This article was first published by Masaar on July 25, 2023.
Introduction
Without any exception, women suffer from discrimination and bias in all aspects of life. This extends across all human societies, including advanced and wealthy ones, differing only in the level or extent of this discrimination. One of the primary needs for every individual is access to healthcare that preserves their physical and mental well-being and protects their very lives. Therefore, discrimination against women in accessing essential healthcare services at an appropriate level is one of the most dangerous and significant forms of discrimination against them. In recent years, information and communication technologies have been developing new technological solutions that can provide women around the world and from different socio-economic backgrounds with the hope for improved access to healthcare services they critically need, but of which many are still deprived for various reasons.
Some key information and communication technologies, such as the Internet, smartphones, and artificial intelligence, contribute to offering new opportunities for women to access healthcare services at different stages of their needs. These services range from health awareness and periodic follow-up of general and reproductive health indicators to early detection of diseases, obtaining medical consultations for health issues, providing necessary treatments and medications, and even facilitating surgical procedures when necessary. Despite the broad horizons that these technological applications open for adjusting the balance of gender equity in accessing healthcare, many of them remain out of reach for the majority of women due to economic and technological reasons. Moreover, there are numerous considerations that need to be taken into account when resorting to these applications, including the protection of the right to privacy and ensuring safe services free from any potential harm.
This paper aims to provide a comprehensive overview of the potential uses of information and communication technologies in delivering better healthcare services for women. It begins by briefly presenting the reasons why many women are deprived of adequate healthcare services. It then provides an overview of how information and communication technologies qualify to play a significant role in improving women’s opportunities to access suitable healthcare services that meet their diverse needs and ensure sufficient quality.
The paper also delves into more detail on each of the following: key technologies such as the Internet, smartphones, and artificial intelligence, and what each can offer; The primary healthcare needs of women, including health awareness, Periodic follow-up and early diagnosis of diseases, consultations, treatments, and surgical procedures, and what technology can contribute to each of these areas. Finally, the paper reviews the precautions and considerations that must be taken into account, including the protection of privacy rights, data, and information security, ensuring service safety, and regulating services within a legal framework that safeguards the interests of women who seek this new type of health care service.
Why Women Struggle Accessing Adequate Healthcare?
Often, general factors such as economic conditions contribute to difficulties in accessing healthcare services for both genders. However, discrimination against women due to cultural and social reasons leads them to bear much greater burdens than men under the same circumstances. In many cultures, women’s access to healthcare when facing physical or mental distress is not considered a priority to the same extent as it is for men.
The low rates of women’s education in many impoverished and conservative societies result in a lack of awareness among women themselves and those around them. Consequently, considerations such as periodic follow-up of health indicators are almost completely absent in such societies. This makes early detection of any health problems highly unlikely. Combined with the hesitation of women to seek medical attention when experiencing symptoms, due to not taking their health complaints seriously, women often do not reach healthcare providers until the advanced stages of severe illnesses, including various types of cancers, making it difficult, if not impossible, to provide effective assistance to protect their lives. In many cases, women may not even have access to such assistance before succumbing to the disease.
The prevalence of a misogynistic culture that places women in a subordinate position to men and attributes qualities such as irrationality and exaggeration to them negatively affects healthcare services provided to women, even in the most advanced countries. Doctors tend to downplay the extent of women’s pain, assuming that they are always exaggerating. This leads to neglect in early diagnosis of serious illnesses, even when women seek consultation with specialists. In various cultures around the world, there is also a prevailing perception that health issues resulting from the biological and physiological nature of women are considered normal and not in need of attention. Health problems related to menstrual cycles, pregnancy, postpartum period, and premenopausal phase are often trivialized, and they are not seen as a reason to seek healthcare services. This lax attitude extends even to the doctors themselves, who may not prescribe appropriate treatment except in cases of extreme severity. Most women are advised to endure the pain as a natural part of being women or mothers.
What qualifies information and communication technologies to play an important role in providing healthcare for women?
The initial applications of information and communication technologies in the field of healthcare began to emerge in the early 1960s and 1970s. These applications remained limited in terms of capability and spread for a long time. However, in recent decades, information and communication technologies have witnessed significant development, allowing for expanded use of their applications in healthcare. The most impactful aspects of this development include:
- Improved data processing capabilities, enabling a larger proportion of today’s computers to handle a vast amount of data more quickly. This is of great significance in healthcare because the data that needs to be processed is typically large in volume, and the patient’s life or well-being often relies on analyzing this data as quickly as possible.
