Setting the Feminist Agenda: Universal Healthcare and Women

Published By

Women in Global Health

Published Date

June 25, 2020

At today's webinar hosted by the National Women's Council of Ireland, Women in Global Health Deputy Director Sarah Hillware offered the following remarks:

Distinguished fellow panelists and guests, it is a privilege to be here today. Sincere thanks to the National Women's Council of Ireland for having me, and congratulations on 45 years. Women in Global Health is a global movement which challenges power and privilege for gender equity in health. We mobilize, advocate, garner commitments on gender equity from key global health institutions and hold them accountable. We also co-convene the newly formed Alliance for Gender Equality and UHC with the International Women's Health Coalition, Women Deliver, SAMA India and SPECTRA Rwanda to ensure gender equality and women's rights, including SRHR, are mainstreamed throughout the UHC political agenda.

Let's start with the good news: there is a vibrant global movement of women in health actively organizing around basic health rights, and especially in the wake of COVID-19, women are actively working across borders in solidarity, sharing knowledge and resources and organizing around health for all. There is also a growing recognition that women are the majority in health and social care. Now is our time to lead.

The bad news: globally, women's rights and gender equality is still seen as a technical, siloed issue. This is magnified during COVID-19, when we've been hearing from governments that now is not the time to focus on gender equality. Our message to the world is this: If not now, then when? If not this pandemic, which one? Unless gender equality is viewed as a foundational pillar of any health system, we will continue to miss the mark. At a time when women are being disproportionately impacted by COVID-19, we must change the narrative and view women as leaders and part of the solution, not as victims or beneficiaries.

Make no mistake: UHC will be delivered by women. Women health workers currently deliver services to around 5 billion people and comprise 70% of the health and social care workforce, yet occupy only 25% of leadership roles in health. To build back better post-pandemic, we must challenge power and privilege in health to ensure women are at the decision-making table, in both the design and delivery of health systems. We won't achieve health for all unless we can reach the most marginalized girls and women, and connect local reality to policy, hardwiring rights and agency across the board, and safeguarding access to services, especially sexual and reproductive health.

Let me be clear: UHC will not be achieved anywhere, in high-income and LMICs alike, without addressing gender equality, women's rights and the role of women in the global health workforce.

I have six key points:
MAINSTREAM a gender perspective in UHC design, delivery and monitoring with a view to achieving gender equality and the empowerment of women in health policies and systems: this will require radical, deliberate action and will entail women playing an equal part in UHC leadership at all levels from community to global. Global health will look different and be different.

INTEGRATE SRHR into UHC and by 2030 ensure universal access to sexual and reproductive health care services: this will require action at national level to integrate SRHR into national UHC plans and to embed the wider rights needed to underpin this, particularly for women, girls and youth.

PROTECT health workers from all forms of violence and ensure safe and decent working conditions and enable female health workers and address barriers to leadership and decision making. Women account for 70% of all health and social care workers but hold only 25% of leadership roles. If women are to fill the 18 million health worker jobs needed to reach UHC, urgent action will be needed to address gender gaps in leadership and pay as well as the discrimination, bias and lack of family-friendly policies that constrain their careers.

COMMIT to recording, recognising and rewarding women's unpaid work in health and social care, estimated at half the US$3 trillion women contribute. One of the serious omissions in the UHC Political Declaration is that health systems are currently subsidised by this unpaid work, such as caring for elderly parents which predominantly falls on women, which takes women out of the paid labor market and girls out of school and needs urgent action.

FUND women's organisations at community, national and global levels: OECD data shows that increased funding was allocated to gender equality in 2016-17 but only 1% of gender focused aid went to women's organisations. The feminist organisations that have driven gender equality and rights for decades need substantial, long term funding to enable them to scale up their work in health and social care. The story of the UHC process over this last year highlights the political and technical role played by women's movements and organisations, particularly those in the Alliance for Gender Equality and UHC, in keeping gender equality and the rights of women and girls on the UHC agenda.

INCLUDE women's voices and leadership in all UHC conversations. This includes gender parity, diversity and inclusion in all conversations. We must ensure that women and other underrepresented groups are at the decision-making table to ensure “leave no one behind” is being implemented from design to delivery.

The bottom line is: gender equality and women's rights in UHC drive better health for all. This is everybody's business.