Accelerating action towards universal health coverage by applying a gender lens.

Perspectives There is a burgeoning movement towards universal health coverage (UHC) – both at the national and the global political level – that seeks to ensure that all people everywhere receive the health services they need without experiencing financial hardship. The 25 wealthiest nations all have some form of universal coverage, as do several middle-income countries, including Brazil, Mexico and Thailand, and lower-income nations, such as Ghana, the Philippines, Rwanda and Viet Nam, are working towards achieving UHC. 1 Action to accelerate work towards UHC is also taking place at the global policy level as evidenced by the 2011 World Health Organization Resolution on UHC, the 2012 United Nations Resolution on UHC and the inclusion of UHC in debates on the post-2015 agenda. In many ways the UHC movement builds on the 1978 Declaration of Alma Ata, which reaffirmed that health is a human right and identified primary health care as the means for attaining " health for all ". However, UHC does not necessarily guarantee universal access to health services. Thus, as countries develop strategies for transitioning towards UHC, it is critical that government leaders and policy-makers take into consideration the unique health needs of women, who make up 51% of the world's population and 60% of the world's poor. Biological and gender-based differences between women and men result in differences in health risks, disease incidence and health service needs. For example, women are 1.2 times more susceptible to infection with the human immunodeficiency virus (HIV) than men and this difference is even more marked in adolescence. 2 Gender-based differences exist in terms of access to and control of household resources; power and decision-making within and outside the home; and roles and responsibilities within the family, the community and the labour market. In addition, in some places women are less able to move about than men because of social norms that prohibit them from travelling alone, lack of money for transportation or the opportunity cost associated with travel time. All of these gender-related factors have a decisive influence on health-seeking behaviour, health status and access to health services. Millennium Development Goal Three – to " promote gender equality and empower women " – seeks to address the barriers that hinder equal access to health services for men and women. Thus, if countries are to accelerate action towards achieving UHC and meet their targets for increasing access to health services, …