Diagnostics for women’s health: Coming of age?

Women’s health is an ever-evolving field, with new developments in diagnostic testing happening every day. Despite this, women in India often find themselves under-diagnosed and under-treated in comparison to their male counterparts. This is largely due to a lack of awareness and access to quality healthcare services in the country.

Commenting on this, Dr Akshay Tiwari, Consultant Pathologist and Business Head-Central India, Pathkindlabs said, “Blame it on the Indian culture or the patriarchal society, women are not groomed to take care of themselves. They would rather take medicines over the counter without getting the right diagnosis and hope to get well on their own. However, this approach can lead to dire consequences and thus it is most important for the community to change this way of thinking by consciously educating the women, across every strata of the society, about the relevance of timely diagnosis and keeping in good health.”

Dr Padma Srivastava, Consultant Obstetrician and Gynaecologist, Motherhood Hospitals also feels that, “Women often shoulder the responsibility of their professional and personal life and fail to pay attention to their health. They neglect their health while striking a work-life balance. Hence, a majority of women are detected with a plethora of health issues that can steal their peace of mind.  Early diagnosis is key to the management of health problems in women. Just like men, it is imperative for women to pay attention to their physical and mental well-being. While women are susceptible to similar health issues as men, there are certain issues that impact women exclusively or predominately. Women often fail to prioritise their health and land themselves in trouble. Gynecological health and disorders affecting women include menstruation and menstrual irregularities; urinary tract health, including urinary incontinence and pelvic floor disorders; and such disorders as bacterial vaginosis, vaginitis, uterine fibroids, and vulvodynia. Apart from that, a range of other health issues can be problematic for women.”

The disease burden affecting women is on rise. In addition to all the possible diseases that can afflict a human being, women are considered to be more susceptible to certain disorders such as osteoporosis, menstrual disorders, cancer, and autoimmune diseases. The rise in innovative diagnostics solutions for women’s health gives physicians the ability to provide the right treatment at the right time. Overall, there are a variety of diagnostic tools available for women in India that can be used to identify health issues and start timely treatment. With improved access to quality
healthcare services and greater awareness of the importance of early detection and prevention, more women in India are able to take advantage of these services and receive the care they need.

Talking about the role of early screening/diagnosis of women’ health issues, Dr Anju Wali, Medical Director, PSRI Hospital said, “To improve women’s health, we need to address issues related to maternal deaths, reproductive health, malnutrition and noncommunicable diseases through quality and affordable health services. A holistic and comprehensive approach beyond reproductive health is needed which encompasses better health for women starting from adolescence, pregnancy throughout their reproductive years and ageing period. Women must be empowered to take charge of their health.”

Dr Sonam Gupta, Sr. Consultant & Head Unit II – Obs & Gynae, Asian Institute of Medical Sciences opines, “The prevalence of women’s health issues is particularly concerning. Women are more likely to develop depression, anxiety, and other mental health-related disorders compared to men. They are also more likely to experience chronic pain and autoimmune diseases. In addition, they are at a higher risk of developing certain forms of cancer, such as breast and ovarian cancer. The need for early diagnosis of women’s health issues is paramount. Early detection and diagnosis can lead to better treatment outcomes and improved health for women. Screening tests, such as mammograms and Pap smears, can help detect certain issues before they become more serious. Additionally, regular health check-ups can help identify any changes in women’s health that may require further investigation and treatment.”

Dr Archit Pandit, Director, Surgical Oncology, Sanar International Hospitals, Gurugram said, “Unfortunately, the urban and rural divide still persists owing to limited access to affordable healthcare facility and trained experts. We still have a huge unscreened population in rural areas who are at a great disadvantage and vulnerable to many health relates risks. Women play a significant role in the development of the society, their health concerns should be prioritised – encouraging them and making them aware about the importance of regular preventive health check-ups for early detection of the diseases and positive treatment outcomes.”

