Framing gynaecological health: A landscaping of health policy and services in India.

Gynaecological health requires a health systems approach through the life course to address 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 and 2025. The extraction of 34 documents examined whether a condition/symptom was covered in policy and included in guidelines for community awareness/outreach and facility-based treatment. The analysis assessed the extent of policy guidelines and data available for 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 gaps remain in community-based outreach and access to conservative treatment options. Nationally representative surveys currently collect data on some gynaecological conditions, but there are limited population-level data on the prevalence of and treatment for menstrual disorders, infertility and sexual health. Advacing women's health will will require policy and service guidelines that address the range of gynaecological conditions in an integrated approach, including community outreach, facility-based management and national, routine data colleciton.