2019 is the year of Universal Health Coverage (UHC). Achieving inclusive healthcare provision means that all people can obtain the quality, accessible and comprehensive health package services they need without suffering financial hardship. This can be done through increasing services covered, extending coverage to those individuals who previously were not covered and/or reducing cost sharing and fees.
With more than 200 million women unable to access modern contraceptives, 45 million receiving inadequate or no antenatal care and more than 30 million not delivering in a health facility in developing countries, these are clear indications of the gaps and failures that exist in addressing basic and comprehensive Sexual and Reproductive Health and Rights (SRHR) services, especially among women and young girls. Sexual and reproductive health and rights are fundamental to people’s lives and well-being, a corner-stone in the advancement of social, political and overall economic progress in any nation or region. Fully meeting the needs for sexual and reproductive health services in developing countries would have a tremendous positive impact; maternal deaths would drop by 60%; newborn deaths would drop by 75%; significant reduction in physical and mental disabilities related to pregnancy and delivery by both women and newborns and; mother-to-child HIV transmission would be nearly eliminated.
As more and more African Countries set the ground to implement UHC, it’s an opportune time to address the place of SRHR within national health frameworks, policies and practices. Already, the African Population Health and Research Centre’s (APHRC) engagements with partners and evidence make a strong economic, social and political case for sexual and reproductive health as key to realization of the overall sustainable development agenda, UHC being one of the target under goal 3.
On March 4 2019, APHRC in collaboration with SIDA, UNFPA, and SRHR Africa Trust convened one-day meeting with 48 SRHR advocates from across Africa, to discuss the place of sexual and reproductive health in current UHC discourses, and the policy opportunities that exist to advance the provision of these rights within an inclusive healthcare context. The workshop was held on the eve of the Africa Health Agenda International Conference (AHAIC), whose main focus for 2019 was multi-sectoral action to achieve Universal Health Coverage. Through interactive, engaging and challenging discussions, the national and regional SRHR champions identified the existing gaps and opportunities needed to advance health for all through sexual and reproductive health interventions at national, regional and global levels. These include strengthening advocacy skills, technical understanding of UHC and, development of accountability mechanisms. There was a general understanding that UHC can be approached from a human rights and economic gains perspective and these would need to be balanced appropriately.
The 2018 Guttmacher-Lancet Commission estimates that only US $ 9 per person annually would cover the total cost of meeting a women’s needs for contraception and provide essential healthcare services for pregnant women and newborns. Furthermore, evidence shows that investments in SRHR cuts across generations and facilitates the achievement of other development goals making it a worthwhile investment. Therefore, designing UHC frameworks needs to take into account cost-effective approaches and investments- focusing on sexual and reproductive health provides a channel for this.
Recognizing its complexity, continuous engagement of all stakeholders including community and civil society, will serve to accelerate progress towards universal SRHR improving health equity, sustainable financing of critical SRH services; and defragmentation of multiple planning, financing, and delivery systems as a path to realization of UHC and the wider development goals in Africa.