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Health financing and Universal Health Coverage - What's gender got to do with it?


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Presentation given by Sophie Witter for DFID lunchtime seminar on 19th January 2016

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Health financing and Universal Health Coverage - What's gender got to do with it?

  1. 1. Health financing & UHC – what’s gender got to do with it? Sophie Witter January 2016
  2. 2. Background: webinar panel, 1 July 2015 Introduction to health financing and UHC Rob Yates, Chatham House, UK Gendered questions related to health financing and gaps in health literature Sophie Witter, Queen Margaret University, UK Gender implications of health financing reforms Veloshnee Govender, University of Cape Town, South Africa Lessons on health sector reforms and gender from India, and lessons for UHC TK Sundari Ravindran, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India Commentary Sarah Ssali, Makerere University, School of Women and Gender Studies, Uganda Q&A
  3. 3. Webinar process and outputs • X people participated; positive feedback – mostly excellent ratings, some good • Video of webinar, webinar slides, storify and blog relating to it all posted on RinGS site: • Article in draft for special edition of Health Policy and Planning – ‘minding the gaps’
  4. 4. Some core insights – minding the (research) gap • Need for more cross-cutting of silos: shocking that work on health financing and gender is so limited • Most work as been done on user fees and gender and household impacts, plus some analysis of funding allocations to MCH/RH • All other areas remain under-explored – especially on resource allocation, purchasing, benefits packages and governance • Also need more investigation of gender implications of different health financing reforms and relationship between gender equity and UHC
  5. 5. Core insights – minding the (equity) gap • Gender-based vulnerabilities not factored into the design of health financing schemes (e.g. high % of women in informal sector) • Education, employment & wealth do not mean that women automatically have access to cash - critical consideration for UHC • Addressing unintended consequences, e.g. insurance packages with limited household numbers & adverse effects • UHC requires an essential health package that goes beyond maternal health & addresses women's needs across the life cycle (including routine SRH services) • Abortion remains very contested service, even in countries which have comprehensive packages • Market failures, e.g. gender-biases and profit-seeking combine to produce peculiar distortions (e.g. unnecessary hysterectomies) • To operationalise 'progressive universalism' we must engage with the politics, as well as underlying social determinants