Countries can narrow economic and social inequalities, and deliver on long-term commitments to sexual and reproductive health and rights, by prioritizing universal health care.
Giving birth can lead to a significant financial burden for parents. For some, the costs of prohibitively expensive care can lead to life-and-death decisions, such as delaying regular prenatal visits or skipping medications. For many mothers, public hospitals are often the only option but even those may levy unaffordable fees for the poor. This can lead to situations where low-income families are forced to make tradeoffs between medically necessary treatment and other household obligations such as rent, transportation, and food.
Social and economic inequalities remain a substantial stumbling block for universal health care, which aims to provide equitable and accessible health care to everyone. Access to sexual and reproductive health services remains lower in poor, uneducated, and rural populations. Financial constraints, insufficient knowledge, distance from facilities, concerns surrounding confidentiality, poor interactions with care providers, and stigma also limit access to sexual and reproductive health and rights.
Governments have committed to achieving universal health care by 2030 as part of the 2015 Sustainable Development Goals (SDGs), ensuring that all individuals have access to a full range of quality health services without falling into financial hardship. Universal health care is critical in the fight against poverty as health is a fundamental human right and an essential element of social protection. Without good health, people are unable to reach their full social and economic potential. Sexual and reproductive health and rights are closely linked to the gender equality, poverty reduction, and environmental sustainability targets of the 2030 Agenda for Sustainable Development.
Universal access to all essential sexual and reproductive health and rights services includes antenatal and postnatal care, contraception, prevention, and management of gender-based violence, abortion care, sexually transmitted infections, HIV/AIDS, prevention, and treatment of reproductive cancers, and comprehensive sexuality education. An estimated 140 million women of reproductive age in Asia and the Pacific have unmet needs for modern family planning methods. In meeting these needs and ending preventable maternal deaths, UNFPA estimates that the return on investments is about eight dollars for every dollar spent.
Although significant strides have been made since the renewed commitments of development organizations and multilateral development banks on attaining the SDGs, the time needed to close the health and survival gap remains unclear as the progress on health and gender equality has stalled.
Sexual and reproductive health and rights are closely linked to the gender equality, poverty reduction, and environmental sustainability targets of the 2030 Agenda for Sustainable Development.
Here are three transformative gender approaches that developing countries can use to put sexual and reproductive health and rights and gender-responsive strategies at the policy forefront:
Improve data collection systems to generate better evidence to improve health service quality and provision. More evidence is needed to inform policies for realizing the SDGs and universal health care. In many countries, there is a limited understanding of the drivers of inequalities in health outcomes and no routine monitoring systems that can collect sex-disaggregated data, even for global commitments such as the SDG targets. With better data, policymakers can understand the needs of different users and design gender-responsive health policies and financing frameworks that will serve the most vulnerable.
Encourage women’s participation and leadership in designing solutions to improve sexual and reproductive health and rights access. Evidence suggests that women-led countries had lower death rates during the COVID-19 pandemic. Women leaders tend to take a more collective and collaborative approach, which is critical for patient-centric health systems. Participation of marginalized, under-represented groups of women and girls, including adolescents, is central to the human rights approach to gender equality. There’s no better way to ensure that the needs of the most vulnerable populations are met than to include them in the consultative process and engage them to deliver solutions. In India, for example, female community health workers were recruited to conduct outreach services for primary health care and provide training on maternal health, gender-based violence, and reproductive rights. As a result, institutional deliveries were increased in urban areas, antenatal coverage improved, and immunization of infants also improved.
Use innovative approaches to actively address entrenched gender norms and power imbalances that perpetuate harmful ideas about sexual and reproductive health and rights. Development partners need to go beyond traditional gender mainstreaming strategies and identify solutions to tackle the underlying barriers limiting access to sexual and reproductive health and rights services. Countries should integrate comprehensive sexuality education programs to teach young boys and girls about healthy relationships and how to prevent gender-based violence. Promoting community outreach and behavior change programs for mothers-in-law who have outsized influence on access to health services for new moms and babies.
Given the current momentum behind universal health care, together with better data, women’s participation in designing solutions and innovative approaches, we can ensure that health services are accessible and benefit everyone.
By prioritizing universal health care, countries can narrow economic and social inequalities, as well as existing gender gaps, and deliver on long-term commitments to ensure universal access to sexual and reproductive health and rights.