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Girls' and women's health is in transition and, although some aspects of it have improved substantially in the past few decades, there are still important unmet needs. Population ageing and transformations in the social determinants of health have increased the coexistence of disease burdens related to reproductive health, nutrition, and infections, and the emerging epidemic of chronic and non-communicable diseases (NCDs). Simultaneously, worldwide priorities in women's health have themselves been changing from a narrow focus on maternal and child health to the broader framework of sexual and reproductive health and to the encompassing concept of women's health, which is founded on a life-course approach. This expanded vision incorporates health challenges that affect women beyond their reproductive years and those that they share with men, but with manifestations and results that affect women disproportionally owing to biological, gender, and other social determinants.
The complexity of the challenges faced by women throughout the life course needs an increased focus on health systems, which heavily rely on the many contributions of women to care as members of the health workforce, in which their numbers are rapidly increasing, and in their traditional roles as primary caregivers at home and in communities.
Women and Health—the focus of this Commission—is a novel concept that refers to the multifaceted pathways through which women and health interact, moving beyond the traditional and exclusive focus on women's health to address the roles of women as both users and providers of health care, and highlighting the potential for synergy between them. We envision a virtuous cycle that builds on the premise that women who are healthy throughout their lives experience gender equality and are enabled, empowered, and valued in their societies, including in their roles as caregivers, are well prepared to achieve their potential and make substantial contributions to their own health and wellbeing, to that of their families and communities, and, ultimately, to sustainable development.
Such thinking needs an interdisciplinary, cross-sectoral perspective to identify women-centred solutions to the unique obstacles that girls and women face as both consumers and providers of health care.
In this Commission, we analyse existing and original evidence about the complex relations between women and health. We examine the major economic, environmental, social, political, demographic, and epidemiological transitions happening worldwide, their implications on the health system, and their effects on women and health. The health status of girls and women is analysed using a life-course approach to show the breadth of women's health beyond the reproductive role. We estimate the financial value of the paid and unpaid health-care-related duties that women undertake in health systems and in their homes and communities, which are a hidden subsidy to health systems and societies. We conclude that gender-transformative policies are needed to enable women to integrate their social, biological, and occupational roles and function to their full capacity, and that healthy, valued, enabled, and empowered women will make substantial contributions to sustainable development (key messages). In view of these issues, we propose crucial actions for development partners, governments, civil society, advocates, academics, and professional associations that are needed to advance the women and health agenda (panel 1).