News
Why proven women’s health innovations still can’t find a home
By the Health Innovation Exchange
For more than a decade, femtech’s scale gap has been treated as a funding problem. What if that diagnosis is incomplete?
Despite growing attention, women founders still receive just 2 per cent of global venture funding, and years of advocacy have failed to shift the needle.
This persistence is no longer just a concern; it signals a deeper structural failure.
This is not just a funding gap. It is a system failure.
As Pradeep Kakkitill, founder and CEO of the Health Innovation Exchange (HIEx), argues, the sector continues to operate on a flawed assumption.
The belief that better support to founders alone will unlock scale overlooks the deeper structural constraints that determine whether the innovation is adopted at all.
Barriers That Go Beyond Capital
These insights are not theoretical. Global research reinforces that these challenges are not isolated, highlighting structural, financial and systemic barriers that shape how women-led and under-represented ventures access funding, markets and pathways to scale.
Importantly, these findings are not draw from research alone, but from the lived experiences of women and under-represented founders themselves.
Across HIEx-led interviews and focus group discussions conducted as part of the Reckitt Catalyst Programme, founders repeatedly described the same challenges: fragmented financing, unclear adoption pathways, repeated cycles of proof, and systems that lacked clear routes from validation to procurement and scale.
These experiences suggest that the barriers facing women-led innovation are not simply financial. They are structural.
Many high-potential ventures are not failing because funding is absent.
They are failing because the systems that determine scale, including public procurement, regulation and financing, are not built to move proven solutions beyond pilots into widespread adoption.
This is not a founder problem. It is a system design failure.
Beneath these structural constraints sits a more persistent challenge. Entrenched attitudes shaped by unconscious bias continue to influence decision making.
Across investment and public-sector systems, innovation led by women and underrepresented founders is still frequently perceived as higher risk.
These perceptions shape how opportunities are evaluated, increase the burden of proof placed on founders, and slow decision making. In practice, this results in systematically higher barriers to both funding and adoption.
Systems Unable to Absorb Innovation
Dr. Abas Hassen, lead executive officer for health innovation and quality at Ethiopia’s Ministry of Health, underscores this point.
The primary constraints are not about innovation quality, but about the systems that determine adoption and scale, including procurement, regulation, financing and delivery.
He identifies three persistent challenges: institutional resistance to change, “pilot purgatory” where solutions are repeatedly tested but not integrated into public systems, and a disconnect between what external funders support and what governments can sustain.
Ethiopia’s response reflects a broader shift. Innovation is no longer treated as isolated pilots, but as a structured component of system design.
The country’s system-led innovation model combines regulatory pathways, prioritisation frameworks and structured testing environments to embed innovation directly within the health system.
The implication is clear.
Scaling innovation is not only about accelerating individual ventures alone. It is about strengthening the systems that determine whether innovation is adopted at scale.
The Missing Middle: From Pilot to Procurement
In many low- and middle-income countries, public systems remain the largest market for health and WASH solutions, accounting for the majority of service delivery and procurement.
Yet capital is deployed through models that do not reflect this reality, as scaling depends on public-sector adoption, long procurement cycles and regulatory integration rather than rapid returns.
This creates a misalignment within the financial ecosystem, where capital is structured for faster high returns, while impact depends on long-term system integration.
At its core, the challenge is the absence of clear adoption pathways.
Without structured routes from validation to procurement and system-wide use, even effective solutions struggle to move beyond pilots.
This is the “missing middle”, the gap between early validation and large-scale adoption.
The consequences of this “missing middle” are perhaps best illustrated by the founders trying to navigate it.
Temie Giwa-Tubosun, founder and CEO of LifeBank, describes her decade-old company as an “orphan” within existing financial structures, too commercial for impact investors and too impact driven for venture capital.
Businesses operating within health systems often fall between funding models that were not designed for them.
Thato Schermer, co-founder of Zoie Health, describes a similar challenge.
Even companies with strong revenue and clear demand struggle to secure funding at the right stage, as they are assessed through frameworks that do not reflect the healthcare markets.
Across interviews and focus group discussions, these patterns were consistent.
Founders described fragmented financing, unclear adoption pathways, and repeated cycles of proof, where they are asked to keep proving their solutions without a clear route to scale.
These are not isolated challenges. They reflect how innovation is funded, evaluated and integrated across the system.
The barrier to scale is not a lack of viable solutions. It is about the systems and models that are not designed to support them.
Reducing Risk Through System Design
From an HIEx perspective, a different approach is emerging, one that focuses not on fixing founders, but on designing how systems manage risk and adopt innovation.
Rather than avoiding risk, Ethiopia is working to manage it through structured processes.
The system is “risk-aware, not risk-averse.” It uses innovation sandboxes, structured testing environments within public systems that allow new solutions to be evaluated under controlled conditions.
These mechanisms, generate decision-grade evidence while limiting system-wide exposure, creating clearer pathways from validation to adoption.
When innovations are tested within public systems, they gain institutional legitimacy. This reduces perceived risk for both governments and investors and enables more confident decision making.
