{"id":987668851,"date":"2023-11-28T13:10:05","date_gmt":"2023-11-28T12:10:05","guid":{"rendered":"https:\/\/p4h.world\/?p=987668851"},"modified":"2024-07-02T20:29:17","modified_gmt":"2024-07-02T19:29:17","slug":"gender-blindness-in-social-health-protection-could-deter-africas-progress-towards-universal-health-coverage","status":"publish","type":"post","link":"https:\/\/p4h.world\/en\/gender-blindness-in-social-health-protection-could-deter-africas-progress-towards-universal-health-coverage\/","title":{"rendered":"Gender blindness in social health protection could deter Africa\u2019s progress towards universal health coverage"},"content":{"rendered":"

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In recent years social protection has gained increased recognition as a powerful tool for poverty alleviation and vulnerability reduction. The International Labour Organization<\/a> acknowledges its significance, and it’s explicitly incorporated into the United Nations Sustainable Development Goal target 1.3-a commitment ratified by most African nations. In the context of health, social protection provides universal access to needed health care\u00a0that is affordable, available, of adequate quality and is provided with financial protection in times of illness, injury, and maternity[1]<\/a><\/sup>. Hence, effective social health protection programmes can contribute to accelerating a country\u2019s progress towards universal health coverage (UHC). The World Health Organization defines UHC<\/a> as all people everywhere receiving the health services they need, when and where they need them without financial hardship.<\/span><\/p>\n

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Many African countries are adopting government-sponsored health insurance to strengthen social health protection (SHP) and advance UHC[2].<\/a><\/sup> However, a significant portion of the population in many countries, particularly informal workers, remain uncovered because of unaffordable premiums. Only three countries \u2013 Algeria<\/a>, Tunisia<\/a> and Rwanda<\/a> \u2013 have over 80% of their population covered by their national health insurance (NHI), while in the rest\u00a0of African countries, the coverage range is 3%-62%.<\/a><\/p>\n

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There are also notable gender disparities in NHI coverage with women more likely to be excluded from NHI schemes in Africa for various reasons including the following three.<\/p>\n<\/blockquote>\n

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  1. Women are generally poorer than men<\/b>. In 2022, the UN Women and United Nations Development Programme projected that, compared to men, poverty<\/span><\/a> had deepened for women and girls and <\/span>that the majority (62.8%) of extremely poor women are in sub-Saharan Africa.\u00a0<\/span><\/span><\/li>\n
  2. Time use and labour market participation<\/b>. Related to the above, in sub-Saharan Africa, women make up more than 74% of the informal sector<\/span><\/a>. When it comes to caregiving, women<\/span><\/a> make up the majority of childcare givers\u00a0 <\/span>and caregivers during sickness. Many African countries do not have public financing systems for care work (both childcare and long-term care for the elderly). These realities limit a woman\u2019s participation in the formal labour force and their ability to contribute towards health insurance premiums or other costs such as copayments and travel expenses.\u00a0<\/span><\/li>\n
  3. Disease burden.<\/b> Compared to men, women carry a heavier disease burden such as maternal-mortality and morbidity. The findings from another study<\/span><\/a> suggest that overall prevalence of reporting of at least one noncommunicable disease was found to be higher in women as compared to men.\u00a0<\/span><\/li>\n<\/ol>\n

    [\/et_pb_text][ba_gradient_heading title=”Coverage is not enough; it matters what is covered” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=”HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”||10px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 4 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n

    Even in countries where NHI coverage is high, effective coverage is quite low. <\/b>Preventive health care services whose beneficiaries are mostly women and children are often excluded from health insurance benefit packages as discussed in a report by Abt Associates[3]<\/a><\/sup>. These services include family planning services and child immunizations.\u00a0<\/span><\/p>\n

    Recognizing the different needs that women and children have, some countries, including Uganda<\/span><\/a>, Sierra Leone<\/span><\/a> and Malawi<\/span><\/a>,<\/span> removed user fees for selected maternal and child-related services, including family planning services. \u00a0<\/span><\/p>\n

    Removing user fees is not enough.<\/p>\n

    [\/et_pb_text][ba_gradient_heading title=”Systemic challenges in user fee reforms undermine financial protection for women” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=”HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”15px||10px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 4 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n

    Evidence in Sierra Leone <\/span><\/a>and Malawi<\/span><\/a> shows that systemic challenges such as persistent drug stockouts and human resources shortages undermine user fee reforms. This is because women are prescribed medication they must buy from a pharmacy or private provider. If they lack the financial means to do so, they risk incurring catastrophic health expenditures for their households.<\/p>\n

    [\/et_pb_text][ba_gradient_heading title=”Potential strategies for promoting equity and access in SHP” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=”HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”||10px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 5″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n

    To promote greater equity and access to health care, several potential strategies could be pursued.<\/p>\n