Research for stronger health systems during and after crisis

Employment-based health financing does not support gender equity in universal health coverage

Global commitments to improve women’s access to healthcare have been made repeatedly, most recently through the sustainable development goals and the 2019 political declaration on universal health coverage. These commitments echo the vision of the 1995 Beijing Declaration to ensure that women access equitable, appropriate, affordable, and quality healthcare throughout their life. Yet, 25 years later, women remain disproportionately underserved, and their basic health needs remain unmet. This paper explores why this is and found the following:

  • Progress towards universal health coverage needs financing systems that ensure women’s access to equitable, appropriate, affordable, and quality healthcare throughout their lives.

  • Women’s access to healthcare is threatened when it is linked to their employment terms, because women face more employment insecurity and transitions across their work lives, including for reproduction and unpaid care work.

  • Gender equitable universal health coverage reforms are needed to ensure continuity of access to high quality health benefits and financial protection during changing circumstances, such as work transitions.

  • Reforms should also be based on principles of accountability, non-discrimination, valuation of unpaid care work, and an evidenced based understanding of intersecting inequities

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  • Lavanya Vijayasingham, Postdoctoral fellow1*

  • Veloshnee Govender, Scientist2

  • Sophie Witter, Professor of International Health Financing and Health Systems3

  • Michelle Remme, research lead - gender and health1

1 United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia
2 World Health Organization, Geneva, Switzerland
3 Institute of Global Health and Development, Queen Margaret University, Edinburgh, UK

* Correspondence to Lavanya Vijayasingham