On April 29, 2019, the International Women’s Health Coalition (IWHC) submitted statements addressed to the Interactive Multi-Stakeholder Hearing on Universal Health Care (UHC). In the statements, IWHC addresses three themes: (1) Universal Health Coverage as a driver for inclusive development and prosperity (2) Leave No One Behind – Universal Health Coverage as a commitment to equity (3) Multi-sectoral and multi-stakeholder actions and investments in UHC
The full text of the statements is below.
Submitted to the Interactive Multi-Stakeholder Hearing on UHC, April 29, 2019
Theme 1: Universal Health Coverage as a driver for inclusive development and prosperity
By Francoise Girard, President, International Women’s Health Coalition
Ensuring the highest attainable standard of physical and mental health for every person – and leaving no one behind – depends upon ensuring the sexual and reproductive health and rights of every person, in particular, women, girls and adolescents. States have an obligation to respect, protect and fulfill those rights. Achieving universal health coverage depends upon it.
To do this, governments must guarantee access to a core set of sexual and reproductive health services to meet both individual and public health goals and fulfill human rights standards. As was agreed at the ICPD 25 years ago, these services must include contraception; safe abortion and post-abortion care; antenatal, delivery and postnatal care; prevention and treatment of infertility, reproductive tract infections, sexually transmissible infections, including HIV, and reproductive cancers; vaccines; and services to address gender-based violence. These services are cost-effective and should be integrated to primary care service and UHC benefits packages. Contraception and abortion are often overlooked, but are essential to achieve women’s rights to health, as evidenced by the data, and need to be covered as urgently as comprehensive maternity care.
UHC policies and programs can and must also drive progress to break down persistent gender-related barriers to care that are interconnected with social norms and patriarchal culture, and which are also violations of women’s and girls’ human rights.
We have an opportunity now to ensure that UHC policies and programs not only aspire to support healthy lives, but are also transformative – if we put human rights at their center. Let’s take this unique opportunity.
Theme 2: Leave No One Behind – Universal Health Coverage as a commitment to equity
By Patricia Nudi, Kisumu Medical and Education Trust (KMET), on behalf of IWHC Advocacy in Practice group: Young Women For Change, KMET, SPECTRA, Vision Spring Initiatives, Youth Coalition for Sexual & Reproductive Rights, International Women’s Health Coalition
Member States must ensure that universal health coverage adopts a gender-responsive, right-based approach that specifically considers the rights of adolescents and young people, in order to guarantee that no one is left behind.
Young people, especially young women and girls, face specific structural barriers to accessing health services that member states must address, including, but not limited to: restrictive laws, lack of information about their own health; limited accessibility to health services; limited bodily autonomy; and stigmatization of certain essential services. These barriers lead to higher rates of adolescent pregnancy, child and early marriage, and maternal mortality, particularly for the most marginalized young people.
Member states must ensure that sexual and reproductive health services and information, including for young people, are an essential component of UHC in terms of financing for health commodities, training health workers, de-stigmatizing SRH, and ensuring quality and accessibility.
Allocating sufficient funding and centralizing young people’s SRHR and gender equality in UHC would greatly contribute to ensuring young people all over the world are empowered and can realise their rights and attain their full potential.
Theme 3: Multi-sectoral and multi-stakeholder actions and investments in UHC
by Shannon Kowalski, Director of Advocacy and Policy, International Women’s Health Coalition
UHC should be driven by the people it serves. Too often women and adolescent girls are left out of decision-making during the design, implementation and monitoring of policies and programs. Women are 51% of the population and must have equal voice in UHC. But the category of women is not monolithic; intersecting identities in terms of race, ethnicity, age, ability, migrant status, gender identity or expression, indigeneity, class or caste play an important role in access, influence and health results. The most marginalized are often left out of discussions and planning, resulting in health systems and services designed to fail.
For UHC to be transformative in shaping equitable, inclusive and effective health systems, services and outcomes, it must be developed with the principle of participatory planning and include women in all their diversity through meaningful, not tokenistic, participation.
As a step toward overcoming pervasive social and cultural norms that entrench unequal power dynamics and maintain institutional discrimination, gender-based violence and resource inequities, governments should:
- provide formal opportunities to input;
- engage at community and household levels, including in local languages;
- reach out to health workers in the formal and informal, paid and unpaid sectors;
- undertake gender budgeting; and
- elicit the expertise and experience of women and girls on their own health priorities.
UHC policies and programs must engage in creating leadership pathways for women, adolescents and marginalized peoples in design and delivery, from community and municipality to national and international levels.