Rights Promised vs. Rights in Practice: Justice Gaps in Women’s Health
8 March 2026
Across regions, legal frameworks affirm women’s rights to safety, health, dignity, and leadership. Constitutions enshrine equality. National laws promise protection from violence. Policies commit to fair representation and bodily autonomy. On paper, the commitments are strong.
Yet, across countries and contexts, a familiar gap persists between what is promised in law and what is experienced in daily life.
As part of our International Women’s Day 2026 campaign, Women in Global Health Chapters across 60 countries came together to contribute country-specific narratives reflecting on this reality. Under the theme “Rights Promised vs. Rights in Practice,” chapters examined how legal commitments translate into lived experiences within their national contexts.
Through these country-led reflections, chapters highlight where progress exists and where justice still falters, particularly in ways that affect women’s health, safety, and leadership.
Together, they reveal how justice gaps continue to shape women’s health, safety, and leadership worldwide.
Spain
Rights Promised
Spain has a strong legal framework that promises women safety, equality, and bodily autonomy. Organic Law 3/2007 commits public institutions to prevent sex-based discrimination, including direct/indirect forms and harassment, while promoting equal opportunities via gender mainstreaming, equality plans, balanced representation in decision-making, and work-life balance measures like paternity leave. Organic Law 1/2004 on Integrated Protection Measures against Gender-Based Violence establishes prevention and protection mechanisms for survivors and reinforces access to support services, including healthcare, legal aid, and protection measures. In addition, Organic Law 1/2023 on sexual and reproductive health and the voluntary interruption of pregnancy reaffirms sexual and reproductive rights and aims to remove barriers to abortion care within the health system.
Rights in Practice
In practice, many women still experience a gap between Spain’s robust legal rights and their real-world access to protection and care. Gender-based violence survivors encounter stigma, fear, bureaucratic delays,, and uneven availability of specialised services, which prolong risks and exacerbate trauma, chronic stress, anxiety, and lasting health effects. Abortion access reveals similar shortcomings: despite legal protections, services remain largely private-sector dependent, with conscientious objection and uneven regional disparities, especially for women with fewer resources or those living far from referral centres. True health justice requires consistent, safe, accessible, survivor-centered support that transcends postcode, wealth, or status.
Sources
- Organic Law 3/2007 (Effective equality of women and men) — BOE: BOE-A-2007-6115
- Organic Law 1/2004 (Integrated Protection Measures against Gender Violence) — Government English PDF
- Organic Law 1/2023 (Sexual & Reproductive Health; Voluntary Interruption of Pregnancy) — BOE: BOE-A-2023-5364
- Research on abortion service provision patterns in Spain (2011–2020): “Provision of abortion services in Spain…” (PMC9368144)
Nigeria
Rights Promised
The Violence Against Persons (Prohibition) Act (VAPP) of 2015, assented to by President Goodluck Ebele Jonathan, serves as the cornerstone of legal protection for women’s safety, health, and justice in Nigeria. Created in response to rampant gender-based violence, including rape, acid baths, forceful ejection, and harmful widowhood practices, the Act’s explicit goal is to eliminate violence in private and public life while providing maximum protection and effective remedies for victims. The law is structured into distinct provisions: Part I comprehensively criminalizes a wide range of offences like female genital mutilation, forced financial dependence, and spousal battery; Part II empowers courts to issue critical protection orders; and Part III ensures survivor privacy by prohibiting the disclosure of their identities. Regulated and administered by the National Agency for the Prohibition of Trafficking in Persons (NAPTIP) under Part IV, the VAPP Act has now been domesticated by 35 states, establishing a vital legal baseline that mandates access to safe shelters, justice, and emergency medical interventions to safeguard women’s dignity and bodily autonomy.
