Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College, Trivandrum, Kerala, India.
BMC Public Health. 2012;12 Suppl 1(Suppl 1):S4. doi: 10.1186/1471-2458-12-S1-S4. Epub 2012 Jun 22.
Universal coverage by health services is one of the core obligations that any legitimate government should fulfil vis-à-vis its citizens. However, universal coverage may not in itself ensure universal access to health care. Among the many challenges to ensuring universal coverage as well as access to health care are structural inequalities by caste, race, ethnicity and gender. Based on a review of published literature and applying a gender-analysis framework, this paper highlights ways in which the policies aimed at promoting universal coverage may not benefit women to the same extent as men because of gender-based differentials and inequalities in societies. It also explores how 'gender-blind' organisation and delivery of health care services may deny universal access to women even when universal coverage has been nominally achieved. The paper then makes recommendations for addressing these.
实现全民健康覆盖是任何合法政府对其公民应尽的核心义务之一。然而,全民健康覆盖本身并不能确保全民获得医疗保健。在确保全民健康覆盖和获得医疗保健方面面临的诸多挑战中,包括种姓、种族、民族和性别方面的结构性不平等。本文通过对已发表文献的回顾,并应用性别分析框架,强调了旨在促进全民健康覆盖的政策可能不会像对男性那样使女性同等受益的原因,这是由于社会中存在基于性别的差异和不平等。本文还探讨了即使在名义上实现了全民健康覆盖,“无视性别”的卫生服务提供和组织方式如何使妇女无法获得普遍的医疗服务。本文随后提出了应对这些问题的建议。