The Health of Women and Girls: Health and Social Care Policy - Beyond the Women's Health Plan

3 Population Health: Meeting the needs of women and girls

Within Scotland’s population, women and girls have specific needs that are different to those of men. Population health policies are working to ensure Scotland is meeting the needs of its women and girls, in line with the ambitions of the Population Health Framework.

Screening

In recent years, the Scottish Government has provided a £1million inequalities fund that seeks to address access and uptake inequalities across the cancer screening programmes, including breast and cervical screening. This funding has been used for projects at both health board and national levels.

The National Equity in Screening Strategy was published in June 2023, and the recommendations within it are designed to address inequalities and ensure equitable access for all eligible screening participants. Delivered actions from the Strategy include the launch of the Equity in Screening Network for Scotland, and a requirement for all NHS boards to have developed a Screening Inequalities Plan.

Cervical Cancer Elimination

Eliminating cervical cancer in Scotland will save lives and demonstrate the transformative potential of preventative medicine. The Scottish Government and its healthcare partners are passionate about making this a reality.

In December 2025, an independent expert group, chaired by Professor Anna Glasier, reported on how cervical cancer can be eliminated in Scotland. That report will guide our actions in the months and years to come. However, we already know that elimination will only be possible if we overcome the barriers that deter people from coming forward for screening.

Following the publication of the report, in Spring 2026 we will publish a Cervical Cancer Elimination Action Plan which will set out the steps that need to be taken to eliminate cervical cancer in Scotland. We are also working to rapidly introduce self-sampling to the cervical screening programme, and will start offering it in some of our most deprived areas by Spring 2026.

Breast Screening

In Scotland, more than three in four women (75.9%) took up their screening invitations in 2020-23, the most recent period for which statistics are available. This is above the acceptable uptake standard of 70% and is an increase on the previous three year period (2019-22) when uptake was 74.5%, and the pre-pandemic period (2017-20), when uptake was 72.2%. Despite this, we acknowledge that more needs to be done to reduce inequalities in screening uptake, and to address the barriers some women face when accessing breast screening.

On 27 November 2025, the Scottish Government published a report on the modernisation of the breast screening service. The report highlights the considerable challenges which exist across the programme, and provides recommendations and measures to create a more efficient, equitable and patient-focused service.

Commissioned by the Scottish Government in acknowledgement of the pressures and challenges facing the breast screening programme, this report demonstrates our commitment to recovery and improvement. Work has already commenced on progressing its recommendations, with funding provided to Screening Oversight and Assurance Scotland to ensure that this essential service will be put on a firm footing for the future.

Pregnancy Screening

In Scotland, pregnancy screening is offered to all women at different stages during routine antenatal appointments, while newborn screening is offered to all babies within the first days and weeks of life. These screenings aim to identify the likelihood of certain health conditions in the mother or baby as early as possible.

Two new conditions are being added to the existing newborn blood spot test in 2026. Hereditary Tyrosinemia type 1 (HT1) will be added following a positive recommendation from the UK National Screening Committee (UK NSC). Spinal Muscular Atrophy (SMA) will also be added as part of an In-Service Evaluation, initially for two years with the possibility of extension. This will provide valuable evidence for the UK NSC when they consider whether to make a permanent recommendation to screen for SMA.

HPV Vaccination

HPV vaccine is offered to every S1 pupil in Scotland. Any young person in Scotland who does not take up their HPV vaccine offer in S1 will have further opportunities to receive their vaccination while in school and will continue to be eligible to receive the vaccine free of charge, until their 25^th birthday.

The HPV vaccine protects both boys and girls from HPV-related cancers, specifically: cervical cancer, head and neck cancers (particularly of the oropharynx), anogenital cancers, penile, vulval and vaginal cancer.

Uptake of one dose of HPV vaccine for all S1 pupils slightly increased in 2024/25^[18], with overall coverage rates of 72.6%, compared with 71.5% in 2023/24.

During the school year 2024/25, coverage of one dose of HPV vaccine among girls in S1 was 75.7% with coverage reaching 85.7% in S4.