- The emergence and widespread availability of complete genetic maps worldwide have provided additional data that can be particularly processed and analyzed electronically to gain important insights into genetic diseases, their detection, and management.
- The proliferation of computer use and access to healthcare service centers in various forms (hospitals, health units, private clinics) has enabled these centers to start retaining detailed electronic patient records. This provides additional data related to patients’ medical history, which helps new applications in providing more accurate diagnoses and treatment suggestions.
- The presence of robots in the field of precision surgeries and their significant improvement in performance.
- The emergence of increasingly powerful machine learning models that can handle larger amounts of data more flexibly, opening up broader possibilities for tracking different paths for predicting accurate diagnoses and appropriate treatment options, comparing them, and yielding more precise results in a short period.
- The development of natural language processing models and the availability of massive datasets that can be processed by these models have recently made it possible to develop robots capable of efficiently understanding ordinary human speech. This enables them to engage in a full conversation with the patient and access sufficient information to diagnose their condition more accurately.
What are the key technologies that can help improve healthcare for women?
The key information and communication technologies that can help improve healthcare for women are primarily Internet-based technologies, smartphones, and artificial intelligence (AI). Each of these technologies has revolutionized the way we live our daily lives. First, the Internet has provided us with unprecedented connectivity, followed by smartphones, and today, AI is entering a new stage of development, introducing a new world of applications powered by large language models. Most of the applications that can be provided to improve healthcare for women are built on the combined use of these three technologies.
Smartphone applications operate by connecting to the Internet and typically store most of the data they work with on the cloud. Modern applications utilizing AI are increasingly emerging through websites on the Internet and also in the form of smartphone applications. Therefore, the following categorization of different applications among these three technologies aims to simplify and clarify the discussion. However, it is important to note that any application classified under one of these technologies often utilizes the others as well.
The Internet:
The majority of the world’s population today is connected to the Internet, often without even realizing it. The Internet has become more than ever a two-way communication tool. While it allows browsing countless websites to obtain information about anything imaginable, it also enables interaction with many websites that offer various services, many of which can be personalized to suit the user. This makes the Internet an excellent medium for providing numerous healthcare-related services.
What distinguishes accessing these services through the Internet, particularly for women, are the following:
- Overcoming geographic barriers: Accessing any healthcare service online is possible from anywhere in the world as long as there is an internet connection. This helps women who cannot access healthcare services due to their unavailability in close proximity to them.
- Overcoming economic barriers to some extent: Most healthcare services provided through the Internet are less costly than their real-world counterparts, including services that may be free, such as health awareness. However, the need to travel to access these services incurs costs that exceed the capabilities of many women. On the other hand, some healthcare services available online may require a monetary payment, which is usually less than the cost of the same service provided in physical facilities. This makes the service available to a larger number of women, even if it is not accessible to all those who need it.
- Overcoming certain cultural and social barriers: As long as obtaining the service does not require direct communication with a male doctor, there may be no objection to women accessing it. Online services can achieve this either by being fully automated without the need for direct communication with a human element in the first place, or by enabling communication with a female doctor. The chances of achieving this are much higher through the Internet than in many existing situations, especially since there is no need for the consulted doctor to be in close geographic proximity or even in the same country. Additionally, even in the presence of a language barrier between the parties, modern AI-powered applications allow real-time translation, surpassing this obstacle more efficiently than before.
Smartphones
Smartphones have made accessing the internet easier than ever before. In addition to that, they have made it possible for web applications to exist outside the browser, allowing each application to develop a more flexible and rich user interface. While it is common for smartphone applications to function through the internet, it is not necessary. These applications can store their data on the device, preserving their privacy. There are also various other ways to combine network connectivity with privacy, such as data encryption and more.
It can be said that smartphone applications can provide all the services that the internet offers for accessing healthcare. However, smartphones add additional advantages that cater to the healthcare needs of women and help overcome various obstacles that hinder their access to care. The following are distinguishing features of smartphone applications:
- Specialization: Smartphone applications tend to specialize in specific tasks, making them easier to use compared to network applications that require a higher level of technical knowledge to access through a browser. This makes these applications more user-friendly for a broader sector of women.
- User Interface Flexibility: The visual cues in the user interface make it easier to use the application, as they are more recognizable than relying solely on written text. Again, this allows a wider range of women to use these applications easily.
