“Access to sexual reproductive health is not just a right but a necessity for Universal Health Coverage (UHC) programs to succeed, especially for the growing number of girls reaching the reproductive age across the continent. There is particularly an urgent need for increased universal and youth friendly access to Sexual and Reproductive Health Care service” Read the opening remarks of the Africa Health Agenda International Conference (AHAIC) Preliminary report.
African countries are racing towards achieving UHC for all its citizens in a bid to also achieve Sustainable Development Goal 3. Despite the great momentum toward improving health coverage, millions of people in Africa lack access to services related to sexual and reproductive health (SRH). UHC cannot be achieved if access to quality sexual and reproductive health services is ignored.
The Africa Health Agenda International Conference (AHAIC) in Kigali sought to galvanize stakeholders to strengthen a multi-sectorial collaboration to achieve UHC including SRH Services.
In the spirit of leaving no one behind, delegates reckoned that SRH services and supplies must be included in the basic package of services offered under the UHC strategies, such as national health insurance: From the design phase, stakeholders must make evidence based decisions regarding what SRH services and supplies will be included in the basic package of services, to ensure that services reflect the needs of women, adolescents, and marginalized group.
To advance UHC, the specific needs and challenges facing adolescents must be addressed. Comprehensive Sexuality Education (CSE) empowers young people to safely and positively navigate their sexuality, contributes to safer sexual behaviors and leads to better health and wellbeing outcomes. CSE is a key component in the prevention of poor health outcomes and addressing the social drawbacks of health. Governments must make concurrent investments in CSE across health, education and related sectors to make the strongest possible contribution to health outcomes.
During one of the AHAIC breakout sessions on addressing cultural, social and age barriers to accessing health services in Africa, delegates agreed that such barriers to accessing SRH services must be addressed. They include low literacy levels, subordination within families and communities, violence, lack of partner or parental permission to access services, and stigma and discrimination based on gender and age. Even when high quality SRH services are available, women and young people may face specific barriers to accessing them.
AHAIC symposium; Achieving UHC by strengthening SRHR, organized by Swedish International Development Cooperation, SRHR Team, and UNFPA East and Southern Africa Regional Office (ESARO) and Embassy of Sweden highlighted that effective accountability mechanisms must guide the design and implementation of UHC programs: Regular monitoring and reviewing must be built into UHC programs to ensure that services reflect the needs of women, adolescents, and marginalized groups. In particular, the participation of civil society (including women’s and citizen’s groups, service providers, young people, and health professionals) in accountability for UHC can guarantee that the SRH priorities of the entire population aremet.
The symposium also highlighted the importance of data collection, and monitoring and evaluation systems for UHC that would include a range of indicators. These would be aimed at capturing whether women and adolescents, in particular, are able to access and receive quality SRH services. Indicators can include: service delivery indicators (contraceptive prevalence rate, unmet need for family planning); supply chain performance indicators (availability of medicines and supplies, supply chain responsiveness); health outcome indicators (adolescent birth rate); and equity indicators (gender disparities in impoverishment/financial protection for health, inequality for family planning coverage).
The symposium further suggested that the responsiveness of supply systems must be strengthened: This is necessary to avoid stock-outs of the essential medicines and supplies required to deliver quality SRH services. From the design phase, stakeholders must assess whether current supply systems are sufficiently robust to withstand the additional demands of the UHC strategy.
Embracing technological advancement was also discussed in one of the plenary sessions; (Leveraging technology and innovative models of service delivery to accelerate access) as a mechanism that would be essential in achieving UHC. Mobile Apps and messaging services to reach young people with SRH information was seen as a viable way to address myths and misconceptions that encroach use of family planning. This would enable young people to make informed choices about their bodies. In Uganda, for example, young people have developed mobile apps to monitor fetal distress, diagnose breast cancer, and disseminate information on HIV and AIDS.
Conclusion
Ensuring that all individuals are able access a minimum essential package of quality SRHR services and information will not only benefit broader aspects of health but allows gains in other development outcomes including gender equality, education, employment, sustainable and inclusive growth and poverty eradication.
"Health for all does not come automatically, we want to see not only political will but political leadership, strong investment and the voice of the people at every level of the process," H.E Mrs. Toyin Saraki, Founder The Well Being Foundation Africa
By Lorna Andisi,
Journalist - Right by Her Champion
Member of the IPPFAR Journalists' Network