Women’s s health diagnostic industry: Current market size
As per Research and Markets, “Indian women health diagnostics market is growing at a CAGR of approximately 9.5 per cent during the forecast period. Increasing healthcare infrastructure is estimated to be one of the major factors that are driving the growth of the Indian women health diagnostics market. Over the past few years, a tremendous growth in health sectors in India has been witnessed, along with the increased healthcare spending. Rising incomes and easier access to high quality healthcare facilities and increasing awareness towards health and personal hygiene are estimated to be the major factors that are responsible for improving healthcare infrastructure in India, which augments the Indian women health diagnostics market.”

Giving an overview of the market, Chandra Ganjoo, Group Chief Executive Officer, Trivitron Healthcare said, “Throughout 2022-27, the Indian women’s health diagnostics market is expected to increase at a CAGR of almost 9.5 per cent. One of the main reasons influencing the expansion of the Indian women’s health diagnostics industry is the country’s expanding healthcare infrastructure. In India, the health sector has seen enormous expansion recently, accompanied by a surge in healthcare spending.”

“As far as the size of the global market for women’s health diagnostics is concerned, it was estimated to be worth $19.2 billion in 2020 and is anticipated to increase to $36.3 billion by 2030, rising at a CAGR of 6.9 per cent from 2021 to 2030. The major factor contributing to its rise are sedentary lifestyle, poor diet, lack of awareness, early/late marriages, workplace stress, and others.”

Sharing some numbers, Sachidanand Upadhyay, MD & CEO, Lords Mark Industries said, “According to the IMARC Group report, the global women’s health diagnostics market was valued at $ 21.62 billion in 2021 and is expected to reach $ 35.7 billion by 2027 at an 8.10 percent CAGR between 2022 and 2027. In India, as per the report of Orion Market Research (OMR), the women’s health diagnostics market is projected to grow at a healthy CAGR during 2019–2025.”

“The health consciousness and awareness of the benefits of early diagnosis are on the rise, and this trend is boosting the demand for point-of-care women’s healthcare diagnostics across the world. The awareness of preventive wellness among women is also growing in India”, he added.

Dr Sunita Dube, a Renowned Radiologist and Founder, MedscapeIndia, Aryan hospital also shares, “The market may see rapid growth owing to the increasing incidence of chronic and lifestyle-related disorders. There will be a surge in imaging and diagnostic centers, and the increased adoption of point-of-care and rapid diagnostic tests along with collaborations and partnerships by players. The increasing burden of various diseases will lead to a greater demand for proper diagnosis devices and tests for the diseases and thus driving the growth of the women’s health diagnostics market.”

Latest trends and recent developments in women’s health diagnostic industry Women’s health concerns are no longer restricted to reproductive health or maternal health. The discussions on women’s health now factor in a number of illnesses and health issues that impact women throughout their lifespan, such as cardiovascular diseases, bone diseases, thyroid disorders, diabetes, ovarian and breast cancer, etc. In this context, diagnostic services and solutions can play a pivotal role in building the pathway for better healthcare outcomes for women by facilitating early disease detection. Diagnostic solutions, in a way, empower women with knowledge and awareness of various health issues and help them make informed decisions at the right time.

With the invention of new technologies, including digital platforms, telemedicine, and AI-enabled diagnostics, the healthcare industry in India has seen tremendous growth in the past few years. These technologies allow for more efficient diagnosis of diseases and lead to faster treatment.

On digitisation of women’s diagnostics space, Dr Gautam Wankhede, Director of Medical Affairs, Mylab Discovery Solutions highlights, “In recent years, women healthcare apps such as period, ovulation and pregnancy, etc. and diagnostics have gained considerable momentum apps have gained traction. We will see further growth of such Apps and an increased use of Apps for menopause, other diseases. Digitalisation in health has enabled much-needed attention to women’s health. Advancements in technology will offer new diagnostics for women-centric conditions that include infectious diseases, osteoporosis, and breast cancer. Further, usage of tech can help make solutions more affordable and accessible to women.”