In each year cohort, pupils living in the most deprived quintiles had lower coverage of the HPV vaccine compared with pupils from the least deprived quintiles. These inequalities have worsened over time. In S4 pupils in 2019/20, there was a difference of 3.1 percentage points between the most and least deprived groups (91.1% vs 94.2%); by 2024/25, this was 16.1 percentage points (74.6% vs 90.7%).

Coverage of one dose of HPV immunisation by the end of S4 ranged from 77.8% among girls residing in the most deprived areas to 92.3% in those from the least deprived areas in 2024/25.

The Scottish Government is working through the Scottish Vaccination and Immunisation Programme (SVIP), with Public Health Scotland and Health Boards to reduce vaccine-preventable diseases, increase vaccination uptake, and reduce inequalities. SVIP has published a 5 Year Vaccination and Immunisation Framework and Delivery Plan and an underpinning Implementation Plan is currently in development. The Implementation Plan will set out actions to improve HPV vaccination uptake to support cervical cancer elimination.

Sexual Health and Blood Borne Virus

The Sexual Health and Blood Borne Virus Action Plan was published in 2023. It links with key policies, including the Women’s Health Plan, and focusses on how to ensure that everyone who needs it can access good sexual and reproductive health and BBV care and support, from primary prevention to treatment.

Access to contraception services, including post-partum and post abortion, is one of the ‘priority areas’ in the Action Plan, working in partnership with the WHP to achieve joint goals. This is in addition to young people, sexual wellbeing and recommitment to the hepatitis C and HIV Transmission elimination goals. The importance of these issues has meant recent action has seen the NHS Board Chief Executives focus attention on work to increase access to long-acting methods of contraception and long waits in some Boards for abortion care.

Young people under 25 are one of the groups most at risk of poor sexual health outcomes^[19]. Through the Action Plan and the Women’s Health Plan, work is taking place to understand the factors that are impacting young people’s sexual health and wellbeing and the potential support and interventions they need. Phase Two of the WHP is taking this forward through a National Summit on Young People’s Sexual Health and Wellbeing which is delivered in a WHP and Sexual Health and BBV Action Plan policy partnership.

Diet and healthy weight

The Scottish Government is committed to preventative public health actions to help create a Scotland where everyone eats well and has a healthy weight. Improving healthy weight through a whole-system approach is one of two evidence-based priorities within the Population Health Framework (PHF) that will support the Scottish Government’s aim of increasing life expectancy and reducing inequalities.

The 2024 Scottish Health Survey found that two thirds (66%) of adults in Scotland were living with overweight or obesity. It also showed almost a third (31%) of adults were living with obesity, up from 24% in 2003.

There has been an increase in the percentage of women classed as living with severe obesity (a BMI of over 40) from 3% in 2003 to 7% in 2024. The percentage for men is stable at 2%.

The survey also found that the average adult BMI has been rising over time. This is driven largely by an increase for women from 27.6 in 2003 to 28.6 in 2024 compared to no change for men.

Weight Management Services and Type 2 Diabetes

The Scottish Government’s overall aim is to reduce people’s risk of developing type 2 diabetes and for those diagnosed, potential avoidance of diabetes-related complications or remission of the condition. The Scottish Government has committed over £9 million in funding over the next four years to implement national digital weight management programmes which will support thousands of people to either achieve remission or prevent the onset of type 2 diabetes.

Weight is a modifiable risk factor for type 2 diabetes. Data from Public Health Scotland demonstrates that between October 2019 and September 2022, there was a much larger proportion of referrals to weight management services for women compared to men. Nearly three quarters of referrals were women in the most recent year of data collection (73% in October 2021-September 2022^[20]).

Continued delivery of weight management services that reach all patient groups is vital. The Scottish Government is continuing to invest in weight management services to enable health boards to offer more evidence-based treatment for obesity.

The quality and equity of access to weight management services across Scotland is being improved through minimum standards and pathways. The Scottish Government wants all Boards to ensure they are targeting services to those most vulnerable to reduce diet-related health inequalities.

