Feminist, rights-based solutions to address NCDs: Integrating NCD services and digital health solutions into primary health care.

Towards a global call-to-action to close the gender health gap

At the 67th session of the Commission on the Status of Women (CSW 67) in March 2023, global leaders, researchers, and advocates highlighted the disproportionate burden of NCD and associated risk factors and persistent gaps faced by women and girls in accessing NCD-related information, prevention, timely diagnosis, services, and support.

In response, civil society raised a call to action, setting out four priority actions for Member States to achieve progress towards the Sustainable Development Agenda 2030 and improve health services and outcomes for women and girls.

The call-to-action outlines feminist solutions to addressing NCDs along four strategic areas:

1. Scale up grassroots innovations creating equitable solutions for NCD prevention and control;
2. Integrate NCD services, including digital health solutions, into primary health care;
3. Support the full, meaningful, and active participation of women and girls in health-related decisions, including health planning, programming, and monitoring, and
4. Strengthen the evidence base on sex differences and gender inequities.

This article is the second in a four-part series discussing key aspects and concrete examples of feminist, rights-based solutions to address NCDs outlined in the call to action.

Integrate NCD services and into primary health care

There is growing acknowledgement among major global health stakeholders that person-centered, integrated care is of fundamental importance. Yet, significant knowledge and implementation gaps persist on how integrated services can be effectively supported in practice.

Examining both success stories and challenges of integrating care for and beyond noncommunicable diseases (NCD) services, and shifting perspectives to the viewpoint of program implementers and the people they serve, can help close this gap and improve access to quality care.

Mobile technologies have the potential to revolutionize healthcare, particularly in rural areas where low-skilled community health workers deliver most of the prenatal and postnatal care.

In collaboration with Oxford University, the George Institute has developed SMARTealth Pregnancy, a low-cost, smartphone-based system used by female community health workers to identify pregnant and postpartum women with high-risk conditions including NCDs such as heart disease, stroke and diabetes. With the help of the mobile application, health workers refer women to primary health care facilities and enable two-way communication between primary care providers and the community to ensure timely follow-up and adherence to medications and lifestyle advice.  

Traditionally, postnatal care has prioritized the new-born’s wellbeing and topics such as contraception and immediate recovery from possible complications of birth. Advancing a more integrated care approach to women's health, combining prenatal and primary care with NCD prevention can lower the risk of disease transmission from one generation to the next, encourage earlier and better use of preventive care, and support women's lifelong health.

“Pregnancy conditions such as pre-eclampsia and gestational diabetes identify women at significantly increased NCD risk. SMARTHealth Pregnancy is a low-cost, community-based solution that integrates health promotion into pregnancy and postnatal care.”, concluded  Prof Jane Hirst with the George Institute for Global Health.

Background: Feminist, rights-based innovations, and solutions to address NCDs

The landscape of women’s health has transformed over recent decades. Improved maternal and neonatal health programs, demographic changes, urbanization and shifts in global dietary and behavioral habits mean that NCDs are now the leading causes of death among women and girls globally. Two out of three women die from an NCD  – including cancer, diabetes, cardiovascular diseases, chronic respiratory diseases and mental health conditions– accounting for 19 million deaths every year, a majority of which occur in low- and middle-income countries.

Gender is a major social and structural driver of inequity in health, which is both linked to and exacerbated by NCDs and their associated risk factors. In many countries, women face limited access to timely, safe, and quality health services and information. Similarly, they are often more exposed to NCDs and their risk factors due to persistent social, gender and economic inequalities. Globally, health conditions that affect women more than men garner less funding.

The right of women, girls, and gender minorities to participate in decisions concerning their health and wellbeing and access affordable, quality healthcare at every stage of their lives is a cornerstone of health equity. A feminist approach to addressing NCDs can reduce discrimination and support gender-equitable health and development commitments. To close the gender health gap, developing and supporting grassroot innovations and collaborations that harness new technology, context-relevant research and implementation on the ground offer promising initiatives to reduce premature deaths from NCDs that are worth supporting and scaling.

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Feminist, rights-based solutions to address NCDs: Meaningful and active participation of women and girls in health planning, programming, and monitoring.