Closing diagnostic gaps to achieve parity in women’s healthcare

By guest contributor Dr Soumya Swaminathan

Women and girls account for 50% of the population. Despite this, health systems are ill-equipped to meet their diverse, evolving needs throughout their lives. We must shift towards a more holistic approach to women’s and girls’ health and wellbeing, encompassing more than just sexual and reproductive issues. Critically, we must close the diagnostic gaps that leave too many women and girls suffering from conditions that remain undiagnosed and untreated.

In the last few decades, we have made substantial strides towards better, more equitable health for women and girls. The HPV vaccine shown to cut cervical cancer rates by 90%, offers hope for eliminating it in future generations. Progress has also been made in reducing pregnancy related deaths and advances in contraceptive technology have given women more effective and easy-to-use options for birth control.

Yet, the larger outlook is less encouraging: while maternal mortality trends initially showed some improvement, progress has stalled over the last decade and there are wide variations between states. The health needs of women and girls continue to be under-recognized, under-researched and underfunded. This lack of investment is particularly evident in the unmet diagnostic needs of women and girls.  Often, essential tests are unavailable when and where they are needed. Women and girls face socioeconomic and cultural barriers that limit access to testing – for example, being unable to afford tests, having to travel long distances or facing stigma when seeking testing and healthcare services.

A major cause of this inequity is the misconception that women’s health revolves around sexual and reproductive health. While sexual and reproductive health is a crucial need for millions of women and girls around the world, solely focusing on this area risks neglecting the broader spectrum of their healthcare needs. Research has indicated that while sexual and reproductive health and maternal health issues account for about 5% of the global women’s health burden, an estimated 51% of the women’s health burden comes from conditions that affect women and girls differently or disproportionately. With women spending 25% more of their lives in poor health than men, ensuring health system responsiveness to their broader spectrum of needs is crucial.

The limited focus and investment in women’s health hinders not only their well-being but also undermines the growth of societies and economies. Economic growth has been linked to women’s increased participation in the labour force. This means that gender inequity in healthcare translates in lost economic potential. Investing in women’s health is not only a moral imperative but is also essential for economically robust societies. Studies demonstrate the power of this investment – US$1 invested to improve women’s health could generate US$3 for the economy.

To truly bridge the gaps in women’s health, we must move beyond narrow, disease-specific approaches. Instead, we need a holistic perspective that recognizes women and girls’ changing health needs and priorities across different ages and life stages. This approach must emphasize the central role of diagnostics in promoting their overall health and wellbeing. Countries can achieve this by transforming their approach to women’s health through comprehensive strategies rooted in holistic and integrated care models. Diagnostic packages that enable integrated screening for women, based on age and risk profile, including AI-enabled digital solutions, should be made available at the primary care level. These would enable providers to offer integrated screening targeting both conditions unique to women such as the female cancers and pelvic pain and those that affect women differently or disproportionately such as cardiovascular diseases, anaemia and sexually transmitted illnesses. Establishing national women’s health policies led by dedicated leadership can promote such models, ensuring effective care for diverse health needs.

Making diagnostic testing a cornerstone of women’s health is paramount. This requires prioritizing women-centric approaches that offer accessible, affordable, and acceptable testing and healthcare services. This includes, for example, enabling women to self test for cervical cancer, which provides women with agency and empowers them to take control of their own health. Additionally, leveraging digital technologies and artificial intelligence can lead to the development of non-invasive tools for community settings, promoting self care and further increasing testing accessibility.

In this context, technology-enabled solutions for women’s health or “FemTech” represents a promising field with a market potential of US$50 billion by 2025. With women 75% more likely than men to use digital tools for their health, there is clear demand. Today, there is an emerging pipeline of FemTech solutions to meet unmet diagnostic needs for women’s issues like endometriosis and pre-term birth. Furthermore, digital solutions like wearable devices and at-home diagnostics can empower women to take greater control of their health. These inclusive and innovative solutions hold particular promise in low- and middle-income countries where women face additional barriers to accessing healthcare services.

Prioritizing holistic investment in women’s health is crucial to ensure that women and girls around the world have the support they need to lead healthy, fulfilling lives. By addressing the chronic underfunding of women’s health and closing the diagnostic gap, we can unlock the full potential of half the world’s population. As former UN Secretary-General Ban Ki-moon aptly stated, “When we invest in women’s health, we are investing in our strongest foundation for a peaceful, prosperous, and sustainable world’.

About the author:
Dr Swaminathan is a board member of FIND. She previously served as Chief Scientist at the World Health Organization. Prior to that, she was Secretary to the Government of India for Health Research and Director General of the Indian Council of Medical Research from 2015 to 2017. She is a globally recognised researcher on tuberculosis and HIV and brings over 40 years’ experience in clinical care and research. She has also worked throughout her career to translate research into impactful programmes.

This op-ed was published in PLOS Blogs Speaking of Medicine and Health, 21 March 2024