Universal Health Coverage (UHC) is a global commitment to ensure that all individuals and communities receive the health services they need without suffering financial hardship. The best framework that countries have in ensuring people’s health and wellbeing is through Universal Health Coverage (UHC), which the World Health Organization (WHO) describes to mean that “all individuals and communities receive the health services they need without suffering financial hardship.”
However, for UHC to be truly inclusive, it must encompass comprehensive Sexual and Reproductive Health and Rights (SRHR). This integration is essential for addressing the unique health needs of marginalised populations and promoting gender equality.
The Intersection of SRHR and UHC
While UHC focuses on financial access to health services, SRHR emphasises the availability, acceptability, and quality of services, particularly for women, girls, young people and marginalised groups in all their diversities. In many developing countries in Asia and the Pacific, SRHR services such as contraception, and abortion are often excluded from insurance coverage and healthcare, leaving these essential services inaccessible to those who need them most. This exclusion perpetuates health inequities and undermines the goals of UHC.
Moreover, UHC initiatives must be designed to address non-financial barriers such as discrimination, stigma, and cultural norms that hinder access to SRHR services. Without deliberate efforts to include comprehensive SRHR services in UHC frameworks, existing inequalities may be reinforced, rather than alleviated.
Challenges Faced by Marginalised Populations
Marginalised groups, including rural women, indigenous peoples, and migrants, individuals in all their diversities, often encounter systemic barriers to accessing SRHR services. These barriers include discriminatory laws, cultural stigmas, and a lack of provider training, leading to poor health outcomes and perpetuating cycles of poverty and exclusion.
For instance, in some countries, laws restrict access to SRHR services for unmarried individuals or criminalise certain sexual behaviors, further marginalising those who are already vulnerable. Such legal and social frameworks not only deny individuals their rights but also exacerbate health disparities.
The Role of Gender and Social Norms
Gender inequality and rigid social and gender norms significantly impact access to SRHR services. Across all wealth quintiles, women often experience higher unmet needs for health services compared to men. Traditional gender roles and expectations can limit women and girls’ autonomy over their bodies and health decisions, leading to delayed or denied care.
Policies must challenge and transform these harmful norms by promoting gender-sensitive, rights-based approaches that empower individuals to make informed choices about their sexual and reproductive health.
The Need for Inclusive Health Systems
To realise UHC that truly serves all, health systems must be inclusive and responsive to the diverse needs of the population. This includes integrating comprehensive SRHR services into primary health care, ensuring that health care providers are trained to offer non-discriminatory, culturally competent care, and implementing accountability mechanisms to monitor and address gaps in service delivery.
Additionally, policies should be reformed to protect the rights of marginalised groups and ensure their access to essential SRHR services. This requires political will, community engagement, and sustained advocacy to create an enabling environment for equitable health care.
Conclusion
Achieving UHC is not merely about expanding health coverage; it is about ensuring that all individuals, regardless of their background or identity, can access the sexual and reproductive health services they need. By integrating comprehensive SRHR into UHC frameworks, we can build health systems that are just, equitable, and truly inclusive.
The Asian-Pacific Resource and Research Centre for Women (ARROW) remains committed to advocating for policies and practices that uphold the sexual and reproductive rights of all individuals, particularly of women, girls and young people in all their diversities.
Globally, ARROW is the only regional organisation that has consistently conducted five-yearly research and monitoring of the International Conference on Population and Development (ICPD) Programme of Action (PoA). We have consistently monitored the implementation of SRHR in Asia and the Pacific region to assess progress and also the lack of progress in select countries with the support of national-level partners.
