Universal health coverage, gender equality and social protection: A health systems approach

Against the backdrop of the 2030 Agenda for Sustainable Development and the Sustainable Development Goals (SDGs), this discussion paper focuses on the interconnections between policies to move toward universal health care (UHC) as a key element of social protection and those to advance gender equality, women’s empowerment, and human rights. We examine whether the experience with UHC has been gender-aware in its conceptualization and gender-responsive in its implementation. We argue that a human rights-based approach with an emphasis on the importance of solidarity is needed. We show that standard approaches to achieving UHC often exclude or marginalize gender concerns when framing problems, identifying and gathering data and evidence, and, consequently, in designing programmes and policies. We also argue that considering all elements (not just one or two, such as financing) of a health system and its functioning is necessary to advance towards UHC. Based on an analysis of country experiences, we show how gender is a key fulcrum on which all health system elements are leveraged and is hence central to achieving UHC.