Universal Health Coverage
Universal Health Coverage (UHC) means people having access to quality and affordable health care. Sexual and reproductive health and rights (SRHR) are an essential part of UHC. All UN member States have agreed to achieve Universal Health Coverage by 2030, as part of the Sustainable Development Goals.
According to World Health Organisation Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.
- 30 % of the world’s population still cannot access essential health services
- The COVID-19 pandemic further disrupted essential services in 92% of countries
- Almost 1 billion people spend at least 10 percent of their household budget to pay for health.
Without taking into account a population’s SRHR needs, UHC is impossible to achieve, as many of the basic health needs are linked to people’s sexual and reproductive health. Good sexual and reproductive health means that all individuals have a right to make decisions governing their body and to access services that support that right.
Agenda 2030 explicitly recognizes sexual and reproductive health as essential to health, development and women’s empowerment. In 2019 UN member states agreed that sexual and reproductive health is a component of UHC in the first ever High-level meeting (HLM) on Universal Health Coverage (UHC).
However, comprehensive Sexual and Reproductive Health (SRH) services are not included in health benefit package in many countries, especially in low- and middle-income countries.This leads to inequality in access to Sexual and Reproductive Health services and affects especially vulnerable groups; women and girls’, adolescent, LGBTIQ+ and people with disabilities.
Governments must ensure that everyone has equal access to quality health services across the life course. This needs to include comprehensive Sexual and Reproductive Health services such as (WHO):
- Contraception counselling and provision
- Fertility care
- Antenatal, intrapartum and postnatal care
- Safe abortion care
- Sexual function and psychosexual counselling
- Comprehensive education and information
- Gender-based violence prevention, support and care
- Prevention and control of HIV and other sexually transmissible infections (includes reproductive cancers)
Three cross-cutting principles: equity in access, quality of care and accountability, are key to acquiring a comprehensive approach to SRHR and to advancing both the SRHR aspects of Agenda 2030 and UHC reforms. These principles impact both the delivery of sexual and reproductive health services and the realization of individuals’ sexual and reproductive rights.
- Equity in access – Individuals in need of services can access them irrespective of their ability to pay, socioeconomic status, geographic location, ethnicity, education or gender and are empowered to use these services
- Quality of care – Commodities and facilities are of good quality and services are delivered in a safe, effective, timely, efficient, integrated, equitable and people-centred manner, based on care standards and treatment guidelines and taking into account people’s experiences and perceptions of care, including affordability and acceptability
- Accountability – SRHR is underpinned by human rights and political, financial and performance accountability, with inclusiveness and transparency at all levels of the health system, and ensuring that rights holders’ views and demands are captured and taken into account in planning and implementation
Sexual and Reproductive Health And Rights: An Essential Element of Universal Health Coverage (2019)
UNFPA has defined and described the key components of a comprehensive life course approach to sexual and reproductive health and rights. Furthermore, this document describes how countries can move towards universal access to sexual and reproductive health and rights as an essential part of universal health coverage and to provide inspiring examples from countries that have moved in this direction.
Universal Health Coverage (WHO 2019)