Dr Sunita Kapoor, Director and Consultant Pathologist, City Xray & Scan Clinic while mentioning about the latest trends said, “In India, factors like digitisation, e-commerce platforms creating ease of access, use of social media platforms for initiating conversations on women’s health, and the government taking measures to educate women in rural areas have added to the demand for goods and services flourishing, paving the way for the growth of women’s healthcare sector.”

Adaption of personalised medicine and growing focus on non-invasive and minimally invasive diagnostic techniques are also gaining attention among women. Moreover, there is an increased acceptance and adaption of Point of Care Testing (POCT).

Runam Mehta, CEO, HealthCube stresses on the role of POC diagnostics and mentions about several key areas where POC diagnostics are enabling easy healthcare access for women. She said, “Even a few years back, there were several barriers limiting women’s access to primary healthcare needs. This includes systemic challenges such as a lack of infrastructure for screening and diagnostic capabilities. Additionally, there was a body-part-by-body-part approach to screening which is not only time-consuming but creates other encumbrances as well. As per a report, the tests women need are often unavailable in health systems; also there are information, financial and cultural barriers created by gender inequality in terms of access to testing. Moreover, there is a lack of trust, fear and stigma associated with medical procedures and diagnosis.”

“And this is where point-of-care diagnostics are emerging as the panacea in the form of access as well as awareness by taking healthcare screening to women at home and work. Dozens of common pathology tests and vital measurements are now possible through simple hand-held diagnostic devices that can be operated by anyone with minimal training. This approach is also ideal for women in tier II and III areas since it resolves the challenge
of access. There are several key areas where POC diagnostics are enabling easy healthcare access for women. The parameters include cervical and breast cancer, prevention of maternal mortality, osteoporosis, and menstrual health, etc. Innovations in healthcare are now ensuring access to minimally invasive tests for these conditions. There are several FemTech startups that have come up with solutions in the area of menstrual health – be it creating a community for girls and women to discuss their challenges or delivering solutions”, she added.

On this, Aayush Rai, Co-Founder and CEOInito added, “With advances in technology, non-invasive point-of-care diagnostic tests has become increasingly popular in the women’s health diagnostic industry. These tests are convenient, safe, and cost-effective, and can be performed at home or in a doctor’s office. The global point-of-care diagnostics market is projected to grow from $36.37 billion in 2022 to $51.94 billion by 2029, at a CAGR of 5.2
per cent during the period.”

Dr Girija Kishore, Lead- Clinical Governance, LivLong believes that the advent of sophisticated healthcare technologies, such as advanced ultrasound imaging, liquid biopsy-based tests, and the use of Artificial Intelligence (AI) in diagnostics, has revolutionised the diagnosis and treatment of women’s health conditions.

He said, “As the rise in chronic and lifestyle-related disorders continues, the expansion of imaging and diagnostic facilities will be further driven, leading to better access to advanced diagnostic procedures for women around the world. In accordance with the latter, the increased use of POCT, diagnostic kits, tele-diagnostics, and rapid diagnostic tests is all expected to contribute to the rapid growth of the women’s health diagnostic market. These advances in the diagnosis of women’s health conditions will go a long way towards improving the quality of care and outcomes, as well as promoting preventative measures for the prevention and early detection of diseases.”

On personalised medicine and minimally invasive techniques, Dr Ashwini Bhalerao, Gandhi, Consultant Gynecologist, P.D. Hinduja Hospital & MRC shares, “One of the most significant trends in the women’s health diagnostic industry is the increasing use of personalised medicine. Personalised medicine involves tailoring treatments to individual patients based on their genetic makeup, medical history, and lifestyle factors especially during pregnancy, post-menopausal period, etc. This approach is becoming increasingly important in the field of women’s health, where there are significant differences in the way women experience and respond to diseases compared to men. Personalised medicine has the potential to improve the accuracy of diagnoses, reduce unnecessary treatments and improve overall patient outcomes. Another trend in the women’s health diagnostic industry is the growing focus on non-invasive and minimally invasive diagnostic techniques. These techniques aim to reduce the discomfort and risks associated with traditional diagnostic methods such as biopsies, which can be painful and carry a risk of infection.”

