Sarah Schaefer

This essay is part of the MEPC's Emerging Voices series, highlighting scholarship from rising academics focused on Middle Eastern studies. Author Sarah Schaefer is an undergraduate international politics student at The Catholic University of America in Washington, D.C., where she concentrates in Islamic world studies and intelligence.

Although gender inequality persists as an enduring issue across the globe, the Middle East and Islamic world is often associated with disproportionate gender standards, resulting in various forms of oppression. The World Economic Forum’s Global Gender Gap Index indicates that, as of 2020, the Middle East and North Africa region has only closed 61.1 percent of its gender gap, making it the least progressive geographic location in relation to women’s equality. The ramifications of gender inequality manifest in various facets of a woman’s life, including the utilization of and access to healthcare. In order to advance holistic gender equality, Middle East countries need to prioritize women’s health education and advance female health care services.

Today, marginalized populations, including many women, across the Middle East and Central Asia face barriers in accessing basic and crucial health resources. Afghan “women and girls struggle to get even the most basic information about health and family planning” and “routine preventive care such as pap smears and mammograms are almost unheard of.” In Iraq, there are very few available female health services and facilities and, even if these services exist, the nation’s general lack of healthcare and high female unemployment rate make visits fiscally unattainable. In Syria, “women’s preventative care… has all but vanished,” leaving zero access to mammograms and cervical cancer screenings specifically. Without drastic changes in both culture and policy, vulnerable women across the Middle East will be behind the curve in identifying and effectively treating serious, and potentially detrimental, female-oriented health concerns.

A 2018 Harvard Medical School study on breast cancer care in Saudi Arabia, Jordan, the United Arab Emirates, Oman, and Kuwait illustrated the considerable consequences of insufficient women’s health services in the Middle East. This research identified a need “to fill in the gaps in service provision, cancer control, and screening” through a recognition of the “discrepancies and inequities” at play when seeking treatment. The study also communicated the usefulness of perceiving the problem of healthcare inequality through a human rights lens, which affirms the imperative of making health services accessible to everyone, regardless of gender.

Not only are many women in the region enduring unaddressed and frequently preventable health conditions, but, when concern does arise, they wait for longer periods of time before seeking treatment. A 2014 study in Saudi Arabia found that males suffering a heart attack averaged a 5-hour pre-hospital delay in seeking treatment, whereas females underwent an average of  a 12.9 hour pre-hospital delay. This significant disparity can be attributed to the fact that 1) women need to obtain male permission prior to a hospital visit led to delays in seeking help; 2) women prioritized their role as caretaker to their families above caretaker to themselves; 3) women were not educated on symptoms of a heart attack; and 4) women did not want to attract attention to themselves.

Although Saudi Arabia has lifted some of its male guardianship requirements, “it is clear that there are distinct cultural issues contributing to the delay faced by females in this study that are clearly illuminated by this qualitative analysis.” Although this study focused solely on heart attacks, it exemplifies a greater sociocultural struggle regarding women's health and the general adversities they face prior to receiving care.

So, the question becomes: How do we overcome gendered cultural norms to create an environment protective of women’s health? This requires an overall re-prioritization of women’s health specifically.

Governmental and nongovernmental agencies in Middle Eastern countries need to increase their production of gender-specific health data in order to assess and identify disparities and problem areas in both diagnosis and treatment. Expanding the scope of information, and specifically in regard to biases against women’s health services, will allow governments to create tangible objectives to inform policy.

Perhaps more importantly, women need to be better educated on their own health needs, thus increasing the likelihood that they will advocate for and subsequently utilize services. When women’s health is not discussed often and openly, action-oriented responses to health concerns are generally less likely to take place and pre-hospital delays ensue. Ultimately, empowering women with the knowledge necessary to put their own health first is an integral step in advancing a comprehensive and  balanced health care system for all.