Sexual and Reproductive Health and Rights at the Centre of Achieving Universal Health Coverage
By Bekky Ashmore, Coordinator, Action for Global Health UK Network
All individuals have a right to make decisions governing their bodies and to access services that support that right. These rights are essential to the realisation of sexual and reproductive health, sustainable development and are a precondition to gender equality and non-discrimination. It is on this basis that we believe it is vital to prioritise sexual and reproductive health and rights (SRHR) within a holistic UHC approach.
At a time when global momentum is building on the importance of achieving UHC, girls and women are continuing to fight to have their SRHR recognised and met. Whereas significant progress has been made in other areas of health, such as advances in polio eradication and malaria, 4.3 billion people of reproductive age worldwide will have inadequate sexual and reproductive health services over the course of their lives.
Defining the services covered under a UHC package will inevitably necessitate that choices are made over which services to prioritise. Essential sexual and reproductive, maternal, new born, child and adolescent health services, available and accessible to everyone are the foundation to UHC. Many services are being delivered through primary and community-based health systems so inclusion of SRHR must be made during investments to strengthen these parts of the health system.
Action for Global Health UK Network advocates to the UK government to ensure a strong, equitable approach to UHC that prioritises primary health care level as a foundation for strong health systems.
Ensuring that all individuals are able access a minimum essential package of quality SRHR services and information will not only benefit broader aspects of health but allows gains in other development outcomes including gender equality, education, employment, sustainable and inclusive growth and poverty eradication.
There are several critical areas for SRHR that need to be addressed and receive greater attention to achieve UHC for all. The conversations that are needed require global leadership, political will and collaboration in the build up to the High-Level Meeting on UHC in September 2019.
Adolescence is a time of rapid physical, sexual, social and neurological development and a crucial time to lay the foundations for healthy lives. In the advancement of UHC, the specific needs and challenges facing adolescents must be addressed. Comprehensive sexuality education (CSE) empowers young people to safely and positively navigate their sexuality, contributes to safer sexual behaviours and leads to better health and wellbeing outcomes. It is a key component in the prevention of poor health outcomes and addressing the social detainments of health. Governments must make concurrent investments in CSE across health, education and related sectors to make the strongest possible contribution to health outcomes.
Although UHC can often be interpreted through a narrow lens, with a focus only on health services and their costs, the broader social determinants of health play an equally important role. Progress on tackling socio-cultural norms, stigma and discrimination, which overwhelming impact on marginalised populations, are required to advance UHC for the most difficult to reach and left behind populations.
Investments must be made in strengthening health and community systems to deliver available, accessible, acceptable, quality essential healthcare, which includes SRHR, to all ad increase public investment in health. The next 11 months in the lead up to the High Level Meeting on UHC and final stage of the Global Action Plan represent an important opportunity for progress to be made towards a vision of UHC which supports the full realisation of SRHR.
