Addressing the Issue of Gender in Achieving Universal Health Coverage

Addressing the Issue of Gender in Achieving Universal Health Coverage

A girl in the Democratic Republic of Congo {Photo credit: Warren Zelman}Photo credit: Warren Zelman

All involved with women’s health and gender wish that access to quality health care for women and girls was easy to achieve at scale. But the attitudes and expectations of many societies limit women’s and girls’ access to resources and skills associated with better health. And health-related vulnerabilities and poor outcomes for women and girls have social and financial costs that hamper the consistency and quality of available health services. 

To advocate for universal health coverage (UHC), and help countries achieve this worthy goal, health leaders, managers, and those who govern must work to end social biases and gender-based discrimination--whether deliberate or unintended. 

Among other things, health leaders must support the hiring and promotion of women; advocate for gender-sensitive employment and working conditions; help to reduce women’s out-of-pocket healthcare payments (that are generally higher than men’s due in part to the high costs of newborn deliveries and reproductive health services); adjust clinic hours to accommodate women and girls’ mobility constraints; and consider how even unexpected health provider bias can make female clients hesitate to seek the services they need in a timely fashion. 

Those who are responsible for expanding health coverage must consciously examine the possibilities of institutional gender bias and discrimination that impede program effectiveness and outcomes. 

In our efforts to promote health systems strengthening with gender equity in mind, MSH is working to support and advocate for universal health coverage as an overarching health goal for the post-MDG framework. With UHC defined as a system that provides all people with the health services they need, having more women as leaders within the system may, in turn, result in more gender-equitable health planning and service delivery.  

Our congratulations go out to the many countries, including Ethiopia, India, Mexico, and Rwanda, that have developed UHC plans, and to the approximately 50 countries that have thus far attained near-universal health coverage. Cheers to the ministers who have signed relevant political statements and declarations (Bangkok, January 2012 and Mexico, April 2012) reaffirming people’s right to healthcare and the state’s role in realizing this right. Most of all, well done (!) to all of the health leaders, managers, and governors—past, present, and future—who tenaciously continue to make social inclusion and health service access a realizable goal for women and girls around the world. 

Until then, we would ask you to consider how you and your colleagues might take action to help key players in the health system become more aware of then gender-focused determinants of health. Ask yourself how you can help:

  • Adopt improved governance for health and development 
  • Promote participation in policy-making and implementation 
  • Further reorient the health sector towards promoting health and reducing health inequities 
  • Strengthen global governance and collaboration
  • Monitor progress and increase accountability

Together, we can all help create an enabling environment for UHC, and provide better outcomes for the world’s poorest and most vulnerable people.