This post is part of the Woman-Centered Universal Health Coverage Series, hosted by the Maternal Health Task Force and USAID|TRAction, which discusses the importance of utilizing a woman-centered agenda to operationalize universal health coverage.
Who is accountable for the young woman dying during childbirth in a hospital in Lusaka, Zambia? For the woman in a health center in Bugiri in Uganda? For the girl child in a rural home in Uttar Pradesh, India? In a shanty town in Tegucigalpa, Honduras? Who is accountable for the women and adolescent girls in a thousand places everywhere?
The burden of ensuring safe delivery does not fall solely on the shoulders of women and girls, but falls on all of us. Whether we are policymakers, service providers, development workers, husbands, fathers or mothers-in-law, we can all make a difference. It is our responsibility to do so. As a society, we owe it to women to ensure they have a safe delivery and access to family planning information and services.
Complications from pregnancy and childbirth are the leading cause of death among women and female adolescents in their reproductive years in low- and middle-income countries. Both family and cultural structures, as well as the health system, fail many women and girls, especially those living in rural and hard-to-reach regions. This is evidenced by the father who married off his daughter when she was a child, the husband who would not let his wife go to a health facility and a lack of affordable, accessible, quality facility-based care. These factors—in addition to ill-equipped clinics, poorly trained health workers and cultural perceptions that childbirth does not require skilled care—contribute to the high maternal mortality rates in developing countries.
We have the responsibility to hold policymakers accountable for reforming health systems in pursuit of universal health coverage (UHC), which will transform populations’ health and save women’s and children’s lives. UHC shifts the burden of health costs from women to society and in a small way, shows our gratitude to women for giving life. UHC recognizes that women should not be neglected when they give birth and that women should not die while giving life. The responsibility of caring for women during delivery is a societal debt paid partly by eliminating the obstacles to safe, skilled and respectful care during childbirth.
Because women often bear the greatest share of the economic costs associated with their families’ health, UHC can also have a proportionally greater effect on women by dramatically reducing their out-of-pocket costs and offering financial protection.
Low-income countries must start with modest but high-impact services. A core package of services for reproductive, maternal and child health driven by community health workers provides the logical cornerstone of UHC plans.
Family planning should be non-negotiable and included in even the most frugal UHC plans. Everyone has the right to access family planning services, which includes the ability to choose when and how to utilize a variety of options. Fulfilling the unmet need for family planning alone would prevent 150,000 maternal deaths and 640,000 newborn deaths globally each year.
Through UHC, health systems can be strengthened to ensure that frontline health workers are in the right place at the right time to deliver the right services effectively.
Who is accountable? We are. UHC that delivers for women and girls in the post-2015 era requires us all to be accountable. We must embrace this responsibility to accompany, support and empower women and adolescent girls on this journey fraught with both barriers and possibilities.