Why universal health coverage must include abortion
Abortion is health care, and health care is a human right. That’s why efforts to advance universal health coverage (UHC)—an international effort to guarantee that all people, regardless of where they live, have access to essential, quality health services without financial hardship—must include strong language defining sexual and reproductive health care, including abortion care, as an integral part of health and well-being. Ipas is committed to working with the World Health Organization, governments and other partners to attain the Sustainable Development Goal targets, which include achieving UHC.
“The world still has far to go to achieve gender equality,” said Ipas Senior Technical Manager for Community Engagement Tanvi Monga in a recent opinion for Global Health Now. “Women shoulder the burden of child care, elder care, household care, family health and health-care costs—and for poor or near-poor women anywhere in the world, health-care costs can cause irrevocable financial strain.” Plus, health-care services labeled as “for women” are frequently separated from other services—and are harder to access or more expensive.
An estimated 56 million induced abortions occur each year globally. “Long-term, sustainable and equitable access to sexual and reproductive health and rights (SRHR) can only be achieved when safe abortion care is not separated from other components of health care,” said Monga in blog post for Deliver for Good.
Ipas has worked in Nepal and Kenya to ensure that SRHR—including safe abortion care—is included in national commitments toward UHC.
Universal health coverage is a major priority of Nepal’s health strategy, and Ipas Nepal provided input to prioritize safe abortion care in Nepal’s Health Sector Implementation Plan 2016 – 2021. Ipas Nepal also successfully advocated for Nepal’s Basic Health Service Package—which mandates that government-prioritized health services be accessible for all—to include free safe abortion care up to 12 weeks of pregnancy at public health facilities. In 2019, the government of Nepal endorsed the Public Health Act and Safe Motherhood Reproductive Health Right Act, which provide “a strong legal and political basis for safe abortion care to be provided free of cost as a fundamental human right,” said Monga.
In Kenya, Ipas is on the National Task Force developing the Essential Benefits Package for UHC—which includes health services, medicine and commodities that will be available to all Kenyans, without causing financial hardship. Ipas is advocating for the inclusion of SRHR—including, at a minimum, family planning and postabortion care—to be covered under this package and the National Health Insurance Scheme. Ipas is also on an evaluation team studying UHC implementation in four pilot counties; the team will make recommendations for what can be improved at the national level.
These efforts in Nepal and Kenya demonstrate the power of advocacy to ensure that SRHR and access to safe abortion is not forgotten—and that no girl or woman is left behind. “Achieving UHC will only be possible if all girls and women have access to information and services and the self-efficacy needed to make informed decisions about their lives,” said Monga.
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