Reproductive Health is an Essential Part of Universal Health Care

by Gina Myllymäki

Comprehensive sexual and reproductive health and rights (SRHR) need to be included in any system of Universal Health Coverage (UHC). The current global covid-19 pandemic has affected sexual and reproductive health services and sexual rights everywhere. 

The emerging global phenomenon of covid-19 has diminished access to SRHR, especially in low- and middle-income countries. It has also exacerbated existing inequalities for women and girls, as well as discrimination of other marginalized groups including LGBTQ+ people, people living with disabilities, older people, migrants, refugees and those in extreme poverty. 

In many countries, clinics that offer sexual and reproductive services have closed down due to a lack of resources. This might lead to growing numbers of unintended pregnancies, maternity deaths and unsafe abortions. In addition, there have been reported shortages of medications – such as contraceptives, antiretrovirals for HIV/AIDS and antibiotics to treat STIs – due to disruption in supply chains. This is not only a problem in the global South but also in developed countries. For example, in the USA and Poland, policymakers and conservative movements are using covid-19 as an excuse to tighten abortion policies and legislation. 

It is important to recognize SRHR as an essential part of UHC to make sure these services are provided for everyone and all the time. The world has committed to achieve the UN sustainable development goals (SDGs) by 2030. UHC is a crucial part of SDGs that cannot be achieved without acknowledging UHC that includes SRHR. 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. Similarly, universal access to SRHR cannot be achieved without countries defining a pathway towards UHC, which includes prioritizing resources according to health needs.

Policymakers, providers and advocates must be aware of the broad links between the global outbreak response and SRHR  in order to prepare to mitigate the impact. All countries have to implement a comprehensive approach to SRHR which is based in  human rights. These services need to be included in the national health care system in a way that it fulfils the standards of UHC as defined and committed in the 74th session of United Nations General Assembly (2019), where world leaders made a political declaration recommitting to achieving UHC by 2030. This includes financial risk protection, access to high-quality essential health-care services and access to safe, effective, high-quality and affordable essential medicines and vaccines for all.

This requires international cooperation and financial support to low- and middle-income countries to make sure UHC is reached globally. Funding should be targeted in a way that increases domestic capacity to implement UHC, including a comprehensive approach to sexual and reproductive health services and ensuring everyone’s sexual rights across their life course. This requires global actors to meet current funding commitments, and national governments to increase domestic public financing, and fulfilling their commitments to international organizations such as the UN and WHO. Also, it requires a global acknowledgement that SRHR  are fundamental to development and human rights, including the right to a safe abortion and comprehensive sexuality education, as agreed in 1994 at the International Conference on Population and Development (ICPD). Recognizing and implementing SRHR as part of UHC is the only way to ensure that these services and rights are secured all the time, and for everyone. 

Photo credit: Flickr / Marc Nozell