Rights in Practice
Despite the comprehensive legal framework and regulatory oversight by NAPTIP established in the VAPP Act, systemic enforcement gaps and entrenched cultural norms continuously deny women and girls the justice and care promised by the law. The reliance on state and local governments to fund and implement the VAPP Act’s provisions, particularly Part II protection orders and survivor services, has created a stark geographic disparity. Consequently, women residing in under-resourced or rural regions are routinely denied justice, lacking access to functional Sexual Assault Referral Centres (SARCs) and the legally trained personnel required to enforce their rights. Furthermore, deep-seated cultural stigma and fear of retaliation suppress the reporting of the very offences outlined in Part I of the Act, leaving many survivors trapped in abusive cycles instead of utilizing the legal remedies available to them. For frontline health workers navigating these strained systems, these bottlenecks translate to overwhelming challenges in providing the promised post-rape or emergency obstetric care, ultimately driving up preventable maternal morbidity and leaving vulnerable populations with untreated physical and psychological trauma.
Philippine Chapter
Rights Promised
Women in Global Health Philippines has developed a policy review detailing the nature of local policy support to enable the entry of women into leadership roles in the Philippine health sector. Policies have been identified in all four action areas of the WHO framework for change to support women’s leadership (WHO, 2021). Most of these policies focus on creating a legal foundation for gender equality to enable women to engage equally with men at work. However, most of these policies are for the welfare of women or for health workers in general. Laws are still absent in ensuring decent work conditions, workplace protection, and fair compensation, specifically for health professions that are predominantly women. Most of these laws cover only formal and visible workspaces, excluding workers in the informal sector, where the majority of whom are women and should be given the highest priority (Ong et al., 2024).
Rights in Practice
Deep-rooted social norms and stereotypes, and systemic barriers continue to be barriers for women’s protection and advancement in leadership roles. Women continue to face challenges working in the Philippine health and care sector, which has caused some to either leave the profession or migrate for better opportunities (Ong et al., 2024). Despite migration providing better opportunities, women are still at a disadvantaged position. The feminization of migration, as reflected in the demand for care work that is socially coded as women’s work, has pushed 55.6% of the Filipinos who worked abroad to be women. Care work also remains the least regulated form of work, which pushes women to be vulnerable to abuse and at greater risk of adverse health outcomes due to their limited access to care (Baclig, 2026).
References:
- World Health Organization. (2021). Closing the leadership gap: gender equity and leadership in the global health and care workforce. In World Health Organization. World Health Organization. https://www.who.int/publications/i/item/9789240025905
- Ong, L. A., Sales, R., Co, P. A., & Reyes, K. A. (2024). Advancing Women’s Leadership in the Philippine Health Sector: A Policy Review. Review of Women Studies, 34(1), 111-154.
- Baclig, Cristina Eloisa. (2026, January 20). Women OFWs dominate migration, bear higher risks abroad. Inquirer Global Nation. https://globalnation.inquirer.net/306299/women-ofws-dominate-migration-bear-higher-risks-abroad
Colombia
Rights Promised
Colombia has a broad regulatory framework to protect the health, safety, and participation of women and girls. The Political Constitution (arts. 13 and 43) enshrines equality and special protection for women. Law 1257 of 2008 establishes comprehensive measures to prevent, punish, and eradicate violence against women, including protection orders and health care. Law 1719 of 2014 strengthens access to justice in cases of sexual violence and guarantees comprehensive care with a differential approach.
The Constitutional Court has recognized health as a fundamental right and, through Ruling C-055 of 2022, reaffirmed reproductive autonomy as an essential component of the right to health. Colombia has also ratified CEDAW and the Belém do Pará Convention, which impose obligations on the State to exercise due diligence to prevent, investigate, and sanction all forms of violence against women. However, although this framework generally covers gender-based violence, the country does not have a specific and comprehensive law that regulates technology-facilitated violence against women or digital violence from a gender perspective.
