How are countries integrating sexual and reproductive health and rights into Universal Health Coverage – and why does this mean a healthier world for all?
When sexual and reproductive health services are integrated into universal health coverage, all people, everywhere, can get the quality care they need without financial hardship.
“Every individual on the planet has sexual and reproductive health needs, which change throughout their lives,” said Ian Askew, Director of the WHO Department of Sexual and Reproductive Health and Research, including the UN Special Programme HRP.
“For all people to benefit from universal health coverage, countries are addressing the challenge of integrating services which meet those needs within each country’s specific political, social, cultural, gender, economic and financial circumstances to protect the human right to the highest standard of sexual and reproductive health.”
The WHO Compendium: interventions for UHC, including sexual and reproductive health
The United Nations Political Declaration on UHC commits to a healthier world for all by 2030. A powerful new tool to support this work launches on December 14th, following Universal Health Coverage Day: the WHO UHC Compendium of Health Interventions. It can assist countries in decision-making, prioritization and planning processes around packages of health services for UHC.
Universal access to sexual and reproductive health services, and the promotion and protection of human rights, dignity, and empowerment of all people, are globally-agreed commitments underlying UHC, and the WHO UHC Compendium includes many interventions that reflect these priorities.
Pregnancy and birth, sexual well-being, reproductive choice, reproductive cancers, violence against women, and sexually transmissible infections are key areas for health interventions, recognized in the WHO Reproductive Health Strategy and the Sexual health and its linkages to reproductive health: an operational approach.
To ensure that these priorities are easily identified and addressed in national planning for UHC,Sexual and reproductive health interventions in the WHO UHC Compendium is now published alongside the Compendium.
The impact of COVID-19 on sexual and reproductive health services
COVID-19 has disrupted delivery of essential health services in many countries and stretched resources to the limits.
However, it has also show that long-term investment in primary care and public health functions can build a resilient health system; one that continues to provide people with the health services they need, when and where they need them, without financial hardship.
“Thailand has been able to maintain service provision during the pandemic as a result of UHC and health systems capacity - and in some instances at slightly higher levels,” said Warisa Panichkriangkrai, International Health Policy Program, Ministry of Public Health, Thailand.
“The National Health Security Office's monitoring system shows that coverage of standard antiretroviral therapy (ART) for persons living with HIV was 85.3% in 2019 and 88.5% in 2020. Average quarterly cervical screening coverage was 38.7% in 2019 and 39.7% in 2020,” added Viroj Tangcharoensathien, also at the Ministry of Public Health.
Country context: expanding UHC through health benefit packages
Universal Health Coverage: Sexual and Reproductive Rights in Focus, a new supplement published in Sexual and Reproductive Health Matters (SRHM), shows that when it comes to this global commitment, countries are at different stages of progress: towards UHC generally, and comprehensive, rights-based sexual and reproductive health services specifically.
Ministries of health are increasingly focusing on sets of services that can be realistically financed and delivered to meet a particular population need.
“Since 2016, the government of Burkina Faso has introduced a package of free healthcare for pregnant women and children under 5, which includes screening and treatment for cervical cancer. Family planning has been declared free in all regions of the country since July 2020. The goal is to reduce the burden of maternal and infant mortality and morbidity,” explained Dr Dina Gbenou, Technical Officer, SRHR, WHO Office, Burkina Faso.
“WHO, in collaboration with H6 Partners, is supporting the country on expanding the health benefits package and ensuring funding sustainability in the overall context of universal health coverage are as national priorities of the government,” she added.
Such packages vary across settings, depending on health systems capacity, resource availability, priorities – and leadership, which is critical.