Framing Gynaecological Health: A Landscaping of Health Policy and Services in India

Gynaecological health requires a health systems approach through the life course, given the interlinked nature of common gynaecological conditions or symptoms. This narrative review, following the READ approach, examined how the public health system in India addresses gynaecological health, as reflected in policies, services and data. A multi-disciplinary team searched government policies, service guidelines and standards across relevant Ministries and national institutions, Parliamentary Questions, government surveys and administrative data sources between 2005-2025. The extraction of 34 documents examined whether a condition/symptom was covered in policy, included guidelines for community awareness/outreach and facility-based treatment. The analysis assessed the extent of policy guidelines and data available across different gynaecological conditions and across the life course, along with an in-depth analysis of heavy menstrual bleeding across five health system building blocks. India’s health policies cover most gynaecological conditions, to varying degrees. Cancers and reproductive tract infections have comprehensive policies and guidelines for community-based outreach and services, while outreach and services for menstrual disorders, sexual health, infertility and menopause remain limited. Injuries from gender-based violence are a priority policy area. Heavy menstrual bleeding has comprehensive service guidelines, but significant gaps in guidelines for community-based outreach and financing for conservative treatment options. Nationally representative surveys currently collect data on some conditions, but gaps remain regarding prevalence and treatment for menstrual disorders, infertility and sexual health. Equitable gynaecological services will require policy and service guidelines that address a range of conditions in an integrated approach, through community outreach, facility-based management and nationally collected, routine data. • Gynecological health requires a health systems response through women’s life course, from menarche to menopause and beyond • The Indian health system has comprehensive polices and programs for three common gynaecological conditions, while other areas require urgent attention • A comprehensive strategy for gynecological health within women’s health for services at the primary, secondary and tertiary levels is required