Presentation given by Sophie Witter for DFID lunchtime seminar on 19th January 2016

1. Health financing & UHC –
what’s gender got to do
with it?
Sophie Witter
January 2016

2. Background: webinar panel, 1 July 2015
Introduction to health financing and
UHC
Rob Yates,
Chatham House, UK
Gendered questions related to health
financing and gaps in health literature
Sophie Witter,
Queen Margaret University, UK
Gender implications of health financing
reforms
Veloshnee Govender, University of
Cape Town, South Africa
Lessons on health sector reforms and
gender from India, and lessons for UHC
TK Sundari Ravindran,
Sree Chitra Tirunal Institute for Medical
Sciences and Technology, India
Commentary Sarah Ssali,
Makerere University, School of Women
and Gender Studies, Uganda
Q&A

3. Webinar process
and outputs
• X people participated; positive feedback – mostly
excellent ratings, some good
• Video of webinar, webinar slides, storify and blog
relating to it all posted on RinGS site:
http://resyst.lshtm.ac.uk/resources/gender-and-health-systems-financing
• Article in draft for special edition of Health Policy
and Planning – ‘minding the gaps’

4. Some core insights
– minding the
(research) gap
• Need for more cross-cutting of silos: shocking that work on
health financing and gender is so limited
• Most work as been done on user fees and gender and
household impacts, plus some analysis of funding allocations
to MCH/RH
• All other areas remain under-explored – especially on
resource allocation, purchasing, benefits packages and
governance
• Also need more investigation of gender implications of
different health financing reforms and relationship between
gender equity and UHC

5. Core insights – minding the
(equity) gap
• Gender-based vulnerabilities not factored into the design of health
financing schemes (e.g. high % of women in informal sector)
• Education, employment & wealth do not mean that women automatically
have access to cash - critical consideration for UHC
• Addressing unintended consequences, e.g. insurance packages with
limited household numbers & adverse effects
• UHC requires an essential health package that goes beyond maternal
health & addresses women's needs across the life cycle (including routine
SRH services)
• Abortion remains very contested service, even in countries which have
comprehensive packages
• Market failures, e.g. gender-biases and profit-seeking combine to produce
peculiar distortions (e.g. unnecessary hysterectomies)
• To operationalise 'progressive universalism' we must engage with the
politics, as well as underlying social determinants