Also, women’s health care is increasingly shifting from a reactive approach to a proactive one, with a focus on preventive care. This includes early detection and screening of medical conditions, as well as offering lifestyle advice and counselling to promote better health.

Dr Arjun Dang, CEO, Dr Dangs Lab mentions, “In addition to diagnostic testing, there is also a growing focus on preventive care in the women’s health diagnostics industry. This includes providing women with information and education about reproductive and gynecological health, as well as offering screening and early detection services for various conditions. This is a crucial aspect of women’s health, as early detection and treatment can greatly improve outcomes and reduce the risk of complications.”

Dr Wankhede also feels that, “Women are increasingly seeking solutions as per their health conditions. At-home-diagnostics and smart wearables will see an uptick in near future.”

Neetha Joy, Director, ACT For Health see cancer care for women as one of the big emerging areas that has the potential for innovation at scale. She emphasises, “With the incidences of cancer expected to increase in India over the next few years as per the data released by ICMR, it is important to regularly screen women for high-risk and high-incidence cancers like breast, cervical, uterine and ovarian cancer. But with the bulk of cancer screening happening in tertiary centres, there is a very heavy burden placed on the limited number of tertiary centres in the country today. It is important to enable a hub and spoke model to decentralise cancer diagnosis so that equitable access to diagnosis is available to all.”

“While training and capacity building of healthcare workers is the most important lever to bring about this change, innovations in affordable medical devices can play a huge role as well. Early screening, pathology and cytology tests can be brought to the peripheries only through the use of such innovative medtech solutions”, she added.

Sandeep Vyas, Founder, Mild Cares; GynoCup says that one area that has garnered attention in recent years is menstrual health and there is a need for better diagnostic tools to address menstrual disorders. He shares that, “Menstruation is a critical aspect of women’s health and wellness, and the menstrual health sector of the women’s health diagnostic industry has seen significant growth in recent years. Menstrual disorders are one of the most common health concerns affecting women. Disorders such as polycystic ovary syndrome (PCOS), endometriosis, and uterine fibroids can cause pain and discomfort, as well as impact a woman’s overall health and quality of life. In the past, diagnosis of menstrual disorders relied heavily on a combination of medical history, physical exams, and ultrasound tests. However, advances in technology have led to the development of new diagnostic tools that can provide more accurate and efficient results. One such tool is the menstrual cup, which has seen a rise in popularity in recent years. While menstrual cups are primarily used for period protection, they can also be used to monitor menstrual flow and identify potential issues. Changes in menstrual flow, such as heavier or lighter bleeding, can indicate a problem and prompt further diagnostic testing. Additionally, menstrual cups can collect samples of menstrual blood, which can be analysed for abnormalities or infections.”

Public health: What the government is doing and can do in early diagnosis of women’s health issues
The Indian government has taken various initiatives to promote early diagnosis of women’s health issues in India including initiatives like implementing the National Health Mission (NHM), setting up National Institutes of Public Health (NIPH), launching the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), Janani Shishu Suraksha Karyakram (JSSK) and others.

In addition to these initiatives, Ganjoo shares some the additional steps to promote early diagnosis of women’s health issues by Indian government consisting of increasing funding for rural and remote health infrastructure, including diagnostic facilities, Women’s health issues and early detection training for healthcare professionals, including community health workers, encouraging women to undergo routine health examinations and providing
incentives for early detection of health problems, raising women’s awareness of the significance of early diagnosis and the screening options currently available and promoting research on women’s health issues in order to better comprehend the prevalence, risk factors, and treatment options for various diseases.

