Reproductive Health Policy and Cultural Challenges: Navigating Barriers to Women’s Health in Low- and Middle-Income Countries

Abstract

Background: Reproductive health is fundamental to women’s well-being and maternal-child outcomes, yet low- and middle-income countries (LMICs) continue to experience high maternal mortality and low contraceptive uptake. Despite formal reproductive health policies, cultural, religious, and gender-related barriers limit effective implementation.

Objective: To examine how cultural and religious norms shape reproductive health outcomes, assess policy frameworks in LMICs, and evaluate culturally sensitive strategies for improving women’s access to reproductive health services.

Methods: A systematic narrative review was conducted using PRISMA guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched for studies published between 2000 and 2024. Eligible studies included peer-reviewed research and policy reports focusing on reproductive health policy, cultural barriers, and interventions in LMICs. Data were narratively synthesized and summarized into evidence tables.

Results: Policies in LMICs, including Pakistan and India, align with WHO and UNFPA recommendations but face weak governance and implementation gaps.¹¹,¹² Cultural and religious barriers—such as misconceptions that contraception is anti-Islamic reduce service uptake in Pakistan, Bangladesh, and Sub-Saharan Africa.⁶,¹⁵,¹⁶ Women’s autonomy and education strongly predict improved contraceptive use and antenatal care.¹³,¹⁷ Effective interventions include community-based female health workers, integration of religious leaders, and telemedicine platforms.²⁰⁻²³

Conclusion: Reproductive health policies in LMICs cannot succeed without addressing cultural and religious barriers and empowering women. Culturally sensitive, community-based, and technology-supported approaches are essential to bridge the gap between policy and practice. Strengthening women’s autonomy, engaging local leaders, and scaling innovative delivery models are key to reducing maternal mortality and improving reproductive health outcomes.