From Fragmentation to Coordination
Within this context, initiatives such as Reckitt Catalyst, a multi-partner platform supporting women-led health and WASH innovation to scale, play a critical bridging role.
By connecting entrepreneurs with governments, investors and technical partners, and aligning solutions with national priorities, the programme helps to create clearer pathways from pilot to procurement and scale.
But alignment alone is not enough.
As Pradeep Kakkattil notes, the climate movement offers a useful parallel. Climate progress was not driven by evidence alone. It accelerated when investors, governments, and institutions began treating inaction as the greater risk.
Sustained pressure exposed the cost of doing nothing, redefined how risk was assessed and ultimately reshaped capital allocation and policy decisions.
Women’s health and WASH innovation is now at a similar inflection point.
Despite years of evidence and advocacy, outcomes such as women receiving a fraction of global funding persist.
This is not due to a lack of solutions. It is because the systems governing investment, adoption and scale have not been sufficiently challenged.
What is required is not incremental progress.
It is a shift in what the system tolerates – how risk is defined, how capital is allocated, and how accountability is enforced.
A System at an Inflection Point
The implications are clear.
Investors must move beyond rigid funding models and deploy capital aligned to how health systems scale. Governments must build clearer pathways for testing, procurement and adoption.
Ecosystem actors must shift from supporting individual ventures, to enabling system-level integration.
The persistent funding gap is not a result of slow progress; it reflects a system operating exactly as designed. Incremental change will not shift outcomes.
What is required is a fundamental reset of how femtech is financed and scaled: from passive investment to active market-shaping, where capital, policy, and procurement work together to create real pathways to adoption.
Until that shift happens, the sector will continue to produce innovation that the market is not structured to absorb.
Congress is being urged to invest US$20bn over 10 years to close the women’s health gap.
The American College of Obstetricians and Gynecologists, the Society for Women’s Health Research and the Women First Research Coalition have unveiled the National Strategy to Close the Women’s Health Gap.
The framework calls for a coordinated national effort to improve women’s health research, care and outcomes.
It says women make up more than half of the US population, but their health needs across conditions and life stages have been understudied and underserved for decades.
Kathryn Schubert, president and chief executive of the Society for Women’s Health Research, said: “The women’s health gap has persisted for far too long.
“This strategy offers Congress a road map to improve health outcomes, drive innovation, and build a healthier future for women, families, and communities.”
The strategy notes that Congress required women to be included in National Institutes of Health-funded clinical research through the NIH Revitalization Act in 1993.
However, it says major gaps remain in women’s health research, clinical care and how evidence is put into practice.
The plan proposes US$7bn for research and innovation, including expanded federal investment in women’s health research across the NIH, VA, DoD and the Advanced Research Projects Agency for Health.
It would also establish a Women’s Health Research Interdisciplinary Fund at the NIH and create a national network of Women’s Health Centers of Excellence.
The centres would aim to accelerate the translation of research into clinical care and serve as training sites for researchers and clinicians.
A further US$1bn would be used for regulatory coordination and modernisation, including cross-agency collaboration and work to address sex differences in drug and treatment approvals.
Sex differences are biological differences between females and males that can affect disease risk, symptoms, treatment response and side-effects.
The funding would also support updated NIH tracking systems for women’s health research investment and publication standards on how sex as a biological variable is considered in research.
The strategy calls for US$4bn for data and evidence infrastructure, including a public-private partnership focused on women’s midlife health data.
It would also convene a public workshop to review existing women’s health research datasets and develop common data elements to fill gaps and make datasets more widely available.
Another US$7bn would go towards strengthening the clinical and research workforce.
This would include career pathways, loan repayment programmes, a women’s health clinical workforce loan repayment programme modelled on the National Health Service Corps and interdisciplinary training.
The workforce measures would include particular emphasis on rural and underserved areas.
The final US$1bn would support public awareness and education campaigns to improve health literacy, preventive care and participation in women’s health research.
Health literacy means a person’s ability to find, understand and use health information to make decisions about care.
The campaigns would use digital and traditional media developed in consultation with patient advocacy organisations and relevant medical societies.
Sandra E Brooks, chief executive of the American College of Obstetricians and Gynecologists, said: “Closing the women’s health gap requires not only funding research, but also investment in the people who conduct that research and those who translate research findings and discoveries into better patient care.
“Strengthening the women’s health research and clinical workforce is critical to accelerating the innovation needed to improve health outcomes for women.”
The strategy says women have higher annual out-of-pocket healthcare costs than men and live 25 per cent of their lives in poorer health.
Supporters say this strengthens the economic and public health case for long-term congressional investment.
The framework has been endorsed by organisations across women’s health, ageing, heart disease, autoimmune disease, cancer, reproductive medicine and neurological conditions, including the Women’s Alzheimer’s Movement at Cleveland Clinic, the National MS Society and UsAgainstAlzheimer’s.
Stardust shared sensitive period tracking data with third-party analytics firms, according to new privacy research from Mozilla.
The findings expose a privacy divide in femtech, where users often trust apps with highly sensitive reproductive health information.
