The health of women and girls is currently in an era of transition; significant improvements have occurred in the last few decades, but there are still important unmet needs alongside challenging trends related to aging demographics and population growth. There has also been a broadening of focus beyond a narrow emphasis on maternal and child health, including the incorporation of sexual and reproductive health, and a more life-course approach to women’s health more generally. This increasing complexity requires a comprehensive perspective on entire health systems, which in many places is heavily reliant on women in their traditional roles as caregivers, both paid and unpaid. Such an approach must be interdisciplinary and cross-sectoral, and identify women-centred solutions to the unique challenges women and girls face as both consumers and providers of healthcare.
A Lancet Commission was established to examine both existing and original evidence about the complex relations between women and health, including in the context of major economic, environmental, social, political, demographic, and epidemiological transitions happening worldwide. A life-course approach is used to analyse the health status of women and girls worldwide, and the authors estimate the financial value of women’s paid and unpaid healthcare provision, noting that the latter is often an ignored healthcare subsidy. The report is full of useful and interesting infographics, such as a timeline tracing all of the major milestones for women and health since the beginning of the twentieth century, empirical data, and comprehensive and detailed analysis of the intersection of women and health from birth to death.
Seven key messages are highlighted from the report:
- Economic, environmental, social, political, and demographic transitions all affect women’s health, and their rights and roles in society, leading to a complex epidemiological transition and increased caregiving needs and demands.
- To ensure that all women’s comprehensive health needs are met, health systems and societies should simultaneously and effectively complete reproductive health, nutrition, and infectious disease agendas, and the emerging epidemic of chronic and noncommunicable diseases.
- The response to noncommunicable diseases so far is not adequate for those who are especially vulnerable because of biology, gender, and social determinants.
- The cycle of poor women typically receiving care from the most disenfranchised members of the health system needs to be broken, as it leads to the perpetuation of inequities among population groups.
- The importance of women’s contributions in the health-care labour, and their crucial roles in the health care of families and communities, are still underappreciated; on the basis of an analysis of 32 countries accounting for 52% of the world’s population, the report estimates that the financial value of women’s contributions in the health system in 2010 was 2.35% of global GDP for unpaid work and 2.47% of GDP for paid work (equivalent to US$3.052 trillion).
- Few gender-sensitive policies exist that enable women to integrate their social, biological, and occupational roles, function to their full capacity, and realise their fundamental human rights.
- The much needed social, economic, and environmental contributions of women will increase when they are healthy, valued, enabled, and empowered to reach their full potential in all aspects of their lives, including as providers of health care.
The authors conclude that gender-transformative policies are still needed to enable women to integrate their social, biological, and occupational roles. A number of more specific recommendations are provided, grouped into four categories: valuing women; compensating women; counting women, and being accountable to women. These include ensuring women and men receive equal compensation for work, guaranteeing sex- and age-disaggregated data collection and use, and establishing independent mechanisms at global and country level to support, catalyse, and ensure accountability for global, regional, and national action.