Improving Women's Health through Universal Health Coverage: MSH and Partners Convene Meeting During UN Open Working Group

Improving Women's Health through Universal Health Coverage: MSH and Partners Convene Meeting During UN Open Working Group

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

With United Nations (UN) member states continuing to negotiate recommendations on the post-2015 development process, stakeholders met last Thursday in New York to discuss the potential of universal health coverage (UHC) to drive improvements in women’s health.

The event coincided with the 12th session of the Open Working Group of UN member states, whose working draft recommendations had included targets on UHC, maternal and child survival, and reproductive healthcare access; panelists and audience members spanned UN missions, civil society, private sector, foundations, and academia.

Women and development

Interrelatedness of development objectives was a central theme. Women’s empowerment, education and health, said Women Deliver CEO Katja Iversen, are critical to women themselves and to the success of their communities. Management Sciences for Health (MSH) President & CEO Jonathan D. Quick noted that health interventions, which form the core of UHC, are only one part of improving health outcomes for women—social determinants of health are equally critical.

Economist Jeffrey Sachs, director of the Earth Institute at Columbia University, advocated for increased development funding to meet at least the basic requirements of UHC and women’s health in the poorest countries. While the cost of UHC has been a political flashpoint in post-2015 UN deliberations, Sachs argued that these increases are modest and consistent with existing international commitments. The UN Sustainable Development Solutions Network (SDSN), which Sachs chairs, has recommended targets that include overseas development assistance.

Safeguarding women’s health in UHC

UHC as a post-2015 objective has raised some red flags among women’s health advocates. María Antonieta Alcalde, director of advocacy for International Planned Parenthood Federation/Western Hemisphere Region (IPPF/WHR), explained that a concern of women’s health advocates has been the proposal that UHC would serve as an “umbrella” health goal in post-2015. For advocates of sexual and reproductive health and rights (SRHR) in particular, UHC represents a risk: SRHR, which face unique political and social challenges in most settings, can’t be treated as “just another” set of health services under UHC.

Alcalde highlighted a recent World Health Organization post-2015 recommendation, which included other Millennium Development Goal health objectives as freestanding targets, but subsumed SRHR needs under UHC service delivery indicators—subject to a global 80% coverage target, shy of the MDGs’ universal access target.

[(From left) Jeffrey Sachs, Earth Institute at Columbia University; María Antonieta Alcalde, IPPF Western Hemisphere Region; Katja Iversen, Women Deliver; and Jonathan D. Quick, MSH lead the conversation on women's health and UHC.] {Photo credit: MSH staff.}(From left) Jeffrey Sachs, Earth Institute at Columbia University; María Antonieta Alcalde, IPPF Western Hemisphere Region; Katja Iversen, Women Deliver; and Jonathan D. Quick, MSH lead the conversation on women's health and UHC.Photo credit: MSH staff.

Aligning agendas

The event reflected a shift in civil society deliberations on UHC—from “advocates versus opponents” to collaborative discussions on how frameworks can best support priorities like women’s health. Alcalde and Sachs, for example, went back and forth on the need for sexual and reproductive rights indicators in the SDSN proposal.

Beyond the current focus on post-2015, Quick explained, the long-term priority must be optimizing these agendas at the country level. The Philippines, for example, approved a universal family planning law at the same time it was expanding healthcare access under a UHC scheme. Opposition from religious groups stalled implementation of the landmark reproductive health law, undercutting an essential component of UHC and demonstrating the pitfalls for women’s health in many health systems.

UHC is no magic bullet. Even with UHC policies in place, Quick argued, civil society must continue to fight for women’s health and other priorities. It can work: in the Philippines, a Supreme Court decision in April upheld the family planning law.

“We won,” Quick said.

The event was cohosted by the UN permanent missions of France and Zambia along with MSH, Health for All Post-2015, the Aspen Institute, Global Leaders Council for Reproductive Health, Women Deliver, and the One Million Community Health Workers Campaign.

Jonathan Jay, JD, MA, is Senior Writer for MSH and Coordinator of Health for All Post-2015, a global campaign of over 30 civil society organizations supporting universal health coverage in the post-2015 UN development framework.

 

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