Health equity means removing unfair and avoidable barriers so people can access the care they need, when they need it, and with dignity. For women and girls, that means more than simply having healthcare services available. It means care must be reachable, affordable, informed, and responsive to the realities of their lives. Conditions like Female Genital Schistosomiasis (FGS) make that painfully clear by showing what happens when women’s health needs remain overlooked in health systems.
Around International Women’s Day, conversations about women’s health often focus on awareness. Awareness matters, but awareness alone is not enough. The real question is whether women and girls can access diagnosis, treatment, and care without being ignored, misdiagnosed, stigmatized, or left behind. That is where health equity matters most. It moves the conversation from good intentions to actual access.
What is health equity?
Health equity is the absence of unfair, avoidable, or remediable differences in health between groups of people. In simple terms, it means everyone should have a fair opportunity to achieve their best possible health. That does not mean giving everyone the exact same thing. It means recognizing that different people face different barriers, and addressing those barriers is essential to eliminating disparities in access to care.
That distinction matters. Equal treatment can still produce unequal outcomes if a system ignores the real obstacles people face. If services exist but are too far away, too expensive, too poorly understood, or too stigmatized to access, then the system is not equitable. Health equity requires more than service availability.
Why do women still face barriers to care?
Women’s access to healthcare is shaped by more than whether services exist. In many settings, women and girls face barriers linked to poverty, caregiving roles, transportation, limited local services, and stigma. These are exactly the kinds of structural and social conditions that create health inequities.
The World Health Organization notes that health and health equity are shaped by the conditions in which people are born, grow, live, work, and age, along with their access to power, money, and resources. That means health outcomes are not only determined inside hospitals and clinics. They are shaped by whether people can safely reach care, afford care, trust care, and receive care that reflects their actual needs. For women and girls, those gaps can be especially severe when gender, poverty, and exclusion overlap.
How FGS reveals health inequity
Female Genital Schistosomiasis (FGS) is a powerful example of what health inequity can look like. FGS is a hidden crisis affecting women and girls, caused by a microscopic parasite found in contaminated freshwater. Women and girls of any age can be exposed during everyday activities such as washing, swimming, or collecting water. Without access to safe water, sanitation, regular treatment, and informed care, the risk of infection and long-term complications increases.
What makes FGS a health equity issue is not only the disease itself, but the way it is neglected, misunderstood, and invisible within health systems. FGS can lead to chronic pain, infertility, pregnancy complications, increased HIV risk, and social isolation. Many women are misdiagnosed, shamed, or rejected by their communities. That is exactly why this issue belongs in a broader conversation about women’s health, dignity, and access to care.
When a condition affecting women is hidden, stigmatized, or routinely misdiagnosed, women do not just face a medical problem. They face a system problem. They are more likely to be overlooked, more likely to suffer longer, and less likely to receive the right support early. That is not just unfortunate. It is inequitable.
What Pathways to Equity is doing in Liberia
Effect Hope’s Pathways to Equity program shows what it looks like to address health inequity at the system level. Together with the Liberian Ministry of Health and technical expert Unlimit Health, the program is a groundbreaking effort to help make Liberia the first country in the world to fully integrate FGS into its national health system. That matters because it takes FGS from being invisible and fragmented to being recognized, prioritized, and treated as part of real public healthcare.
FGS remains largely invisible within the health system, and that limited integration across policy, human resources, supply chains, data, and financing has hindered equitable access to care. In other words, the problem is not only that women are getting sick. The problem is that the health system has not historically been built to respond to this condition.
Pathways to Equity addresses that by taking a system-wide approach. It supports integration across guidelines, workplans, data systems, supply chains, training, performance measures, and essential service packages so women and girls can access appropriate care regardless of where they are located. That is what health equity looks like in action.
The goal is not only to improve diagnosis and treatment today, but to create lasting change. This work is designed to increase community awareness, reduce stigma, improve diagnostic capacity, strengthen data, and create a proof of concept that could be replicated in other endemic countries. That makes this more than a single disease response. It is a model for building stronger, fairer health systems.
Why health system strengthening matters for women’s health
Achieving equity in health requires systems that are strong enough to meet people where they are. At Effect Hope, as we work towards a world where people are free from the injustice of neglected tropical diseases (NTDs), we remain focused on breaking down barriers to NTD services so everyone can access the care they need, whenever and wherever they need it.
Equitable access to health care is shaped by so much more than the availability of services. It is shaped by whether health workers are trained, whether medicines are available, whether services are inclusive, whether communities understand the condition, and whether stigma is being reduced rather than reinforced.
When a health system is strong, everyone benefits.
What improving health equity looks like
Improving health equity means making individual health needs visible, prioritized, and supported across the whole system. It means recognizing where unfair barriers exist and addressing them directly instead of expecting people to simply work around them.
In practice, improving health equity looks like:
- reducing stigma so people feel safe seeking care
- removing financial barriers to care
- training healthcare workers to diagnose conditions accurately
- improving reliable access to medicines, diagnostics, and treatment
- strengthening health systems so care is consistent and sustainable
- designing services that reflect the realities of individual communities
- expanding access to essential services
That is why FGS is such an important example. It shows how gender, geography, poverty, stigma, and weak systems can combine to create barriers to health care. But it also shows that those barriers are not fixed. With the right policies, partnerships, and health system support, they can be changed.
Health equity is not an abstract idea. It is whether someone can afford to see a health worker when they first get sick. It is whether care is available close to home, not days of travel away. It is whether a diagnosis is accurate and treatment is timely. It is whether people are treated with respect rather than judgment. And it is whether health systems are designed to reach those who have too often been left behind.
For women and girls affected by FGS, health equity means being seen, believed, and supported. And for us at Effect Hope, it means turning policy into care, reducing stigma, and helping build health systems that create lasting change.