- Privacy: Smartphones are personal devices that are not shared among multiple users. This facilitates women’s use of smartphones for their private healthcare matters without the fear of others accidentally accessing their information. To avoid intentional intrusion into personal data, simple and user-friendly security measures can always be employed, including fingerprint authentication and facial recognition for device usage.
- Ease of Connectivity: Smartphones are known for their easy and multiple ways of connecting with other electronic devices. Many personal healthcare devices andfollowing-up tools can connect to smartphones to store the collected data. Examples of such devices include blood pressure monitors and blood glucose meters. It is preferable to periodically record data from these devices for analysis of trends. Connecting any of these measurement devices to a smartphone allows the recorded data to be automatically transferred to the phone. With a suitable application, this data can be analyzed, and alerts can be generated for any concerning indicators.
Artificial Intelligence (AI)
Artificial Intelligence is the fastest-growing field of technology in our current time, and it has recently crossed an important threshold in its development with the emergence of large-scale models for natural language processing. These models allow AI applications, especially conversational robots or chatbots, to understand and generate previously unknown linguistic texts. This means that they can engage in conversations with users in a way that is often indistinguishable from talking to another person. This new technology, along with many others developed in the field of AI, can have a significant role in countless applications in healthcare. Specifically for women, AI can help overcome many barriers that hinder their access to appropriate healthcare services, including:
- The ability to analyze massive databases at a rapid pace: Many women’s health following-up services rely on two main factors: collecting and analyzing multiple health data and indicators, and comparing them with data from a larger number of women. This helps in developing ways to deal with recurrent health issues such as those related to the menstrual cycle, premenstrual syndrome, pregnancy, and premenopausal symptoms. The increasing capabilities of AI applications can isolate factors that affect women’s experiences with these recurring problems. Previously, it was difficult to uncover such factors due to the sheer volume and complexity of the data, which AI applications can now handle.
- AI applications can eliminate some of the stereotypes that complicate women’s access to healthcare services by highlighting the objective basis for women’s complaints about recurring health problems. If AI models are trained on large and pre-filtered databases to ensure a reasonable level of cultural bias, these applications can provide more objective responses to women’s complaints compared to doctors’ responses, which may be susceptible to cultural biases.
- Early diagnosis of various severe diseases that primarily affect women (such as reproductive system diseases) or have a higher prevalence in women (such as breast cancer) relies on analyzing complex digital and imaging data. AI models can easily handle a large amount of data in different forms (text, numerical, and visual), especially when it comes to accurately interpreting X-rays, CT scans, MRIs, and more. Furthermore, when imaging devices are directly connected to computers using AI models, these models can interact with the devices in real time to guide the data collection process and analyze it, leading to precise results in a short time.
- Modern AI models can serve as alternatives to healthcare professionals in initial consultations with patients to provide preliminary diagnoses. For women, this allows easier access to healthcare consultations at a lower cost, overcoming social resistance to visiting a doctor’s clinic or having a home visit.
- Significant advancements in robotic assistants for surgical procedures have enabled many surgeons to perform highly precise operations that were previously either impossible or limited to a few highly skilled and experienced surgeons. Additionally, some of these surgeries can now be performed remotely. In the case of women who often require sudden, varied, and sometimes emergency surgeries, such as transitioning from natural delivery to a cesarean section or the need for fetal surgery to save a baby’s life, the accurate diagnosis and remote surgery solutions offered by AI models provide opportunities to either avoid such sudden developments or address them promptly.
Aspects of healthcare that technology can help improve
Information and Communication Technologies (ICTs) can intervene in all aspects of healthcare service delivery, whether it is preventive (awareness and Periodic follow-up ), diagnostic (early diagnosis, health consultation, prescription of medication or other interventions, direct treatment, andfollowing-up of health status), or post-treatment (recoveryfollowing-up , support, and psychological counseling). This text briefly discusses these aspects and what ICTs can offer in each area to improve healthcare services provided to women and overcome barriers to access.
Health Awareness
The internet is an excellent source for disseminating health education, particularly in raising awareness among women, as many aspects of their daily lives can significantly impact their health. Various factors, such as different household chores, managing children, balancing household and work responsibilities, can all be areas where women can be educated about factors that affect their health. Examples of such factors include the substances used in household cleaning, their potential health hazards, cooking methods and food preparation, and the potential risks associated with some of them, as well as dealing with the physiological processes related to the menstrual cycle, pregnancy, childbirth, postpartum period, and premenopausal phase.