While sharing some of the suggestions on what government can do further, Kiriti Acharjee, co-founder, HealthFab says that, “carefully thought out health research is essential to achieving outstanding health outcomes. For better health outcomes, health research initiatives in India must align with public health priorities. Government-funded and independent research funding agencies, like the National Institutes of Health (NIH) in the United States, must take the lead in the development of evidence for policy. We won’t be able to distribute resources effectively without precise data. To enhance health outcomes and equity, comprehensive evaluations of all the key public health programmes and policies are required.”

“As a crucial tool for ensuring everyone’s health, primary healthcare must be improved. If the government wants to provide universal primary health care through public-private partnerships in India, it may need to adopt the National Health Service (NHS) model from the UK (PPP). The vast majority’s greatest need should be addressed first, because primary healthcare, if done well, will significantly reduce the need for secondary and tertiary care. The government should simultaneously develop a strategy for enhancing the urban poor’s state of health through the use of effective, efficient, and long-lasting strategic intervention techniques. Reforms must be implemented in line with the WHO framework for enhancing health systems, which consists of the following six distinct building blocks: (i) service delivery; (ii) health workforce; (iii) information; (iv) medical products and technologies; (v) financing; and (vi) leadership and governance”, he added.

  • Bridging the rural-urban divide in the access to diagnostic tests for women Increase investments in rural healthcare infrastructure: Investing in rural healthcare infrastructure is essential to bridge the gap between rural and urban access to diagnostic tests. This includes providing more medical professionals, equipment, and technology to rural areas so they can provide quality and comprehensive care.

Dr Jitendra Choudhary, Consultant – Intensive Care & Critical Care, Fortis Hiranandani Hospital stresses that the rural-urban divide in access to diagnostic tests for women is a significant challenge, but there are ways to bridge this divide and improve access to healthcare services for women in rural areas. One being improving roads, telecommunication networks, and electricity, can help to improve access to diagnostic tests for women in rural areas. This can make it easier for women to access healthcare services.”

Ameera Shah, Promoter and Managing Director, Metropolis Healthcare also beleives that “ Investing in healthcare infrastructure in rural areas, including building and upgrading healthcare facilities, can help to increase access to diagnostic tests for women in these areas. Improving transportation and connectivity in rural areas, for example by building roads and bridges, can make it easier for women to access diagnostic tests in urban areas.”

  • Expand public-private partnerships in rural areas: Public-private partnerships between the government and private companies can have a significant impact in improving the access to healthcare for rural communities. Some of these partnerships could focus on providing affordable diagnostic services for women in India.

Commenting on this, Upadhyay said, “The government is expanding the presence of Ayushman Bharat Health and Wellness Centers (AB-HWCs) to bring more and more citizens, including women, under its health care, preventive healthcare, and screening network. The need of the hour is to build an enabling ecosystem for inter-governmental
agencies, non-government organisations, and diagnostics players to come together to manufacture and distribute various diagnosis test kits in government healthcare centres across India at affordable rates to build a robust early-stage healthcare intervention framework. This is critical for bridging the rural-urban divide in healthcare delivery as

Dr Rohita Shetty, Senior Manager-Medical Affairs, Abbott India opines, “Encouraging regular health screenings is critical to identify conditions at early stages, sometimes even before symptoms are apparent. This can take place with community-wide screening programs, as well as targeted screening for women with risk factors for specific conditions, including age and family history. To ensure that all people have equal opportunities in being healthy, we must help bridge the rural-urban divide to reach women in underserved regions of India, from awareness to care. Working with Health and Wellness Centres and on-ground community members like Accredited Social Health Activist (ASHA) workers is important to scale such initiatives for education and diagnosis at a primary care level.”