The research was carried out by Mozilla’s Privacy Not Included team, which tested several period tracking apps.
It found that Stardust, a period tracker used by millions, shared users’ reproductive health data with analytics companies, a practice the research said contrasted with its privacy-first marketing.
Analytics companies collect and examine information about how people use digital products, often to help businesses understand user behaviour or improve marketing.
The findings raise questions about whether privacy promises made by health apps match what happens to users’ data.
According to research reported by TechCrunch, one other period tracking app tested by Mozilla received what researchers called a “squeaky clean” rating, suggesting similar services can operate without sharing sensitive health data in the same way.
Period tracking apps have come under greater scrutiny in the US since the 2022 overturning of Roe v Wade, which removed federal constitutional protection for abortion.
Some users and privacy advocates have warned that menstrual and reproductive health data could potentially be sought in legal cases.
The research also points to a broader regulatory problem for consumer health apps.
In the US, many health apps are not covered by HIPAA, the health privacy law that applies to medical providers and some healthcare organisations.
That means some consumer apps may be able to collect, share or monetise sensitive health data under rules that differ from traditional healthcare privacy protections.
The femtech market, estimated in the report at US$50bn, has grown quickly, but privacy regulation has not always kept pace with app development.
Stardust had not publicly responded to Mozilla’s findings at the time of the original report, and its privacy policy remained live on its website.
The issue is particularly sensitive for period tracking because the data can reveal patterns around fertility, pregnancy, contraception and reproductive health.
Mozilla’s wider Privacy Not Included initiative has examined consumer technology products for privacy and security concerns since launching in 2017, including connected devices, children’s toys and health apps.
The findings come as US lawmakers continue to debate stronger federal privacy rules for sensitive health information collected by consumer apps.
The American Data Privacy and Protection Act, which has been stalled in Congress since 2023, includes provisions addressing sensitive health information collected by consumer apps.
Experts have also warned that anonymised health data can sometimes be re-identified when combined with other information, such as location data.
Re-identification means linking supposedly anonymous data back to a specific person.
A 2019 study found that menstrual cycle data combined with location information could identify individual users with high accuracy.
State-level privacy laws in places such as California, Virginia and Colorado have also given consumers new rights around personal data, although enforcement can vary.
Privacy advocates say the research underlines the need for clearer data practices, stronger safeguards and greater transparency in femtech.
For users, the findings are a reminder that health apps do not automatically protect health information in the same way as healthcare providers.
The report suggests period tracker companies that put privacy first may be better placed to build trust in a market where long-term use depends on confidence.
Mozilla’s investigation suggests privacy promises in femtech do not always match practice, and that period trackers can function without sharing sensitive user data in the same way.
Juno Bio has secured US$3.8m to expand its diagnostics platform for vaginal health and reproductive care.
The funding round was led by Ada Ventures, with participation from Artesian, Entrepreneur First and Illumina Accelerator.
The women’s health startup said the seed funding will support the launch of its first CLIA-certified sequencing laboratory in Oakland, California, and a new clinical vaginal microbiome and STI test for healthcare providers.
CLIA certification refers to US laboratory standards for testing human samples used in diagnosis, prevention or treatment decisions.
Dr Leighton Turner, co-founder and chief scientific officer of Juno Bio, said: “The vaginal microbiome is still one of the least understood systems in the body at a clinical scale.
“With our lab, we’re starting to build a measurement standard that clinicians can actually use.
“We believe the level of detail from this kind of testing can meaningfully improve how vaginal healthcare is provided.”
The company is developing precision diagnostics for vaginal health, where patients can experience recurring symptoms, inconsistent diagnoses and treatments based on trial and error.
Juno Bio said bringing testing in-house gives it greater control over the process, from sample handling to results, while allowing it to refine its technology and build what it says is one of the largest datasets focused on the vaginal microbiome.
The vaginal microbiome is the community of bacteria and fungi that naturally live in the vagina. Changes in this balance can be linked to infections, symptoms and wider reproductive health issues.
Juno Bio’s newly launched clinical test examines the wider vaginal microbiome and screens for four common sexually transmitted infections, or STIs.
Rather than looking for a single cause, the test is intended to give clinicians a broader picture of what may be contributing to symptoms.
Juno Bio says this matters because multiple infections can occur at the same time and microbiome changes may be linked to fertility, menopause or recurrent infections.
Dr Anna Powell of Johns Hopkins said: “Vaginal microbiome testing has the potential to significantly reshape how we understand and manage vaginal health, particularly for patients with recurrent or unexplained symptoms.
“While the field is still evolving, advances in sequencing and data interpretation are moving us closer to a future where more personalised, microbiome-informed care can complement existing diagnostic approaches.”
Check Warner, co-founding partner at Ada Ventures, added: “Juno Bio is setting a new standard for how vaginal health is understood and managed.
“What they’ve built at this stage, with this level of capital efficiency, is exceptional.
“We’re proud to support the team as they scale their clinical infrastructure and continue leading innovation in this critically underserved category.”
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