Numerous entities, including international non-governmental organizations like the World Health Organization, governmental bodies such as health ministries and their affiliated agencies, as well as non-governmental organizations, can utilize the internet to reach the largest possible number of women, especially if they focus on using social media platforms and employ visual and audio media in addition to written text. These entities can also provide tailored awareness by offering the opportunity to answer women’s questions.
Smartphones and artificial intelligence applications enhance the possibilities of customizing health awareness provided to women. Such applications can provide awareness based on personal data input by the user and then adapt the awareness to fit various personal circumstances, including educational level, income level, and social barriers that may hinder the implementation of specific recommendations. The advancement of artificial intelligence applications enables data collection through dialogue with the user, making it easier for the majority of women.
Periodic follow-up and Early Diagnosis
Continuous collection of health data and indicators is of great importance, especially when dealing with health issues that primarily or more frequently affect women than men. Smartphone applications that allow women to record data about their menstrual cycle or measure blood pressure and blood sugar levels can assist users in following-up their health status without the need to remember details over time. These applications can also analyze the recorded data and provide initial advice to avoid health issues. If the application is connected to healthcare service providers, it can provide the user with consultations from a physician based on the collected data.
Regular and continuous collection of essential health data and indicators can often lead to early disease diagnosis. Smartphone applications can also remind users to perform self-examinations, such as breast self-examinations or detecting vaginal and uterine infections, and provide awareness on how to conduct these examinations. Some modern electronic devices that facilitate self-examination are available in certain countries, while others are still in the development and testing phase. With these devices, it is also possible to link them to smartphones to store, analyze, and send the data to healthcare service providers based on the user’s choice.
Health Consultation and Treatment
Information and communication technologies can assist in providing health consultation and treatment with varying degrees of human intervention. In some cases, with the availability of advanced applications and the simplicity of the condition being addressed, a smartphone application can handle the diagnostic process and provide appropriate treatment. In other cases, applications can assist the doctor in the diagnostic and treatment process, saving a lot of time and effort.
In the case of women, the availability of such applications can be a deciding factor in receiving timely and appropriate healthcare or not receiving it at all. By eliminating the need for human intervention in some cases, limiting communication or expanding the range of choice regarding this human element, many geographical, economic, and social barriers that prevent women from visiting a doctor or vice versa can be overcome.
Modern artificial intelligence applications can play a crucial role in helping doctors diagnose diseases with indistinguishable symptoms or complex symptoms dependent on studying the patient’s medical history and surrounding environmental conditions. In the case of women, this assistance is crucial because collecting and analyzing such data may be impossible for most of them, and direct interaction with a doctor may be difficult or even impossible.
Surgical Intervention
Cases that rely on information and communication technology to provide remote surgical services have become increasingly common today. As mentioned before, these technologies can be critical in saving the lives of many women who suddenly require precise surgical intervention that was not preplanned. In many cases, all that is needed is communication with a specialized surgeon who cannot physically be present where the patient urgently needs their expertise. This surgeon can guide a general practitioner or even a nurse to perform the necessary procedures to address the emergency.
In other cases, advanced equipment may be required to perform the surgical procedure. The availability of such equipment can save many lives, as the required surgery can be performed without the intervention of a physician or with limited involvement, without the need for their physical presence.
Warnings and Precautions
All methods of using information and communication technologies in providing healthcare services for women revolve around recording, storing, and transmitting mostly personal and some highly sensitive data. When it comes to women, the scope of personal and sensitive information is much wider than that of men. The right to privacy for women worldwide is more vulnerable to violations than it is for men. Therefore, it is unavoidable that among the barriers to women’s adoption of technology applications in healthcare, there is fear that their personal and sensitive data may reach unauthorized individuals, especially if they specifically want certain people not to access it.
There are several ways to secure data so that it remains within a limited circle with the consent and acceptance of its owner. Ensuring that the entities providing the technological applications follow these measures with appropriate quality and reliability is necessary. The problem is that if left to women themselves, most of them do not possess the required knowledge to verify that the entity providing the application adheres to the proper procedures to secure their data and that it does not collect more data than what is necessary for the provided service, nor does it share any of this data with third parties without obtaining documented consent from the data owner.
The aforementioned requires specific and clear rules and conditions for providing healthcare services through technological applications. Such rules may need to be formulated as laws, administrative decisions, or ethical codes, depending on their level of importance and the need for a certain level of public deterrence to ensure their implementation. This responsibility falls on various entities, including legislative bodies and relevant government ministries. However, the cross-border nature of information and communication technology applications also necessitates an international role in providing regulation and oversight.
