How Listening to Women’s Voices Will Help Achieve Universal Health Coverage

By Amanda Livingstone, Advocacy and Programs Associate, White Ribbon Alliance

 What Women Want... in Kenya. Photo credit: WRA Kenya.

What Women Want... in Kenya. Photo credit: WRA Kenya.

At least half of the world’s population doesn’t have access to fundamental health services, and many are driven into poverty by out of pocket health expenses. Achieving universal health coverage — and Sustainable Development Goal 3, to ensure healthy lives and ensure well-being for all — will require a coordinated effort across sectors, including financing for health, ensuring adequate numbers of trained health workers and the provision of medicines and supplies, to name a few. But at the heart of all health efforts are the people themselves, which is why we must start with understanding their needs. A global campaign launched on International Maternal Health and Rights Day, What Women Want: Demands for quality reproductive and maternal health for women and girls, offers valuable insights for everyone working to achieve universal health coverage.

Despite significant progress, the current state of reproductive, maternal and sexual health for women and girls is far from optimal: Approximately 300,000 women die during pregnancy and childbirth every year. Millions still lack access to quality reproductive and sexual healthcare, 200 million of which lack adequate coverage for family planning[1]. And for girls age 15 to 19 years old, complications during pregnancy and childbirth are the leading cause of death.

Transforming this picture begins with women and girls.

 Volunteer helping find out #WhatWomenWant in Abuja, Nigeria. Photo credit: WRA Nigeria.

Volunteer helping find out #WhatWomenWant in Abuja, Nigeria. Photo credit: WRA Nigeria.

When women and girls are involved in identifying the barriers and solutions to healthcare, progress accelerates. Increasing access to health facilities means little if an adolescent girl is disrespected and abused while receiving health services. Decreasing out of pocket spending means less to a pregnant woman if she must wash her own sheets after giving birth. Understanding high-quality services to mean that people are correctly diagnosed and receive necessary and agreed-upon interventions[2] does not go far enough if a woman must walk miles or wait in hours-long lines to seek care because there are not enough trained doctors, nurses and midwives in her community. Quality has a huge impact on whether a woman or girl will seek care, and we must understand quality from women’s and girls’ perspectives to provide it.

Putting women and girls at the center of their own care will drive demand for quality service coverage, and works toward decreasing inequalities in maternal health services in low- and lower-middle-income countries.

To get a better understanding of what quality means to women and girls around the world, White Ribbon Alliance (WRA) is proud to coordinate the What Women Want campaign, and join more than 180 organizations under one unified effort to put women’s and girls’ voices front and center in identifying their priorities for quality reproductive and maternal health and rights.

Based on a similar campaign from WRA India, What Women Want is bringing together individuals and organizations to ask this basic yet often ignored question: What is your one request for quality reproductive and maternal healthcare services? The answers heard in India were simple: My own bed. Enough supplies for mine and my baby’s medical needs. A clean facility. Those responses have been turned into a 10-point advocacy agenda that is helping to clarify and advance quality and respectful care in India.

Taking the campaign global is a huge step forward, and responses will be aggregated into a global picture of what women want and disaggregated by country to help governments prioritize resources in a meaningful way. Just one week in, women from around the world are eager to have their voices heard and help set the health agenda. In Pakistan, women asked for privacy in facilities and to be treated with dignity. In Kenya, women said they did not want to be insulted by their doctors and nurses. In Nigeria, women asked to be informed of their rights. These asks are modest, yet profound in that every woman should be able to expect access to fundamental services of quality, and respect.

The results from the What Women Want campaign can be a helpful guide for other people-centered efforts around UHC, as it will help governments, health professionals, private providers and civil society organizations better understand what is most important to women and girls when it comes to their healthcare and to push for change within countries and communities.

We hope too, that it will also set an example of what can be accomplished when citizens are involved in creating the health policies and services that are meant for them, because when governments know what citizens want in their health services, it will help them focus their human and financial resources in a way that will improve health outcomes and strengthen health systems. As Ministries of Health begin planning their commitments to increase access and decrease out-of-pocket spending to reach UHC by 2030, it is imperative they take a people-centered approach to understand what it is individuals and communities see as quality health facilities and services.

To learn more about the What Women Want campaign, visit www.whatwomenwant.org and follow @WhatWomenWantHC