childcare-Webinar
UK DWP (United Kingdom Department for Work and Pensions). 2010.
Flexible Working: Working for Families, Working for Business: A Report by
the Family Friendly Working Hours Taskforce. London: UK DWP. http://dera.
ioe.ac.uk/886/1/family-friendly-task-force-report.pdf
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 20
USAID (United States Agency for International Development). 2015.
Healthy Women, Healthy Economies: Literature Review. Washington, DC:
Nathan Associates for USAID. http://healthywomen.apec.org/wpcontent/
uploads/Healthy-Women-Literature-Review.pdf
US DOL (U.S. Department of Labor), Women’s Bureau. 2015. “Workplace
Flexibility: Information and Options for Small Businesses.” Issue Brief.
Washington, DC: DOL. https://www.dol.gov/wb/WorkplaceFlexibility_508_
FINAL.pdf
WIPP (Women Impacting Public Policy). “Healthcare.” https://www.wipp.
org/page/Healthcare
Workplace Gender Equality Agency, Government of Australia. “Employer
of Choice for Gender Equality.” https://www.wgea.gov.au/lead/employer-
choice-gender-equality-0
APEC HEALTHY WOMEN, HEALTHY ECONOMIES
GUIDEBOOK FOR SMES
PAGE 20
