What are the major achievements of India’s maternal health policies , and how have programmes such as the National Health Mission (NHM) contributed to reducing maternal mortality?

India’s maternal health policies represent one of the most significant public health successes of the past two decades. The Maternal Mortality Ratio (MMR) in India has declined dramatically from 362 per 1,00,000 live births in 2000 to around 80 per 1,00,000 in 2023. This progress reflects sustained policy interventions, improved health infrastructure, and greater access to institutional care for pregnant women.Key initiatives under the National Rural Health Mission (NRHM) and later the National Health Mission (NHM) played a central role in achieving these outcomes. These initiatives focused on improving maternal health services through:Institutional deliveries: Programmes such as Janani Suraksha Yojana encouraged women to deliver in health facilities rather than at home.Skilled birth attendants: Expansion of trained health workers such as Accredited Social Health Activists (ASHAs).Antenatal and postnatal care: Regular health check-ups, nutritional support, and monitoring of high-risk pregnancies.Improved health infrastructure and awareness have also contributed to these gains. Expansion of Primary Health Centres (PHCs), community health centres, and Health and Wellness Centres has increased access to maternal care in rural and underserved areas.However, challenges remain. Regional disparities persist across states, and access to reproductive autonomy and safe pregnancy care remains uneven. Therefore, while India has achieved notable progress in maternal health, sustained policy attention and investments are needed to ensure equitable maternal healthcare across all regions.

Why is women’s health beyond childbearing years often neglected in public health policy, and what are the implications of this gap?

Women’s health policies have traditionally focused on reproductive and maternal health, often neglecting health concerns that arise after the childbearing years. While such a focus was necessary to address historically high maternal mortality rates, it has unintentionally created a gap in healthcare attention for women in their 30s, 40s, and later stages of life.This neglect stems from several structural and social factors:Policy priorities: Public health systems historically prioritised maternal and child health indicators.Medical research bias: Many medical studies and treatment protocols were historically designed around male physiological patterns.Social expectations: Women often prioritise family responsibilities over their own health, delaying medical consultation.As a result, midlife health conditions are frequently overlooked. Women are increasingly experiencing higher rates of Non-Communicable Diseases (NCDs) such as hypertension, thyroid disorders, and autoimmune diseases. Studies show that 106 per 1,000 women report at least one NCD compared to 65 per 1,000 men.The implications are significant. Delayed diagnosis and treatment can lead to severe complications, increased healthcare costs, and reduced productivity. Addressing women’s health across the entire life cycle is therefore essential not only for gender equity but also for strengthening national health outcomes and economic productivity.

What structural and medical factors contribute to the invisibility of women’s midlife health issues in healthcare systems?

The invisibility of women’s midlife health issues is the result of both structural biases in healthcare systems and social factors affecting health-seeking behaviour. These blind spots influence how diseases are diagnosed, researched, and treated.One key factor is gender bias in medical research and diagnosis. Many diseases manifest differently in women than in men. For example, women experiencing heart attacks may present symptoms such as fatigue, nausea, anxiety, or back pain rather than the commonly recognised chest pain. Because medical training and awareness campaigns often emphasise the male symptom profile, women’s symptoms may be misinterpreted or ignored.Another factor is the under-recognition of conditions more prevalent among women. Autoimmune disorders, which frequently affect women, often present with vague symptoms such as fatigue, cognitive fog, and diffuse pain. These symptoms may not immediately trigger detailed clinical investigation, leading to delayed diagnosis.Structural design biases also play a role. Everyday objects and environments—such as office furniture, safety equipment, and medical devices—are often designed using male anatomical standards. Even widely used medical instruments, such as the speculum, have seen limited innovation since their 19th-century invention.These combined factors create a systemic blind spot in healthcare. Addressing them requires gender-sensitive research, improved clinical awareness, and inclusive design in both medical and workplace environments.

How can a life-course approach to healthcare improve women’s health outcomes in India?