Obesity medicines (GLP-1 RAs, often referred to as ‘weight loss jabs’)

GLP-1 RAs are a new class of medicines in the treatment of obesity, although they have been used for some time for the effective treatment of type 2 diabetes. Clinical trial and real-world evaluation of the impact of GLP-1/GIP RAs are demonstrating weight loss outcomes of 15-20%^[21].

The Scottish Government welcomes the decision by the independent Scottish Medicines Consortium (SMC) to accept certain obesity medicines for the treatment of obesity in eligible patients, to be used alongside a reduced calorie diet and increased physical activity. The SMC has assessed the clinical and cost effectiveness of these medicines and has recommended, with restrictions, that they should be available for routine use within the NHS in Scotland. To support the roll-out of obesity medicines across the NHS in Scotland, the Scottish Government published a national consensus statement in September 2024.

These medicines have particular impacts for women and they must not be taken during pregnancy, while trying to get pregnant, or during breastfeeding.

In June 2025, the Medicines and Healthcare products Regulatory Agency (MHRA) published communications reminding women to use effective contraception while taking these medicines and, in some cases, for up to two months between stopping the medicine and trying to get pregnant.

In April 2025, the British Menopause Society published an new ‘Tool for Clinicians’ on the ‘use of incretin-based therapies in women using HRT’. It summarises that “concerns related to concurrent use of HRT and semaglutide or tirzepatide relate primarily to endometrial protection and a potential risk of reduced absorption of oral progestogens used within HRT regimens”. The document clarifies considerations when prescribing these therapies in women using HRT during the menopause transition and post-menopause.

Folic Acid Fortification

On 20 December 2024, Scottish Ministers introduced legislation to require the fortification of non-wholemeal wheat flour with folic acid to help reduce the number of neural tube defect affected pregnancies. Similar legislation has been laid in England, Northern Ireland and Wales. Fortification requirements will come into force across the UK by the end of December 2026. The Scottish Government expects some products to contain flour fortified with folic acid from Autumn 2025.

Neural tube defects affect around 1,000 pregnancies each year in the UK. The addition of folic acid to non-wholemeal wheat flour is expected to increase levels of folic acid in women and help reduce the number of pregnancies affected by neural tube defects each year by around 20%.

Government advice for women who are pregnant or trying for a baby is that they take a folic acid supplement of 400 micrograms every day as soon as they start trying for a baby (ideally for 3 months before) and for at least the first 12 weeks of pregnancy. Folic acid fortification is intended to support, not replace, current advice on folic acid supplementation.

Supporting women who use drugs and alcohol

Taking an equalities-focused approach to drugs and alcohol policy is essential to ensure that treatment and support services are fair, inclusive, and effective for everyone. Women often encounter distinct barriers when seeking help with treatment and recovery, yet too many services fail to reflect their specific needs.

Through the consultation for Phase Two, women highlighted that those with long term experience of substance use often face stigma and discrimination when they are accessing healthcare services^[22].

In response to these specific needs, the Scottish Government has worked to ensure that a gendered-approach is embedded across all of the work to reduce alcohol and drug related deaths and harms. We have implemented package of initiatives which aim to ensure that high quality drug and alcohol services are available and accessible for women at any point in their recovery journey.

Aberlour Mother and Child Recovery Houses project aims to increase capacity for residential rehabilitation services for women at Aberlour Child Care Trust, through establishing two residential rehabilitation recovery houses. The houses are a transformational new residential recovery service designed specifically to support women and their children up to age five through treatment from substance use, before they reach a point of crisis in having their children removed from their care.

This activity links to Whole Family Wellbeing Fund ambitions and aligns with the national priorities of The Promise and Getting it Right for Every Child, through its wraparound provision of childcare alongside residential rehabilitation. The Whole Family Wellbeing Fund is providing full revenue funding of the project to 2025/26.

We also know that the use of alcohol and drugs during pregnancy can have a detrimental effect on both the mental and physical wellbeing of women, and the emotional and physical development of their infants. This is why we have set up the Supporting Women Reducing Harm Group to explore what pathways are in place for substance-using women during pregnancy and the early years, and develop good practice guidance to support local areas in meeting the needs of these women and their infants.

