Equality for women – can it help to achieve universal health coverage?

Isabelle Parsons Oct. 11, 2017

Focusing on universal health coverage and the sustainable development goals, Isabelle Parsons who recently completed work experience with the Global Health and Development Group at Imperial College London, shares her thoughts on the relationship between improving women’s rights and reducing healthcare costs.

Maternal health care

Universal Healthcare Coverage (UHC) is a basic human right but is something that a great deal of the world’s population doesn’t have access to. Goal 3 of the sustainable development goals is to “ensure healthy lives and promote well-being for all at all ages” and has a set date to be achieved by 2030. The UN has set thirteen targets to achieve UHC including reducing the global maternal mortality ratio to less than 70 per 100,000 live births, to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases, combat hepatitis, water-borne diseases and other communicable diseases. These goals whilst fully achievable with the correct support, almost all apply to the poorest parts of the world in Sub-Saharan Africa and Southern Asia.

These regions also present persistent problems with gender equality and women’s rights: a contributing factor to high rates of infant mortality. Goal 5 of the sustainable development goals is to “Achieve gender equality and empower all women and girls” – which at first may seem unrelated, is entwined with Goal 3. Empowering women and giving them equal rights to education can reduce the number of forced marriages of girls under the age of 18, as girls in education wait longer to marry and then have children. By implementing programmes to inform and educate adolescents and parents in sexual health and the advantages of education for girls, countries can move towards gender equality. This in turn can help a country progress towards achieving health lives for all of its population, as education is likely to reduce adolescent pregnancies and therefore potentially reduce the number of deaths due to child birth. iDSI has carried out work on maternal care and reducing mortality rates due to child birth in Kerala, India which can be found on the iDSI Knowledge Gateway here.

Linking sustainable development goals

Improvements have been made and are continuing to be made by local governments, for example in Southern Asia in 1990 only 74 girls were enrolled in primary school for every 100 boys. However, in 2012, the enrolment ratios were the same for both boys and girls[1]. With the help and funding of more developed countries like the UK more advanced programmes can be implemented to help achieve these basic human rights. Dr. Tedros WHO Director-General is championing women’s equality and healthcare “we must not only place the well-being of women, children and adolescents at the centre of global health and development, but also position health at the centre of the gender equality agenda”.[2] Following this thinking, the large overlap between Goal 3 and Goal 5 regarding maternal care and support should link them together enough for governments to work on achieving them both at the same time. Funders and development partners should be asking: does improving prospects for women reduce the spending required in maternal care? What are the downstream and cross sector effects of complex interventions in particular sectors? If education could lead to reduced cost of maternal healthcare, where could these resources be reallocated to, in order to achieve universal health coverage? A recent iDSI article “We need a NICE for global development spending” looks at the principles of resource allocation and value for money and how evidence based decisions can help funders and recipient countries decide how to best use their resources to achieve the most health for their population.

[1] www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20Summary%20web_english.pdf

[2]  www.who.int/dg/speeches/2017/every-woman-every-child/en/