{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T10:41:24Z","timestamp":1792320084574,"version":"4.4.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Women informal caregivers are overrepresented in unpaid and informal caregiving roles yet remain underrecognized as patients and policy subjects within health and social care systems. Despite extensive evidence that caregiving affects women\u2019s own health and healthcare engagement, their access barriers are frequently attributed to individual help-seeking behaviors rather than to systemic and gendered conditions. This conceptual paper argues that women informal caregivers\u2019 access to healthcare and support services should be understood as a gendered health systems issue shaped by sociocultural expectations, material constraints, organizational design, interprofessional recognition, and the embodied consequences of caregiving. Drawing on purposively selected contemporary and foundational literature including evidence on women informal caregivers\u2019 healthcare engagement, ethnic minority caregivers\u2019 service access, rural caregivers\u2019 financial barriers, and caregivers\u2019 self-identified support needs this paper synthesizes key evidence to develop an explanatory conceptual framework. The Gendered Caregiver Access Framework conceptualizes women informal caregivers\u2019 access across five interacting domains: sociocultural and gendered expectations, material and policy conditions, organizational and system design, interpersonal and provider recognition, and individual caregiving burden and embodied consequences. Cross-cutting equity modifiers including race and ethnicity, rurality, income, language, disability, and caregiving intensity shape how barriers are experienced and compounded across domains. Drawing on intersectionality scholarship, the framework treats these conditions as mutually constitutive rather than additive. The framework has implications for policy (caregiver-responsive infrastructure, navigability, disaggregated measurement), practice (routine caregiver identification, culturally responsive recognition, access friction reduction), and research (intersectional, longitudinal, and multilevel intervention designs). Women informal caregivers\u2019 access to care is not a peripheral issue; it is a central indicator of whether health and social care systems equitably support the people on whom they depend. Reframing access as a gendered health systems issue is essential for more just and responsive policy, practice, and research.<\/jats:p>","DOI":"10.1177\/17455057261498619","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:55:01Z","timestamp":1792068901000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Invisible patients: Reframing women informal caregivers\u2019 access to healthcare and support services as a gendered health systems issue"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2353-0410","authenticated-orcid":false,"given":"Kechi C.","family":"Iheduru-Anderson","sequence":"first","affiliation":[{"name":"Central Michigan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roop C.","family":"Jayaraman","sequence":"additional","affiliation":[{"name":"Central Michigan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris J.","family":"Hamlyn","sequence":"additional","affiliation":[{"name":"Central Michigan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent E.","family":"Mumford","sequence":"additional","affiliation":[{"name":"Central Michigan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Inungu","sequence":"additional","affiliation":[{"name":"Central Michigan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzw004"},{"key":"e_1_3_8_3_2","volume-title":"Supporting informal carers of older people: Policies to leave no carer behind","author":"Rocard E","year":"2022","unstructured":"Rocard E, Llena-Nozal A. Supporting informal carers of older people: Policies to leave no carer behind: OECD Publishing, 2022. [cited 2026 May 14]. Report No. 140. Available from. https:\/\/www.oecd.org\/en\/publications\/supporting-informal-carers-of-older-people_0f0c0d52-en.html"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1155\/hsc\/2778779"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/07399339709516314"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06736-2"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.14104"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12116"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12273"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-05853-5"},{"key":"e_1_3_8_11_2","unstructured":"American Association of Retired Persons (AARP) National Alliance for Caregiving. Caregiving in the US 2025 [AARP Research Report]: AARP Public Policy Institute 2025. [cited 2026 Jul 26]. p. 140. Available from. https:\/\/www.aarp.org\/pri\/topics\/ltss\/family-caregiving\/caregiving-in-the-us-2025\/"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jomf.70030"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/61.1.P33"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12062-015-9116-0"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-0010.21"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/phrs.2026.1609117"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198102000-00001"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.2307\/2137284"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-18"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/30.5.583"},{"key":"e_1_3_8_21_2","volume-title":"Framework on integrated, people-centred health services: Report by the Secretariat [Internet]","author":"World Health Organization","year":"2016","unstructured":"World Health Organization. Framework on integrated, people-centred health services: Report by the Secretariat [Internet]. : WHO, 2016. [cited 2026 May 14]. p. 1\u201312. Available from. https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA69\/A69_39-en.pdf"},{"key":"e_1_3_8_22_2","unstructured":"World Health Organization. Operational framework for primary health care -Transforming vision into action [Internet]. [cited 2026 Apr 21]. Available from. https:\/\/www.who.int\/docs\/default-source\/primary-health\/operational-framework-for-primary-health-care-wha73.pdf?sfvrsn=5c9b5b84_2&utm_source=chatgpt.com (2020)."},{"key":"e_1_3_8_23_2","volume-title":"National Strategy to Support Family Caregivers","author":"Administration for Community Living","year":"2025","unstructured":"Administration for Community Living. National Strategy to Support Family Caregivers. U.S. Department of Health and Human Services, 2025. [cited 2026 May 14]. 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