Endometriosis policy and delivery systems: a comprehensive global scoping review

Gibbons T., Evans D., Skidmore B., Becker CM., Missmer SA., Giudice LC., Adamson GD., Zondervan K., Abbott J., Abrao M., Bush D., Canis M., Cox E., Dyer S., Farquhar C., Flores I., Gajbhiye R., Guo S-W., Gupta J., Harada T., Horne A., Hummelshoj L., Johnson N., Kihara A., Kvaskoff M., Maggiore ULR., Nap A., Njagi JN., O'Hara B., Oral E., Salamon A., Tomassetti C., Weckesser A., Zegers-Hochschild F., Zhang J.

Despite the prevalence and socioeconomic impact of endometriosis, it is under-represented in global health policy. To our knowledge, this scoping review is the first to comprehensively map the availability of global endometriosis policies. The 477 included documents identified three frameworks and one approach used by countries to develop and operationalise endometriosis policies and initiatives: (1) stand-alone endometriosis national action plans (NAPs); (2) integration of endometriosis policy and initiatives into other health NAPs; (3) stand-alone endometriosis laws; and (4) ad-hoc initiatives. A thematic analysis enabled the aggregation of global endometriosis policies and initiatives within the WHO health system building blocks. Further analysis revealed the maturity of countries’ policy development. No information could be detected for 98 countries. However, 48 countries were raising awareness of endometriosis as a national problem, 36 countries had placed endometriosis on the political agenda, eight were adopting policies for a national endometriosis strategy, and four were implementing and evaluating strategies. Despite the global scarcity of endometriosis policy framework documents, this Review highlights promising examples, most notably Australia's and France's endometriosis NAP, which could be adapted by countries seeking to advance their endometriosis policies.

DOI

10.1016/j.lanogw.2025.100027

Type

Journal article

Publisher

Elsevier

Publication Date

2025-11-01T00:00:00+00:00

Volume

1

Pages

e232 - e244

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