Exploresearch (ISSN: 3048-815X) ( Vol. 03 | No. 2 | April - June, 2026 )

Navigating Healthcare in the Shadows: A Systematic Review on How Women’s Socio-Economic Context Shapes Health Literacy and Medical Decision-Making in Achieving SDG3 in India

Author: Dr. Chauhan Geeta, Dr. Agarwal Gunjan & Dr. Saini Aarti

To make progress towards the United Nations Sustainable Development Goal 3: Good health and well-being by 2030, structural social barriers need to be addressed to promote health equity. While the Government of India has made extensive investments in opening the healthcare facilities and improving the provision of rural healthcare services, there is a disproportionate risk to health of vulnerable groups, particularly those in rural-poor areas. In addition to its physical and economic measurement, the measurement of health access should also be done in economic terms and in health literacy, which refers to a constellation of cognitive, digital and social skills that enable individuals to find, understand, evaluate and use health information to make health decisions. This Systematic Literature Review (SLR) aims to review empirical evidence to understand the relationship between the socio-economic status (SES) of women in India with their health literacy profile, their autonomy in medical decision making process and the implications for health-related SDG 3 Target achievement in India. Instructional searches were carried out on PubMed/MEDLINE, Scopus, Web of Science, Google Scholar search engines, on UGC-CARE indexed repositories according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines with only peer-reviewed literature from year 2010-2025. After careful screening, 38 primary empirical studies were chosen after strict inclusion and exclusion criteria were applied to the total number of environmental studies, to be ultimately qualified and quantified synthetically. Thematic synthesis reveals that a woman's functional, communicative, and critical health literacy is directly related to her structural context (caste, income, geography and education). There are two positive feedback mechanisms identified: the Health Disparity Trap (which starts with low income productive to functional illiteracy, and this stagnates and promotes his advancement into advanced illness, and finally makes the OoP expenses beyond his reach owing to the lack of income), and the System Trust Spiral (which lays down the continuous failure of beneficiaries to follow through with treatments leads to poor clinical results, which eventually makes them doubt the competence of the health system, which promotes them to move to the treatments provided by informal providers). As a result of intra-marriage relationships where the females are under the control of males (patriarchal control) and are limited in their financial independence, their first concern is their family's needs, putting their health last. Administratively burdened, endogenously resource poor, frontline health workers like Accredited Social Health Activists (ASHAs) serve as important health literacy proxies, but capacity to do their work effectively is limited due to lack of resources. It is not as if these self-reinforcing barriers can be broken with information-only linear interventions. Effective actions for SDG 3 are not to be based solely upon policy approaches on one hand (MFI, CBL, CBE, support for frontline workers) but involving health literacy with an "ecology" of policies.

Geeta, C., Gunjan, A. & Aarti, S. (2026). Navigating Healthcare in the Shadows: A Systematic Review on How Women’s Socio-Economic Context Shapes Health Literacy and Medical Decision-Making in Achieving SDG3 in India. Exploresearch, 03(02), 161–174. https://doi.org/10.62823/ExRe/2026/03/02.230

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DOI:

Article DOI: 10.62823/ExRe/2026/03/02.230

DOI URL: https://doi.org/10.62823/ExRe/2026/03/02.230

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