Health sectorreformsnadia

Women’s Global Network Women’s Global Network for Reproductive Rights for Reproductive Rights

(WGNRR)(WGNRR)

WGNRR Health Sector Reforms - Women Pay the Price

Health Sector Reforms: Women Pay the Price

Sexual and Reproductive Rights Women’s Access to Health Health Sector Reforms

What? Why? Women paying the price...


Sexual and Reproductive Health

and Rights

Series of basic human rights which enable women to “have a safe, responsible and fulfilling sex life, and the freedom to decide if, when and how often to have children” (WHO)


Sexual and Reproductive Health

and RightsExamples:

• safe pregnancy and childbirth• safe, legal and voluntary abortion• sexuality education and information• safe and voluntary contraception• good quality health services• sexual self determination• protection against sexual violence


Sexual and Reproductive Health and Rights

ICPD (1994) - governments must make reproductive health accessible through PHC system before 2015.

Beijing (1995)-autonomy, empowerment and self-determination of women are cornerstone of all health and population programs - life-cycle approach

MDGs (2000)


Sexual and Reproductive Rights

Without the fulfilment of sexual and reproductive rights,

the right to health cannot be fulfilled.


Women’s Access to Health

Specific health needs of women:

- sexuality and reproductive system

- violence

- position in society (cultural, religious,

economic, political)

- less opportunities to access health services

- care takers of others in family and society



Limited by:• Growing poverty (70% women)• Low social status of women (last to eat food in family)• Wars and conflicts, increased violence• Religious fundamentalisms• Lack access to essential services like water (result of

privatization) • Rise of communicable diseases like AIDS

(most new infections with women)• Population policies (targets)



Limited by:lack of (access to) health services

- no SRH & maternal services- lowering health budgets- privatization- user fees- lack quality of services (no control system)- no women-friendly / youth friendly services


Health Sector Reforms

- Since 1980s (reaction to debt crisis)- Part of neo-liberal agenda of

international institutions(World Bank, IMF, regional development banks, donor governments)

- Introducing market-mechanism into health care provision ( private sector & competition)


Health Sector Reforms: Why?

Reasons behind HSR: cost-effectiveness of health sector efficiency of health sector


HSR: What’s the price?

- health as a commodity instead of a right, leading to less access for the poor

- Lack of mechanisms to control quality of care

- unregulated health market is largely ignored by HSR (in parts of Africa 80% of pop. uses traditional medicine for PHC). Results differ / unknown.


HSR: Women pay the price

As health services are decreased, much of the work is transferred from the formal health-care system to the informal (and usually unpaid) care system = women

HSR lead to less services / clinics = women are less mobile (time, culture, money) so have less access



HSR lead to decrease in preventive and promotive care, especially SRH services (abortion, violence prevention, sexual health services for adolescents)

User fees limit access to maternal health services: in Nigeria maternal deaths increased by 56% after introduction of user fees (1983-1998)



Sometimes exemptions are in place, but often women are not informed.

Sometimes national health insurances are in place, but women rarely profit (deliveries and abortions not included, women of reproductive ages not included, only formal sector included)


What to lobby for?

Demands on governments:1. take responsibility for women’s health2. develop more gender sensitive policies3. Health budgets be increased with earmarked budgets

for women’s sexual and reproductive health4. Quality of health services be prioritised over targets5. Health is recognized in a holistic and integrated

manner (incl. preventive, promotive, curative)6. Participation of women in all levels


Time for Action!

Put people first, not profit!

HEALTH FOR WOMEN; HEALTH FOR ALL.

Thank you

Health sectorreformsnadia

Health & Medicine

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