“Tangible change can come with collective action. Public-private partnerships across the healthcare ecosystem can be a way to drive change and help prioritise women’s health needs. By promoting early preventive and proactive measures, we can help empower more women to improve their quality of life and health outcomes, so they can live healthier, fuller, and more thriving lives”, she added.

As per Dr Choudhary, “Community health workers can play a crucial role in improving access to diagnostic tests for women in rural areas. They can educate women about the importance of diagnostic tests, help them to access healthcare services, and provide support during the diagnostic process.”

According to Sujata Pawar, Co-founder and CEO, Avni, “Rather than assuming that all women will be able to authenticate and afford health care services in a remote location, it is critical to bring more diagnostics services to the doorstep of women. Rural communities’ diversity mandates local solutions to local problems. Healthcare institutes, private stakeholders, and the government in each region of India can work together to reduce the
rural-urban testing divide by empowering a mix of medical workers, including midwives, pharmacists, and community health professionals so that they can educate women and neighbourhoods about the benefits of testing as well as aid in reducing stigma, and dispelling myths about diagnostics.”

  • Lack of trained healthcare professionals in rural areas

Dr Dang shares, “Despite all the efforts from the government, there are still several challenges facing the women’s health diagnostics industry in India. One of the major challenges is the lack of trained healthcare professionals, particularly in rural areas where access to quality care is often limited. Another challenge is the lack of awareness about women’s health issues and the importance of preventative care, particularly among women in rural areas. This can result in late diagnoses and poor outcomes for many women. To address these challenges, the Indian government and private players in the women’s health diagnostics industry need to work together to provide affordable and accessible diagnostic services to women in all regions of the country. The government could provide subsidies and other incentives to private players to encourage them to invest in rural areas and provide high-quality diagnostic services to women in these areas.”

Kalyan Sivasailam, Co-Founder and CEO, 5C Network considers combining healthcare with technology to bridge the gap. He added, “India currently has an average of 15,000 radiologists who are mostly in top tier cities. Teleradiology platforms enable radiologists to report anywhere and anytime and allow them to provide accurate diagnostic reports in less time to people living in remote areas. Combining healthcare with technology can help overcome women’s health literacy barriers and create better community health centers that are technologically powered.”

On strengthening of the healthcare workforce, Shah said, “Improving the quality of healthcare services in rural areas requires a well-trained and motivated healthcare workforce. The government could consider investing in training and capacity-building programs for healthcare workers in rural areas, with a focus on women’s health.”

  • Increase investment in telemedicine: Telemedicine has the potential to bridge the gap between rural and urban access to diagnostic tests. The government should invest in telemedicine infrastructure and services in rural areas so that women can access quality care without needing to travel long distances.

Rai stresses, “Bridging the rural-urban divide in the access to diagnostic tests for women in India is a critical issue that needs to be addressed. With advancements in telemedicine and point-of-care technologies, access to care in rural areas has increased. These technologies allow for rapid and accurate diagnostic testing to be performed at the point of care, rather than requiring samples to be sent to a laboratory. This can greatly improve the speed and efficiency of diagnosis, especially in areas where laboratory services are limited. Point-of-care technologies can also reduce the cost of diagnostic testing, making it more accessible to women in rural areas.”

Way forward
Provide subsidies and other incentives for diagnostic tests: The government can provide subsidies and other incentives to encourage people living in rural areas to avail diagnostic tests and related treatments. This will help in making these services more affordable and accessible to women living in rural India.

Talking about way forward, Dr Tiwari said, “In order to ensure good health of women, it is imperative to educate them enough about their health and wellbeing. It will start with everybody, including the players in the private sector pitching with their set of enablers without expecting everything to be done by the government. Our women folk must also prioritise their health and be aware of the facilities that are being provided to them by the government and other bodies. Public-private partnership is very crucial to make healthcare and diagnostics services accessible in every nook and corner of the country at an affordable prices thereby ensuring universal health coverage in the true sense of the word.”