A life-course approach to healthcare recognises that health outcomes are shaped by experiences, exposures, and behaviours across an individual’s entire lifetime. Instead of focusing only on specific life stages such as pregnancy, this approach integrates preventive care, early detection, and long-term disease management.Applying this approach to women’s health involves several strategies:Early prevention: Promoting nutrition, physical activity, and health awareness during adolescence.Regular screening: Detecting diseases such as breast cancer, cervical cancer, and hypertension at early stages.Chronic disease management: Providing long-term support for conditions like diabetes, thyroid disorders, and autoimmune diseases.India has begun implementing elements of this approach. Health and Wellness Centres under the National Health Mission are expanding their services beyond maternal health to include prevention and management of Non-Communicable Diseases. Population-based screening programmes for breast and cervical cancers represent an important step toward early detection.However, the success of this approach depends on strengthening frontline healthcare systems. Adequate staffing, training of community health workers, and increased awareness among women about early symptoms are essential for effective implementation.By integrating preventive and curative services throughout a woman’s life, a life-course approach can significantly improve long-term health outcomes and reduce the burden of chronic diseases.

Critically analyse the gender bias in medical research and healthcare design and its impact on women’s health outcomes.

Gender bias in medical research and healthcare design has historically resulted in a healthcare system that inadequately addresses women’s unique health needs. For decades, clinical trials and medical research largely focused on male participants, assuming that findings would apply equally to women.This bias has several consequences. First, diseases may manifest differently in women, yet diagnostic guidelines often rely on male-centric symptom patterns. For instance, heart disease—the leading cause of death globally—often presents differently in women, resulting in delayed diagnosis and treatment.Second, healthcare technologies and devices may not fully account for women’s physiological differences. Medical instruments, workplace equipment, and safety gear are often designed using male anatomical measurements. Such design limitations can reduce effectiveness or increase discomfort for women.Third, research funding and innovation in women-specific health conditions have historically been limited. Conditions such as endometriosis, autoimmune disorders, and menopause-related complications have received comparatively less scientific attention.Addressing this bias requires systemic reform. Increasing women’s participation in clinical trials, encouraging gender-sensitive medical research, and promoting inclusive product design are essential steps.Ultimately, eliminating gender bias in healthcare is not only a matter of equity but also a critical requirement for improving the accuracy, effectiveness, and inclusiveness of modern medical systems.

Provide examples of policy and technological innovations that can strengthen women’s healthcare across different life stages in India.

Strengthening women’s healthcare requires both policy reforms and technological innovation that address health challenges across the entire life cycle. India has already initiated several programmes, but expanding and integrating them further could significantly improve outcomes.Policy innovations include:Expansion of Health and Wellness Centres: These centres provide preventive care, screening for NCDs, and management of chronic diseases.Population-based cancer screening: Early detection programmes for breast and cervical cancer under the National Health Mission.Community health outreach: ASHA workers play a critical role in raising awareness and connecting women with healthcare services.Technological innovations can further enhance healthcare delivery. Digital health platforms and telemedicine services can improve access for women in rural and remote areas. Mobile health applications can help monitor chronic diseases and encourage preventive health behaviours.Medical innovation is equally important. India’s growing pharmaceutical and medical device ecosystem presents opportunities to develop improved diagnostics, gender-sensitive medical instruments, and therapies specifically designed for women’s health conditions.For example, improved diagnostic tools for autoimmune diseases or menopause-related conditions could significantly reduce delays in treatment. Similarly, wearable technologies could help monitor cardiovascular risks among midlife women.Thus, combining policy reforms with technological innovation can create a comprehensive and inclusive healthcare system that supports women’s health throughout their lives.

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Addressing the Systemic Invisibility of Women's Midlife Health

Understanding how societal and medical perceptions neglect vital aspects of women's health beyond childbearing years.

Surya

•March 6, 2026•6 mins read

Women’s midlife health needs greater policy attention

India has made significant progress in improving maternal health over the past two decades. Government programmes have successfully reduced maternal deaths and expanded access to institutional healthcare during pregnancy and childbirth. However, women’s health challenges do not end with the reproductive phase. Health issues that emerge...

Addressing the Systemic Invisibility of Women's Midlife Health

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