Blueprint to Close the Women%E2%80%99s Health Gap 2025

Average CPG analysis for 15 selected countries FIGURE 7 Sour ce: The Forum and MHI analysis on assessment of national CPGs against global benchmarks. Methodology of grading and specific CPGs ar e included in the technical appendix25.2% 28.9% 37.1% 8.9% XX% 12 0102029 53950 30405060 No CPG identifiedNo CPG identified No mention of any criteria 0 Mention of any aspect of criteria1 Mention some, but not all criteria2 Recommended practice 3Total number of CPGs No mention of any criteriaMention of any aspect of criteriaMention some, but not all criteriaRecommended practicePercentage of CPGs out of totalAcross countries and conditions, <9% of clinical practice guidelines met recommended global standards of evidence-based practice Assessment level based on criteria such as: inclusion of female specific risk factors, diagnostic cut off, treatment protocols and pathways 2.3.1 Among selected conditions, less than 9% of CPGs in the studied countries met recommended global standards The Forum and MHI analysis found that none of the selected conditions had comprehensive or complete CPGs in all studied countries – and none of the studied countries had comprehensive or complete CPGs for all conditions. Practice-standard CPGs for women-specific conditions that affect health span were particularly sparse: in 25% of cases, there is either no CPG identified or no mention of any female-specific criteria across risk factors, diagnostic cut-off, treatment protocols or pathways. CPGs for cervical cancer are present in all 15 of the studied countries, a feat not achieved by the other selected conditions. However, the country-level CPGs for cervical cancer were often incomplete – for example, specifics regarding vaccination targets, screening and time to treatment varied and were not always aligned with clinical evidence. Vaccination for human papilloma virus (HPV) almost entirely prevents cervical cancer, yet less than 25% of LICs have introduced HPV vaccination into their vaccine schedules and fewer than one in five girls around the world have been vaccinated for HPV.111 Fewer than 5% of women in LICs and LMICs are screened for cervical cancer,112 reaching as low as 1% of women screened in parts of Africa.113 Screening coverage in HICs is at least seven times higher than it is in LICs and LMICs.114 CPGs for ischaemic heart disease met the standard for evidence-based recommended practice in only one of the studied countries, even though ischaemic heart disease is the leading cause of death for men and women worldwide. Few country-level CPGs for ischaemic heart disease acknowledge sex-based differences: 64% of CPGs for ischaemic heart disease mention women- specific risk factors and risk scores (e.g. age, menopause and hormone replacement therapy [HRT]); 64% of CPGs for ischaemic heart disease mention that women may present differently from men with acute cardiac events (e.g. with dizziness, nausea and fatigue); 29% of CPGs for ischaemic heart disease acknowledge that women may respond differently from men to treatment or may require a different treatment pathway (for example, blood pressure optimization, given that standard dosing of some medications such as ACE inhibitors and beta blockers can lead to increased side effects in women and personalized adjustment of medication for women may need to account for physiological differences). Only the Brazilian guidelines mentioned evidence-based diagnostic cut-offs for women. One country lacked CPGs for ischaemic heart disease completely. Blueprint to Close the Women’s Health Gap: How to Improve Lives and Economies for All 23