Alcohol Harm Prevention

A Public Health Scotland evaluation estimated that the Minimum Unit Pricing policy has saved hundreds of lives and is likely to have averted hundreds of alcohol-attributable hospital admissions. This Government’s work to continue and increase the minimum unit price of alcohol to 65 pence is an example of our approach to take concrete action to reduce alcohol harms.

The Scottish Government remains committed to progressing work on protecting children and young people from exposure to alcohol marketing and promotion. Research has consistently shown that exposure to marketing is associated with an increased likelihood that children will start to drink or, if they already drink, drink more. We will also take action through the recently published Population Health Framework that seeks to reduce health inequalities and improve population health, including reducing harms caused by alcohol.

The Alcohol Framework (2018) sets out a commitment to increase awareness of FASD and support improved diagnosis. It includes an action to continue to prevent and reduce the harm caused by alcohol consumption in pregnancy. The 2025/26 Programme for Government commits to embed early conversations on preparing for pregnancy into routine health care, to optimise preconception health and care. This will be a key action within Phase Two of the Women’s Health Plan.

There is no known amount, type or timing of alcohol that is safe in pregnancy. Avoiding alcohol during pregnancy and when contemplating pregnancy is the only way to be sure that the baby will not be affected by FASD. The advice of Scotland’s Chief Medical Officer is therefore to avoid alcohol completely when pregnant or trying to conceive – No Alcohol No Risk.

As part of the new maternity pathway published in 2025, midwives will begin having conversations with women about alcohol use from their first maternity appointment, and will revisit this as appropriate throughout the pregnancy.

Women experiencing social complexities such as alcohol use should have continuity of care, where the majority of their care is provided by their primary midwife. This can help women develop a strong, trusting relationship with their midwife throughout their pregnancy. Midwives can refer women who need additional support to specialist services. In cases where there is significant alcohol use, midwives can also refer women to an obstetrician for their care planning, to make sure they are receiving the care they need.

Ready Steady Baby! includes information about alcohol in pregnancy. It advises women that the safest option is to stop drinking when trying to get pregnant or as soon as they know they are pregnant. It provides women with additional information about the impact of alcohol on their baby, and signposts women to resources of help and support.

Physical Activity and Sport for Women and Girls

Tackling inequalities in physical activity and sport is central to the National Physical Activity for Health Framework, and directly supports the ambitions of Phase Two of the Women’s Health Plan, which includes actions on physical activity and the health of women and girls.

The most recent data from the Scottish Health Survey shows that women and adolescent girls in Scotland remain less likely to be physically active than men and adolescent boys, consequently impacting on their physical, mental and social health and wellbeing.

• Adult women continue to be less active than men, both in meeting the recommended levels of moderate-to-vigorous physical activity (MVPA) – 58% of women compared with 66% of men in 2024 – and in sports participation – 45% of women compared with 54% of men in 2023.
• Activity levels generally decline with age after early childhood. Of particular concern are teenage girls and women aged over 75 years, where fewer than 50% meet recommended levels of MVPA.

Physical activity is a powerful tool for the prevention of ill health. There is robust evidence of its protective effect against conditions such as coronary heart disease, some cancers, hypertension, obesity, type 2 diabetes, and osteoporosis. It also plays a vital role in supporting pelvic health and maintaining strength and balance, key components of optimising future health that help sustain mobility, confidence and independence, particularly in later life.

These benefits are especially important during life stages such as menopause, when women may face increased health risks and often experience a decline in activity levels. Movement of any kind, such as gardening or walking, can help manage symptoms and support overall wellbeing. The Scottish Government is working with Public Health Scotland, SAMH and others to develop menopause-specific guidance that supports women to stay active.

Improving visibility is also essential to driving change. Increasing the representation of women and girls in sport and physical activity, through campaigns, role models and leadership opportunities, helps challenge stereotypes and inspire participation. The annual Scottish Women and Girls in Sport Week, established in 2017, is a flagship campaign that celebrates the benefits of being active and showcases the breadth of opportunities available. Now a well-established part of the sporting calendar, it enables partners across Scotland to share good practice and amplify their work to empower women and girls to be more active, more often.