Rights in Practice
In practice, women continue to face significant barriers to accessing protection and justice, especially in digital contexts. The absence of specific legislation on digital violence with a gender perspective generates normative fragmentation and difficulties in the classification, investigation, and sanctioning of behaviors such as the non-consensual dissemination of intimate content, online harassment, or digital threats. These facts are usually processed under general assaults, such as insult, slander, or cybercrimes, which do not adequately recognize the dimension of gender-based violence, contributing to higher levels of impunity. Additionally, procedural delays, repetitive institutional practices, and territorial barriers to accessing specialized services persist. This gap between formal recognition of rights and effective guarantees directly impacts women’s physical and mental health, generating anxiety, depression, social withdrawal, work-related issues, and risks to their integrity.
Singapore
Rights Promised
Singapore’s 2023 Elective Egg Freezing Law: A Step Toward Reproductive Autonomy
In 2023, Singapore took a landmark step in women’s reproductive rights. Following an intensive and lengthy public debate, the government announced that elective egg freezing for fertility preservation would be permitted, with all women aged between 21 and 37 eligible to undergo the procedure regardless of marital status. This came under the Assisted Reproduction Services Regulations of the Healthcare Services Act, making Singapore one of the few countries in the Asia-Pacific region to extend this right to unmarried women. For the first time, a woman in Singapore did not have to be married — or even in a relationship — to take control of her biological clock. The egg freezing process allows a woman to retrieve and preserve her healthy eggs when she is younger, so that she has the option to conceive later on in her life using those healthy eggs. The regulation was widely seen as acknowledging what women’s advocates had long argued: that reproductive choices should not be gatekept by marital status.
References: Singapore Ministry of Health | Singapore Legal Advice | Annals Academy of Medicine Singapore
Rights in Practice
The Right to Freeze, But Not to Use What is Yours
The promise is real — but incomplete. Although all women, regardless of marital status, can undergo the egg freezing procedure, they must be legally married before being allowed to utilise their frozen eggs to conceive a child, in keeping with the Singapore government’s policy of encouraging motherhood within the context of heterosexual marriage and strict traditional family structure. In other words: a single woman can freeze her eggs, but she loses the right to what is hers — if she chooses to be without a husband. IVF treatment for single women and same-sex marriages is banned, and de facto marriage via cohabitation with a live-in partner is not recognised by the legal system. Deep-seated cultural norms act as an invisible but powerful barrier, with deep-rooted stigma attached to unmarried childless women. Women who do pursue single motherhood — for example, by exporting their frozen eggs to overseas IVF clinics — face discriminatory consequences, including a lack of government pro-family incentives and challenges with inheritance rights. In reality, women in Singapore continue to face a trade-off between investing in their education and career or pursuing marriage and parenthood. Ultimately, the burden of children’s education and household care is disproportionately placed on women. The result is a law that grants women a right in name, while the social and policy environment ensures many will never exercise it. The frozen eggs sit in storage or, worse, discarded — a symbol of autonomy promised, but not yet truly delivered.
References: East Asia Forum | Springer Nature Research Communities | Annals Academy of Medicine Singapore | South China Morning Post
Closing Reflection
From Europe to Africa, from Southeast Asia to Latin America, these stories reveal a shared pattern: rights enshrined in law do not automatically translate into protection, access, or dignity.
The gap between formal recognition and lived reality is not a technical oversight; it is a justice issue. When protection orders are delayed, when services are geographically uneven, when care work is undervalued, and when digital abuse goes unrecognised, women’s health suffers. Trauma deepens. Inequities widen. Leadership pipelines narrow.
On International Women’s Day 2026, these chapter-led narratives remind us that legal reform is only the beginning. Health systems are justice systems. And justice must move beyond legislation into implementation — consistent, survivor-centered, and equitable across geography, income, and status.
Because rights promised must become rights practised.
On this International Women’s Day, Women in Global Health calls on governments, institutions, and global health leaders to move beyond commitments and ensure that laws, policies, and health systems deliver real protection, equitable access, and leadership opportunities for women everywhere.
