Sexual and reproductive health services in universal health coverage: a review of recent evidence from low- and middle-income countries

Ravindran, T. K. Sundari and Govender, Veloshnee, (2020). Sexual and reproductive health services in universal health coverage: a review of recent evidence from low- and middle-income countries. Sexual and Reproductive Health Matters, 28(2), 1-22

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  • Sub-type Journal article
    Author Ravindran, T. K. Sundari
    Govender, Veloshnee
    Title Sexual and reproductive health services in universal health coverage: a review of recent evidence from low- and middle-income countries
    Appearing in Sexual and Reproductive Health Matters
    Volume 28
    Issue No. 2
    Publication Date 2020
    Place of Publication Abingdon, UK
    Publisher Taylor & Francis
    Start page 1
    End page 22
    Language eng
    Abstract If universal health coverage (UHC) cannot be achieved without the sexual and reproductive health (SRH) needs of the population being met, what then is the current situation vis-à-vis universal coverage of SRH services, and the extent to which SRH services have been prioritised in national UHC plans and processes? This was the central question that guided this critical review of more than 200 publications between 2010 and 2019. The findings are the following. The Essential Package of Healthcare Services (EPHS) across many countries excludes several critical SRH services (e.g. safe abortion services, reproductive cancers) that are already poorly available. Inadequate international and domestic public funding of SRH services contributes to a sustained burden of out-of-pocket expenditure (OOPE) and inequities in access to SRH services. Policy and legal barriers, restrictive gender norms and gender-based inequalities challenge the delivery and access to quality SRH services. The evidence is mixed as to whether an expanded role and scope of the private sector improves availability and access to services of underserved populations. As momentum gathers towards SRH and UHC, the following actions are necessary and urgent. Advocacy for greater priority for SRH in government EPHS and health budgets aligned with SRH and UHC goals is needed. Implementation of stable and sustained financing mechanisms that would reduce the proportion of SRH-financing from OOPE is a priority. Evidence, moving from descriptive towards explanatory studies which provide insights into the “hows” and “whys” of processes and pathways are essential for guiding policy and programme actions.
    Keyword Universal health coverage
    Sexual and Reproductive Health
    Health financing
    Access
    Gender
    Copyright Holder The Authors
    Copyright Year 2020
    Copyright type All rights reserved
    DOI https://doi.org/10.1080/26410397.2020.1779632
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    Created: Mon, 03 Aug 2020, 15:05:36 JST by Nor Sazlin Said on behalf of UNU IIGH