Achieving health equity: the place of sexual and reproductive health services

This blog post was written by Youth Coalition member Anna Szczegielniak. Anna graduated from Medical School at the Medical University of Silesia, and holds a MSc in Physiotherapy from Opole University of Technology. She currently works as a psychiatry trainee and conducts PhD research in the field of sexology in Poland.

According to the World Health Organization (WHO), around 50% of the global population do not have access to essential health services, and for many people the costs related to healthcare procedures are the sole reason of living in extreme poverty. (1) Acknowledging that health is at the foundation of sustainable development led to increased interest around Universal Health Coverage (UHC), which focus on intersectionality of health, economic empowerment, gender equality, inclusive growth, quality education, environmental protection, and poverty eradication. There is a growing consensus that the discussion around UHC is up-to-date and essential, proving it to be both a mean to achieve Sustainable Development Goals (2), as well as a target itself. Some critical comments (3) were mostly connected to possible widening the medical services available at the expense of prevention and health promotion, which may lead to worse health outcomes that would favour wealthier part of society.

The question ‘what is the role of sexual and reproductive health in relation to UHC?’ (4) becomes relevant when discussing possible packages of services offered in every country that are defined as affordable, available, acceptable and of a good quality for all while addressing social determinants of health. Core package of basic services must always contain sexual and reproductive health and rights information and medical procedures (5). It seems that especially in relation to the medical services, those who are at the moment most remote from available health facilities should be a priority in addressing the needs to make sure we are not falling into the trap of reaching only those who have already been covered. Making governments accountable for strengthening network of basic procedures in primary healthcare facilities and on community level is the responsibility of civil society. (6) It is also our responsibility to make sure that policy makers and all stakeholders do understand the importance of social determinants of health for the concept of the UHC; and how sexual and reproductive health services, along with Comprehensive Sexuality Education (CSE), link with them, especially in regards to education, gender inequalities, stigmatization, and challenging social norms. It is essential to understand that we need to focus to empower people and make sure they can make conscious decisions regarding their own bodies, not leaving any “controversial topics” behind (such as safe and legal abortion, contraception). Only by reaching marginalized groups and delivering comprehensive package of sexual and reproductive health services we can improve overall health outcomes.

The World Health Organization (WHO) was established in 1948 from the need to recognize access to health as a fundamental human right and to ensure the availability of the essential services on the highest  possible level for everyone without discrimination and financial discomfort. It was decided that the way to achieve goals is goes through, among others, fostering international collaboration, shaping research questions, watching over quality and accessibility of basic health knowledge, promoting evidence-based health policies, as well as monitoring health trends globally. Every year on 7th April, to commemorate this moment, we celebrate World Health Day with different topics that fit into current health-related challenges across the globe. Last year depression was in the spotlight as the leading cause of disability worldwide. This year, on 70th anniversary of World Health Organization, under the slogan “Health for All” we have found much needed discussion on Universal Health Coverage that goes beyond financial mechanism (7) and focus on inclusion with reaching out in active manner to those most vulnerable.

Bibliography:

  1. World Health Organization, World Health Day 2018 website (Campaign Essentials, Fact Sheet, Key Messages) http://www.who.int/campaigns/world-health-day/2018/en/
  2. High Level Dialogue on Health in the Post-2015 Development Agenda (2013) Health in the post-2015 agenda.
  3. Schmidt, Harald and Gostin, Lawrence O. and Emanuel, Ezekiel, Public Health, Universal Health Coverage, and Sustainable Development Goals: Can They Coexist? (June 29, 2015). The Lancet, Published Online June 30, 2015.
  4. Countdown 2030 Europe, Action for Global Health. Universal Health Coverage: Sexual and Reproductive Health and Rights on the Agenda. 25 April 2017. http://www.countdown2030europe.org/storage/app/media/universal-health-coverage-srhr-on-the-agenda-afgh-countdown2030.pdf
  5. Quick J, Jay J, Langer A (2014) Improving Women’s Health through Universal Health Coverage. PLoS Med 11(1): e1001580.
  6. Tangcharoensathien V, et al. Accelerating health equity: the key role of universal health coverage in the sustainable development goals. BMC Med. 2015;13:101..
  7. World Health Organization (2010) Health systems financing: the path to universal coverage. Geneva: WHO.