Ten arguments for why gender should be a central focus for UHC
To make universal health coverage (UHC) truly universal we need an approach which places gender and power at the centre of our analysis. This means we need a discussion about who is included, how health is defined, what coverage
entails and whether equity is ensured.
Gender affects both vulnerability to illness and access to health care. Gender influences how women, men, and people of other genders perceive, behave, interact and this impacts the social experience of being sick, seeking and receiving care.
Gender combines with other social determinants in varied ways. How gender is experienced can change when interacting with other forms of inequality, such as age, poverty, geography, caste, race, ethnicity, disability,
Marginalized people (ethnic minorities, inhabitants of informal settlements, people employed in illegal occupations, etc.) may have different access to health care or receive different treatment by health care workers compared to others. Power relations between individuals (for example, husbands and wives or health care professionals
and patients) influences the effectiveness of policies and programmes to achieve UHC.
Coverage can’t be universal if some services and service users are routinely left off the list. Financial protection packages (i.e. prepaid health services under UHC schemes) often exclude essential and routine sexual and reproductive health services, such as delivery and emergency obstetric care, family planning, and safe abortion.
Coverage can’t be universal unless it extends to all contexts. UHC will not be achieved without additional research,
resources and health system development in fragile and conflict affected contexts.
Paying out-of-pocket expenses for services adversely effects women. This reflects hardship and injustice as women tend to have less income and less control over it and yet have to pay for health services that are more likely to not be
covered by financial protection schemes.
Policy makers need to use evidence that incorporates gender and power in their decision making around access to services. Gender permeates all aspects of the health system and must be dealt with on different levels.