In August 2025, the Scottish Government hosted a Women’s Sport Symposium alongside the Welsh Government. This event took place in the margins of the Women’s Rugby World Cup and explored the investment, visibility, and leadership in women’s sport. New research shared at the event will be used by the sector to inform communications and media strategies, as well as facilitating connections between sponsors, media, and wider partners to further grow women’s sport. You can find this research here: Glasgow 2026 a Golden Opportunity to Cement Record Growth in Scotland and Wales – Womens Sport Trust

The Scottish Government have delivered on its commitment to make Active Schools free for all. With nearly 50% female participation, it is one of the most gender-balanced large-scale sporting programmes in Scotland. The national agency for sport, sportscotland, also delivers wider initiatives such as Fit for Girls and the Young Ambassadors Programme, which continue to break down barriers and build confidence, leadership and visibility for women and girls in sport.

Fit for Girls

Fit for Girls is a national programme developed in partnership between sportscotland and the Youth Sport Trust. Since 2008, it has continually developed to meet the needs of girls and the sport and physical activity workforce in Scotland.

The Fit for Girls programme empowers young women and girls to play a key role in addressing barriers to participation, while also increasing visibility, confidence and leadership of women and girls in sport.

The programme offers support to local authorities, governing bodies and other national partners who have identified a need to improve the provision of sport and physical activity for girls and young women, and the programme empowers girls as part of that process.

Workshops are co-delivered by two members of the Fit for Girls tutor team which allows for meaningful peer to peer delivery. The tutors aim to inspire and empower girls and young women to create local change in their school, club and community by developing their self-esteem and confidence to inspire others.

Further information on Fit for Girls can be found here: Fit for Girls.

Gambling

Gambling harm is a significant issue, affecting not only people who gamble but also their families, relationships, communities and wider society.

Gambling harms are estimated to cost up to £60 million in Scotland (PHS).

The effects of gambling go beyond the person engaged in gambling and it is estimated that at least six people are directly affected by the person experiencing gambling harms, with women more likely to be an affected other.

Aila

The Aila website, has been developed by the RCA Trust and Simon Community Scotland, as a dedicated resource focused on women’s experiences of gambling related harms and is a source on how to find support when needed.

The site, importantly, has advice on how to provide professional support to women in need. It has been created by women with lived experience of gambling harm as a safe, psychologically informed digital environment to provide support and elevate female voices in Scotland.

The introduction of the statutory gambling levy marked a generational change in research, prevention and treatment of gambling-related harm. The first year of the levy raised just under £120m.

The levy is charged to operators as a proportion of Gross Gambling Yield (GGY). UK Government will assess the likely impact of tax changes on levy yield over the coming months. The Scottish Government is working closely with a wide range of stakeholders as part of a bidding process for Levy funding in 2026/27.

Health support for Women in Prison

To support trauma-informed care, the Scottish Government provides additional funding for the two SPS Community Custody Units (CCUs) in Dundee and Glasgow, marking a significant shift in the rehabilitation of women in custody. The HMP Bella Centre in Dundee and the HMP Lilias Centre in Glasgow focus on helping women build essential life skills and independence, improving their chances of successful reintegration into the community.

The CCUs adopt a holistic, needs-based approach to health and wellbeing, aiming to reduce reoffending through tailored support. Services include:

• Occupational therapy throughout the custodial journey
• Recovery cafés
• Blood-borne virus (BBV) testing and sexual health advice
• In-house cervical screening
• In-possession medication (excluding controlled substances)
• Healthy eating and menopause information sessions
• Vaccination clinics

Additionally, Scottish Government provides funding for NHS healthcare at HMP Stirling, the national SPS facility for women, including those with complex needs and risks. Opened in 2023, it replaces the previous facility, which was outdated and not fit for purpose. HMP Stirling has been purposefully designed to provide a gender-specific, trauma-informed environment that supports rehabilitation and prepares women for release.