Context:
An editorial highlights the neglect of women’s health during midlife and beyond in India, emphasizing the need for a life-course approach to healthcare that addresses conditions affecting women after their reproductive years.
Key Highlights:
Improvements in Maternal Health
• India has made significant progress in reducing maternal mortality.
• The Maternal Mortality Ratio (MMR) declined from 362 per 100,000 live births in 2000 to about 80 per 100,000 in 2023.
• Initiatives under the National Health Mission (NHM) have improved institutional deliveries, skilled birth attendance, antenatal and postnatal care.
Persistent Gaps in Women’s Health Policy
• Despite improvements in maternal care, women’s health policies remain focused mainly on reproductive years.
• Healthcare systems often neglect health needs beyond childbearing age.
• This creates gaps in addressing age-related diseases and chronic health conditions among women.
Rising Non-Communicable Diseases (NCDs) Among Women
• Women aged 30–40 years are increasingly affected by chronic conditions such as:
- Hypertension
- Thyroid disorders
- Autoimmune diseases
• According to estimates, 106 per 1,000 women report at least one NCD, compared to 65 per 1,000 men.
Invisible Bias in Medical Diagnosis
• Medical research and diagnostics often use male bodies as the standard reference.
• Symptoms of diseases in women may differ from those in men, leading to misdiagnosis or delayed diagnosis.
• For example, heart attack symptoms in women often include fatigue, nausea, anxiety, or back pain rather than the typical chest pain.
Structural and Social Barriers
• Social roles and gender norms often lead women to prioritize family health over their own health needs.
• In many workplaces, infrastructure and facilities are designed around male norms, contributing to women’s health invisibility.
Healthcare System Challenges
• The health system focuses heavily on maternal and reproductive services, while screening for midlife diseases remains inadequate.
• There is a lack of widespread population-based screening programs for conditions like breast and cervical cancer.
Emerging Government Efforts
• Some progress is being made through Ayushman Bharat Health and Wellness Centres (HWCs), which aim to expand primary healthcare services.
• These centres include screening for NCDs, cancers, and chronic diseases.
Relevant Prelims Points:
- National Health Mission (NHM)
- Launched in 2005 as the National Rural Health Mission, later expanded.
- Aims to strengthen primary healthcare and reduce maternal and infant mortality.
- Maternal Mortality Ratio (MMR)
- Number of maternal deaths per 100,000 live births.
- A key indicator of healthcare quality and women’s health outcomes.
- Non-Communicable Diseases (NCDs)
- Chronic diseases such as:
- Cardiovascular diseases
- Cancer
- Diabetes
- Chronic respiratory diseases
- Major cause of mortality globally.
- Health and Wellness Centres (HWCs)
- Established under Ayushman Bharat Programme.
- Provide comprehensive primary healthcare, including NCD screening and preventive services.
- Ayushman Bharat Programme
- Two key components:
- Pradhan Mantri Jan Arogya Yojana (PM-JAY) – health insurance for secondary and tertiary care.
- Health and Wellness Centres (HWCs) – strengthened primary healthcare system.
Relevant Mains Points:
- Gender Bias in Healthcare Systems
- Medical research historically focuses on male subjects, leading to gaps in understanding women’s health conditions.
- Diagnostic criteria and treatment protocols may fail to account for gender differences.
- Midlife Health as a Public Health Priority
- As life expectancy increases, women spend a large part of their lives post-reproductive age.
- Ignoring midlife health undermines long-term well-being and economic productivity.
- Socio-Cultural Factors Affecting Women’s Health
- Patriarchal norms often lead to delayed healthcare-seeking behaviour among women.
- Women frequently prioritize family responsibilities over personal health.
- Economic and Development Implications
- Poor midlife health affects women’s participation in the workforce.
- Improving women’s health contributes to economic productivity and inclusive growth.
- Need for a Life-Course Approach
- Healthcare policy should address health needs from adolescence to old age.
- Integrated strategies should include preventive care, screening, and gender-sensitive health services.
Way Forward
• Adopt a life-course approach to women’s healthcare policy.
• Expand screening programs for NCDs and cancers among midlife women.
• Promote gender-sensitive medical research and diagnostics.
• Improve health awareness and preventive healthcare access for women.
• Strengthen primary healthcare infrastructure through Health and Wellness Centres.
UPSC Relevance:
• GS Paper 2: Governance and Social Justice – gender-sensitive health policies
• GS Paper 1: Indian Society – gender inequality and health outcomes
• GS Paper 3: Health sector and NCD burden in India