Health financing & UHC – what’s gender got to do

with it?Sophie WitterJanuary 2016

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

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:http://resyst.lshtm.ac.uk/resources/gender-and-health-systems-financing

• Article in draft for special edition of Health Policy and Planning – ‘minding the gaps’

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

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