Women's rights will drive universal health coverage

Abstract

We support Simon Wright and Refiloe Mabjeane,1Wright S Mabejane R The 2019 UN high-level meeting on universal health coverage.Lancet. 2019; 3931931Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar who wrote on behalf of the Civil Society Engagement Mechanism for UHC2030, calling for a “radically different approach” to the UN high-level meeting on universal health coverage (UHC) on Sept 23, 2019. However, a radically different approach means prioritising gender equality and girls and women's health and rights in UHC, and this includes the health workforce. Firstly, UHC design and delivery should address the needs of girls, women, adolescents, and marginalised groups throughout the life course, and this includes protecting their sexual and reproductive health and rights.2WHODelivered by women, led by men: a gender and equity analysis of the global health and social workforce. World Health Organization, Geneva2019Google Scholar UHC must incorporate comprehensive sexual and reproductive health services into essential benefits packages, and must respond to girls’ and women's diversity and intersecting identities of race, ethnicity, age, ability, migrant status, gender identity or expression, indigeneity, health condition, or socioeconomic status that can impact health.2WHODelivered by women, led by men: a gender and equity analysis of the global health and social workforce. World Health Organization, Geneva2019Google Scholar To protect girls and women from financial risk, they must be able to fully participate in financial protection schemes and coverage must be adequate.3Witter S Govender V Ravindran TKS Yates R Minding the gaps: health financing, universal health coverage and gender.Health Policy Plan. 2017; 32: v4-12Crossref PubMed Scopus (37) Google Scholar Secondly, UHC should address socially constructed gender roles and gender determinants of health that drive risk and poor health. Greater risk taking, violence, and avoidance of health services affect men's life expectancy, whereas the health of women and transgender people is affected by gender-based discrimination, harmful practices, and poor autonomy over their own bodies. UHC needs a gender lens and gender-disaggregated data to prioritise the most marginalised individuals and tackle inequities.2WHODelivered by women, led by men: a gender and equity analysis of the global health and social workforce. World Health Organization, Geneva2019Google Scholar, 3Witter S Govender V Ravindran TKS Yates R Minding the gaps: health financing, universal health coverage and gender.Health Policy Plan. 2017; 32: v4-12Crossref PubMed Scopus (37) Google Scholar Thirdly, women comprise 70% of the health workforce and are central to filling 18 million additional health worker jobs for UHC. However, they hold only 25% of global health leadership posts and generally have lower status, lower pay, or even unpaid roles. Women will deliver UHC, but only with investment in decent work protecting their fundamental rights, guaranteeing fair pay and safe workplaces, and integrating unpaid health and social care into the formal sector.2WHODelivered by women, led by men: a gender and equity analysis of the global health and social workforce. World Health Organization, Geneva2019Google Scholar As emphasised by the UN Secretary-General, women and girls should not only be beneficiaries of UHC systems—they should also be involved in their design.4Deliver for GoodA fundamental question of power: a Q&A with the United Nations Secretary-General.https://deliverforgood.org/a-fundamental-question-of-power-a-qa-with-the-united-nations-secretary-general/Date: May 8, 2019Date accessed: May 10, 2019Google Scholar UHC discussions risk forgetting that gender equality and women's rights drive health for all. The International Women's Health Coalition, Women Deliver, and Women in Global Health have convened 107 organisations in a global Alliance for Gender Equality and UHC. Building on the six asks set by the UHC2030 movement, the Alliance for Gender Equality and UHC has issued a seventh ask to UN member states and partners to commit to gender equality and women's rights in UHC.5Women in Global HealthCall to action: universal health coverage. To the members of the UN high level meeting on UHC.https://www.womeningh.org/uhc-genderDate: 2019Date accessed: May 10, 2019Google Scholar KI is President/CEO of Women Deliver. AK has held a consultancy contract with WHO since March 18, 2019 (extended to Aug 15, 2019). CP was doing an internship in the Antimicrobial Resistance and Healthcare-Associated Infections Department of Public Health England during the preparation of this Correspondence. All other authors declare no competing interests. The 2019 UN high-level meeting on universal health coverageIn their discussion of universal health coverage (UHC), the Editors (Jan 5, p 1)1 rightly state that “simply convening a UN high-level meeting is not enough” to achieve UHC. The Civil Society Engagement Mechanism for UHC2030 (CSEM) strongly agrees and is concerned that, without a radically different approach, the meeting will be a business-as-usual global health event. We are concerned that speakers at the high-level meeting on UHC on Sept 23, 2019, will declare support for UHC and leaving no one behind, but will not be held to account for their contradictory policies and actions. Full-Text PDF