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Universal healthcare coverage

PillsData shows that women will use healthcare services more than men as they bear a greater burden of disease due to maternity, sexually transmitted diseases such as HIV and AIDS, and illnesses in their old age due to higher life expectancy rates. Despite this girls and women are more likely to have unmet healthcare needs across their lifetimes. Privatisation of healthcare services contributes to the violation of women’s right to health from birth, as adolescent girls, workers and in their old age. Women living in poverty are likely to lack time and resources as they are engaged in unpaid care work alongside unpaid work or low paid work, the cost of out-of-pocket payments is a barrier to accessing healthcare services where these are available. Women living in rural areas face even greater challenges due to the lack of available and quality services.

The ILO estimated in 2014 that close to 40 per cent of the world’s population do not have any form of health coverage. In sub-Saharan Africa and India, 80 percent of the population are without health coverage. The global social protection floor includes universal health protection coverage as one of four key minimum components of any social protection system to try to meet these gaps and guarantee the right to health. Cash transfers through child and old age grants can go some way in providing households with income to access healthcare services. However, this depends on the amount of the grant, its administration and critically the availability of quality healthcare services. Women’s ability to assert control over the cash transfer within the household will also determine whether they can use these funds to access healthcare services.

Health coverage that aims to empower women must therefore be universal and invest in sexual and reproductive health services for all including adolescent girls. Without adequate coverage and quality provision sexual and reproductive health services remain out of reach for the poorest and most marginalised women and girls. Access to contraception, safe abortions, HIV and AIDS treatment, and maternal health services will not only save women’s lives, but also empower women’s voice, choice and control over life decisions that affect them. For adolescent girls and women, being able to decide if they want children and control the number and spacing between their children allows them to make choices about continuing their education, the nature of their employment, and balancing their work alongside their unpaid care and domestic work.

Universal health coverage for pre and ante natal care coupled with income security for pregnant women and mothers of new born children are two components of an effective social protection programme. Women workers take on great risks to their personal health and that of their infants by returning to work shortly after delivery. Access to maternal healthcare and income security promotes equality in employment opportunities and challenges gender segregation within the labour market. Recently a number of countries including Argentina, Bangladesh, Bolivia, Brazil, Ghana, India, Indonesia, Jordan and South Africa have expanded maternity coverage to include women in the informal sector. Expanding paternity leave and benefits in low income and middle income countries can also be a way to encourage more men to take up childcare and help to redistribute women’s unequal share of unpaid care and domestic work.

The resources below outline the gaps in universal health coverage and assess the specific ways in which policies could change to improve women’s access to healthcare services. Though there are targeted services for adolescent girls and women, this is framed within a broader universal healthcare coverage as the most effective way to reach all women and girls – particularly the most marginalised.

Recommended reading

Extension of social security long - term care protection for older persons: a review of coverage deficits in 46 countries
X. Scheil - Adlung / International Labour Organization 2015
Due to the global demographic ageing, all countries are challenged by growing long-term care (LTC) needs for older persons. However, these needs are largely ignored and range very low on the policy agendas of most countries. Th...
Health financing and delivery in India: an overview of selected schemes
K. Jain / Women in Informal Employment Globalizing and Organizing 2013
In recent years, the government of India has made attempts to address its notorious health inequities by providing health protection to poor and vulnerable citizens. This paper presents an overview of India’s health care system ...
Social protection for maternity: key policy trends and statistics
International Labour Organization 2015
Despite efforts of the Millennium Development Goals, maternal mortality remains very high in developing countries. Nearly 800 mothers die every day from childbirth, and women also face discrimination at the workplace due to inadequate...
Evidence on gender inequities in social health protection: the case of women living in rural areas
X. Scheil-Adlung; C. Kuhl / International Labour Organization 2012
While in many low- and middle-income countries, urban women have had better opportunities to join growing formal economies, rural women are often stuck in harsh living and working conditions in informal economies. The aim of this repo...
Addressing the global health crisis: universal health protection policies
International Labour Organization 2014
Access to health protection is crucial for both good health of the population and for boosting the economy. Ensuring that everyone can attend quality health care is a prerequisite for sustainable development based on equity and inclus...
The Ghana National Health Insurance Scheme: Barriers to Access for Informal Workers
L Alfers / Women in Informal Employment Globalizing and Organizing 2013
Ghana’s National Health Insurance Scheme (NHIS) is an innovative attempt to extend social protection to informal workers, and, as such, it may hold important policy lessons for other countries where the informal economy is large...