more_vert
As we mark International Women’s Day, it is time to recognise that gender justice in health requires more than improving access within existing systems, it demands redesigning how those systems are funded, governed, and led.
Inequity in the Australian health system is not uncommon. Some people have greater access to health services and move smoothly through the health system, while others face repeated barriers: delayed care, fragmented services, missed follow-up and preventable deterioration. These patterns reflect how health systems are designed, who they work well for, and who they repeatedly fail.
This is where gender justice matters.
Gender equity aims to improve access within existing systems. Gender justice asks a more basic question: do those systems work for people’s lived realities in the first place? When the same groups of women continue to miss out despite decades of reform, that points to a systemic problem rather than individual behaviour.
Gender justice in practice
Gender justice encompasses the full realisation of rights and opportunities for all genders — particularly women and diverse gender identities. The World Economic Forum’s 2025 Global Gender Gap Report estimates the global gender gap at 31.2%, requiring 123 years to achieve parity. Australia ranked second in East Asia-Pacific and 13th globally for gender parity; however, its performance in the health and survival sub-index is notably weaker, ranking 96th. This reflects enduring gender differences in health outcomes, as indicated by life expectancy and sex ratios at birth.
Migrant and refugee women experience persistent barriers to healthcare, including language barriers, visa insecurity and discrimination. National survey data showed that 24% of migrant and refugee women did not know where to seek help for physical or mental health concerns, with rates reaching 35% among women on temporary visas. Geography compounds inequity: those living in very remote communities averaged just 3.3 GP visits per person compared to 6.3 in metropolitan areas, and the rates of family and domestic violence hospitalisation were 41 times as high compared to people living in major cities. For Aboriginal and Torres Strait Islander women, inequity is further shaped by colonisation and systemic racism, with life expectancy eight years lower than for non-Aboriginal and Torres Strait Islander women.
The Lancet Commission on Gender and Health
The recent Lancet Commission on Gender and Health reinforced that gender inequities in health persist not because we lack solutions, but because we lack the political will to redistribute it. The Commission showed that health systems are shaped by governance, financing, and accountability arrangements that concentrate decision-making authority with those least affected by inequity. Without redesigning how decisions are made and resources are controlled, health systems will continue to produce unequal outcomes, even when equity is an explicit goal. Gender justice requires more than good intentions. It requires structural change: shifting power to those most affected, measuring success by who benefits rather than what is delivered and holding systems accountable when they consistently fail the same groups of women.
Taking gender justice forward in Australia
To move the dial on gender justice in Australia, we need to change how health systems are designed, funded, and governed. Only 3.3% of government research funding in 2023-24 was dedicated to women’s health, leaving many conditions that only, differently or disproportionately affect women critically underfunded and poorly understood. Additionally, fragmentation of funding for health programs influences inadequate access to high-need groups. This fragmentation particularly affects vulnerable populations, including women living with disabilities, older women, and those with chronic conditions, creating gaps in care and lengthy delays while bureaucratic processes determine funding responsibility.
In Australia, although women comprise approximately 75% of the healthcare workforce, they are significantly underrepresented in health leadership: only 45% of public hospital board chairs, 39% of private hospital CEOs, and 38% of chief medical or health officers are women. This imbalance matters because leadership shapes priorities, funding decisions, and service models. When leadership does not reflect the gendered composition of the frontline workforce, decision-making is less likely to incorporate lived experience of care delivery and is more likely to privilege efficiency and standardisation over equity and responsiveness.
For clinicians, the effect is visible in practice. Systems that prioritise output and standardisation over continuity and context are poorly equipped to respond to mobility, trauma, language barriers, different cultures, and remoteness, with 30.8% of Australian women reporting unacceptable waits for specialists and 30% delaying/skipping GP visits. This contributes to higher rates of missed appointments, delayed presentation and preventable hospitalisation among migrant women, women in rural and remote communities, and Aboriginal and Torres Strait Islander women.
There is strong Australian evidence that different models work better. Aboriginal Community Controlled Health Services, which are governed and led by communities, consistently demonstrate improved access, greater cultural safety, and higher levels of trust than mainstream services. These services also demonstrate better engagement in preventive care and chronic disease management.
Taking gender justice forward means expanding models that prioritise diversity, community leadership, continuity of care, and local decision-making to close the gender gap. For policymakers, this includes longer funding horizons, greater flexibility in program delivery, and accountability measures that prioritise equity and sustainability over speed alone. For research institutions, this means reforming authorship, governance, and grant structures so that women, organisations, and partners are given real authority rather than symbolic inclusion.
Supporting gender-just systems means advocating for service models that reflect how people live, work, and care for others. Australia has the evidence, resources, and institutional capacity to lead differently. Taking gender justice forward now requires closing the gender gap, shifting power closer to communities, redesigning systems around lived realities, and measuring success by who benefits, not just what is delivered.
We would like to thank Prof Fran Baum, Dr Adele Murdolo, and Heather Keighley for generously sharing their ideas at the Women in Global Health Australia’s event ‘Gender Justice in Global Health – What it means for Australia and the Region,’ on 27th of November 2025
Adeline Tinessia is a research officer and PhD candidate at the University of Sydney. A secretariat member of Women in Global Health Australia, she is committed to gender equity in public health.
Emily Zhou is a PhD candidate at the University of Sydney within the School of Medical Sciences. She is a member of the secretariat of Women in Global Health Australia and is committed to advancing gender equity across all spheres of society.
Heather Keighley is a Registered Nurse and Midwife with remote area clinical management experience, is currently Chief Remote Area Nurse (RAN) for CRANAplus, Chair of the National Rural Health Alliance, and Vice President of the Australian College of Nursing. She is a strong advocate for health equity for the 30% of Australians who live in rural and remote Australia.
Zohra Lassi is an associate professor at the University of Adelaide and an internationally recognised leader in maternal, adolescent, and reproductive health, with expertise in health equity. She leads global collaboration to strengthen the RMNCAH continuum of care and is a committee member at Women in Global Health Australia.
Jennifer Gersbeck is recognised as a global leader in the eye health and international development sector. Previous roles included leading global partnerships and advocacy efforts at the Fred Hollows Foundation. She is a champion for gender equity and is Co-Chair of Women in Global Health Australia.
Meru Sheel is a professor of infectious diseases and global health at the University of Sydney, working extensively across the Asia-Pacific region. She leads the Infectious Diseases, Immunisation, and Emergencies (IDIE) group at the Sydney School of Public Health. She is an advocate for women and diversity in leadership and Chair of Women in Global Health Australia.
The authors do not work for, consult, or own shares in or receive funding from any company or organisation that would benefit from this article.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
Subscribe to the free InSight+ weekly newsletter here. It is available to all readers, not just registered medical practitioners.
If you would like to submit an article for consideration, send a Word version to mjainsight-editor@ampco.com.au.