Despite major advances in medicine, many women still struggle to access timely and appropriate healthcare. Although women are the primary users of health systems and the backbone of caregiving globally, systemic gaps continue to limit their own care.

So what are the biggest barriers facing women’s health today — and what needs to change to improve access at scale?

We explore these questions with women’s health experts Nicole Althaus and Esther Ruiter, and entrepreneur and advocate Amy Silberzahn.

 

A System Built Around Services, Not Women’s Lives

According to our US Ambassador Nicole Althaus, the challenge is not simply a lack of services but the way healthcare systems are designed.

“Healthcare systems were largely designed around treating isolated diseases and episodic care, rather than around women’s actual lived experiences, life stages, and care journeys,” she explains.

Women often coordinate care not only for themselves, but also for their children, partners, and ageing parents, all while balancing work and family responsibilities. Yet care delivery remains fragmented, making healthcare difficult to navigate and often disconnected from the social, economic, and behavioural factors that influence health outcomes.

This fragmentation contributes to delayed diagnoses, workforce shortages, financial barriers, and persistent gaps in research and health literacy. Conditions such as cardiovascular disease, autoimmune disorders, chronic pain, and menopause-related health issues continue to be under-recognised or diagnosed too late.

 

The Cost of Fragmentation

For Esther Ruiter, our Africa Ambassador, fragmentation extends beyond the clinical setting.

“A massive disconnect exists between public health policy and where women actually seek care,” she says.

In many regions, women seek maternal and reproductive healthcare through private or faith-based facilities because they perceive higher quality care, shorter waiting times, or more reliable services. However, this often comes at a significant financial cost.

“Without blended financing models or structured public-private partnerships, healthcare remains fragmented, forcing women to choose between financial ruin and delayed care,” Esther notes.

Financial barriers continue to be among the most significant obstacles women face. Out-of-pocket costs, transportation challenges, childcare responsibilities, and time away from work can all delay access to essential services. At the same time, women may encounter difficulties moving between providers and healthcare settings, often becoming the coordinators of their own care.

As Nicole observes, “Even when services exist, women are often left to connect the dots themselves.”

 

Investing in the Frontline Workforce

Improving access requires more than additional infrastructure—it also requires investment in the people delivering care.

“Midwives and frontline healthcare workers represent the backbone of women’s health,” says Esther.

Yet these professionals are frequently under-resourced, under-recognised, and excluded from opportunities for professional development. Strengthening midwifery services and expanding appropriate task-sharing models can improve access, particularly in underserved communities, while enabling specialist physicians to focus on more complex cases.

Alongside workforce investment, evidence supports care-navigation programmes, community-based healthcare models, digital health solutions, and team-based approaches that bring together nurses, pharmacists, community health workers, and patient navigators.

 

Evidence-Based Interventions at Scale

To improve access at scale, systems must look beyond clinic walls to make care easier to navigate and personalise. According to Nicole Althaus, six evidence-based approaches have the greatest impact:

• Care Coordination: Navigation programmes streamline the journey across multiple providers, measurably improving screening rates, treatment completion, and patient satisfaction.
• Whole-Person Care: Integrating medical services with community resources, housing, and mental health support addresses the social factors driving poor health.
• Digital Health: Appropriately designed telehealth and remote monitoring reduce geographic, transportation, and scheduling barriers.
• Team-Based Models: Leveraging nurses, pharmacists, and community health workers expands clinic capacity and reduces doctor burnout.
• Lifespan Investment: Shifting focus beyond reproductive care to fund cardiovascular, mental, musculoskeletal, and menopause care as women age.
• Better Data: Tracking patient-reported outcomes and experience data uncovers hidden gaps, ensuring unmet needs are caught and prioritised early [Learn more in Nicole’s white paper “AI and Women’s Health: Closing the Gap Before It Widens.”]

 

When Identity Shapes Access to Care

Women’s health advocate and mother Amy Silberzahn believes it is impossible to discuss women’s health without considering the wider social realities that shape healthcare experiences.

“Healthcare outcomes are shaped by much more than medicine alone. When social, economic, and cultural challenges intersect, they don’t just make care inconvenient—they lead to measurably poorer health outcomes” she says.

A woman’s income, education, language, cultural background, family responsibilities, and geographic location all influence her ability to access care. For marginalised women, these barriers often overlap and reinforce one another.

Improving women’s healthcare therefore requires more than expanding services. It requires designing systems that are accessible, respectful, and responsive to diverse experiences.

 

Looking Ahead

While the barriers are complex, the solutions are increasingly clear. Better care coordination, stronger frontline workforces, improved financial protection, and a broader understanding of women’s health across the lifespan can help create healthcare systems that are easier to access, more equitable, and more responsive to women’s needs.

As Nicole puts it, “Women do not experience health in silos, and our systems should not be designed that way.”