Minding the gaps

Health financing, universal health coverage and gender

Bibliographic Data

ID11490376
AuthorsSophie Witter (0000-0002-7656-6188, Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK, corresponding author), Veloshnee Govender (0000-0002-5467-7477, University of Cape Town), Tk Sundari Ravindran (Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India), Robert Yates (0000-0001-5337-8806, Centre on Global Health Security Chatham House, The Royal Institute of International Affairs, 10 St James's Square, London, SW1Y 4LE UK)
Year2017
Volume32
Issuesuppl_5
Pagesv4-v12
Publication date2017-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czx063
PMID28973503
OpenAlexW2738833087
LanguageEN
Citations received29
References cited31

In a webinar in 2015 on health financing and gender, the question was raised why we need to focus on gender, given that a well-functioning system moving towards Universal Health Coverage (UHC) will automatically be equitable and gender balanced. This article provides a reflection on this question from a panel of health financing and gender experts.We trace the evidence of how health-financing reforms have impacted gender and health access through a general literature review and a more detailed case-study of India. We find that unless explicit attention is paid to gender and its intersectionality with other social stratifications, through explicit protection and careful linking of benefits to needs of target populations (e.g. poor women, unemployed men, female-headed households), movement towards UHC can fail to achieve gender balance or improve equity, and may even exacerbate gender inequity. Political trade-offs are made on the road to UHC and the needs of less powerful groups, which can include women and children, are not necessarily given priority.We identify the need for closer collaboration between health economists and gender experts, and highlight a number of research gaps in this field which should be addressed. While some aspects of cost sharing and some analysis of expenditure on maternal and child health have been analysed from a gender perspective, there is a much richer set of research questions to be explored to guide policy making. Given the political nature of UHC decisions, political economy as well as technical research should be prioritized.We conclude that countries should adopt an equitable approach towards achieving UHC and, therefore, prioritize high-need groups and those requiring additional financial protection, in particular women and children. This constitutes the 'progressive universalism' advocated for by the 2013 Lancet Commission on Investing in Health.

Business · Demographic economics · Economic growth · Economics · Gender gap · Health care · Universal coverage · Finance · Global Health Care Issues · Global Maternal and Child Health · Healthcare Systems and Reforms · Health Policy