Healthcare is a central element of women’s lives, shaping their ability to care for themselves and their families, to be productive members of their communities, to contribute to the workforce and to build a base of economic security. Women’s reproductive healthcare needs, their central roles managing family health as parents and as family carers, and their longer lifespans, albeit with greater rates of chronic health problems than men, all shape their relationships with the healthcare system.
While women are major consumers of healthcare services and play a central role as health navigators and carers for their families, structural factors can challenge their ability to get the healthcare that they need. Factors, including national policies that shape the healthcare delivery system to research priorities and discriminatory economic and societal forces, can deprioritise women’s health concerns.
Pharmaceutical and medical science have a massive knowledge gap around women’s health.
Conditions that only affect women, or affect them very differently than men, have been systematically ignored or dismissed for most of medical history. And while that is changing, slowly, there is still a long way to go.
Take menopause, for example. More women are talking about it, and companies now want to support employees better. For a long time, however, it wasn’t something that was discussed openly.
We’ve come a long way since 1995, and it is time to celebrate women and their achievements. However, we must also assess the extent to which our country fulfils women’s rights, particularly the right to health. Thirty years after Malta signed pledges in the 1995 Beijing Declaration and Platform of Action, women still face many health problems, and we must recommit to addressing them.
Significant gaps in what is known about chronic conditions that are specific to women, predominantly impact women or affect them differently-such as endometriosis, pelvic floor disorders, migraines and chronic fatigue syndrome-hinder diagnosis, treatment and prevention.
Having people at the decisionmaking table is vital to ensuring that equality is incorporated into our systems. There is still a shortage of women in leadership roles even in the femtech industry, and this needs to change, from more women at the C-level to more women investors.
Legal issues
At a time when there is a national consensus that quality healthcare should be evidencebased and patient-centred, that we should eliminate unnecessary medical tests and focus tightly on improving health outcomes, our lawmakers continue to enact laws that put ideology above women’s healthcare.
A few remnant anti-choice laws continue requiring healthcare providers to choose between following their medical training and their ethical obligations to their patients and following the law.
Other laws and regulations mandate how healthcare providers must practise medicine, without regard to their professional judgement or their patients’ needs. That is unacceptable, and it flies in the face of the essential work being done to promote higher-quality healthcare. Laws that put the ideological beliefs of politicians ahead of patient needs, medical evidence, and the professional judgement of doctors are bad medicine and deserve to be rejected.
Healthcare treatment decisions are best made between a patient and her physician, not a politician.
Lawmakers’ interference in the patient-provider relationship means that the country needs robust legislation protecting and enhancing women’s healthcare more than ever.
The Millennium Development Goals set ambitious targets for women’s health, including reductions in maternal and child mortality and combating the spread of HIV/AIDS. The law, which historically has often obstructed women’s access to the healthcare that they require, has a dynamic potential to ensure women’s access that is being progressively realised.
Three legal principles are key to advancing women’s reproductive and sexual health.
First, the law should require that care be evidence-based, reflecting medical and social science rather than, for instance, religious ideology or morality.
Secondly, legal guidance should be clear and transparent so that service providers and patients know their responsibilities and entitlements without litigation to resolve uncertainties.
Third, the law should provide applicable measures to ensure fairness in women’s access to services, both general services and those that only women require.
These are the legal developments that can advance women’s equality and social justice.
Women’s health and rights are inextricably linked. Policies and practices that restrict gender equity hamper women’s engagement in the education, employment and civic sectors. Social norms perpetuate violence, early marriage and other domains of gender inequity. Criminal and administrative laws too often fail to provide protection, as in the case of restrictions on women’s property inheritance rights.
Even where legal protection exists, practices are highly influential, for example, the intensity with which reports of gender-based violence are pursued by law enforcement.
The explicit acknowledgement of the synergy between women’s health and their conditions in society should be the catalyst for identifying the need to understand the social factors and determinants which influence women’s health.
A long-felt compassionate measure
Miscarriage is a deeply personal and distressing experience.
Recently, following a growing trend among other countries, Malta has legislated seven consecutive days of paid miscarriage leave for all employees in both the public and private sectors, including part-time workers and the self-employed.
Such a right should become a universal right, given the farreaching physical and emotional impacts of baby loss. It is a compassionate move and gives those who have had a miscarriage time to grieve.
Those grieving deserve the time and support to begin to heal without the added pressure of financial or workplace insecurity. This latest legislative measure will be an important part of their recovery.
