Answer

Introduction

India’s women-centric health policies largely focus on adolescence and maternity, leaving quarter-to-midlife women (25–60 years) underserved. This “missing middle” weakens health equity, economic productivity, and women’s empowerment across the life course.

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Structural Challenges Faced by Midlife Women (25–60 Years)

• Fertility-Centric: Most schemes revolve around reproductive and maternal health, excluding post-reproductive women from regular health coverage.
• Limited Research: Scarcity of longitudinal and life-course studies makes midlife women’s health concerns poorly understood and weakly addressed.
  Eg: AIIMS Patna highlighted lack of longitudinal studies on women’s midlife health under the Majhdhaar initiative.
• NCD Neglect: Hypertension, diabetes, osteoporosis, and cancers remain under-screened as women’s health is often seen only through fertility.
  Eg: National Health Policy (2017) stresses comprehensive care, but midlife NCD focus remains weak.
• Work Burden: Women bear unpaid care work along with informal labour, leaving little time for preventive healthcare and treatment.
  Eg: SHG women under JEEViKA often balance livelihood work with household responsibilities.
• Social Silence: Menopause, mental health, and ageing-related illnesses remain socially under-discussed, delaying diagnosis and care-seeking.
  Eg: Menopause is treated as a single event rather than a broader life-stage transition.

Consequences of Neglecting Midlife Women’s Health

• Poor Health: Women spend nearly one-fourth of life in ill health, reducing quality of life and healthy ageing outcomes.
  Eg: Women live longer than men but >25% of life is affected by ill health.
• Economic Loss: Untreated illnesses reduce women’s workforce participation and productivity during their most economically active years.
• Poverty Trap: Health shocks without support increase out-of-pocket expenditure and deepen feminisation of poverty in vulnerable households.
  Eg: NSSO data shows healthcare costs remain a major cause of rural indebtedness.
• Care Deficit: Poor maternal figures in midlife affect child welfare, elderly care, and household stability, weakening the care economy.
  Eg: Women in this phase manage both children and ageing parents, creating a “sandwich generation” burden.
• Empowerment Loss: Ignoring health vulnerabilities limits women’s participation in SHGs, skilling, and paid work, reducing empowerment gains.

Measures for a Life-Course Healthcare Approach

• Policy Expansion: Women’s health policy must move beyond maternity and include preventive, curative, and geriatric care across life stages.
  Eg: Majhdhaar initiative by PCI India focuses on wellbeing beyond maternity.
• NCD Screening: Routine screening for diabetes, hypertension, cervical and breast cancers should be institutionalised through primary healthcare.
  Eg: Ayushman Arogya Mandir aims to deliver comprehensive primary care.
• Menopause Care: Dedicated counselling, awareness, and treatment support for menopause and perimenopause should be mainstreamed.
• Community Support: SHGs, ASHA workers, and local women’s collectives should promote awareness, referrals, and peer-based support systems.
  Eg: PCI India with partners like AIIMS Patna works through community-based interventions.
• Gender Budgeting: Dedicated financing and age-sensitive health budgeting should ensure sustained services for this neglected demographic.
  Eg: Gender budgeting under the Union Budget can be expanded to include midlife women’s health indicators.

Conclusion

A true life-course healthcare model must recognise women beyond fertility and maternity. Investing in midlife women’s health strengthens families, productivity, and social justice, advancing SDG 3 (Good Health) and SDG 5 (Gender Equality).

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