Towards universal health coverage: applying a gender lens Investment in the health and wellbeing of women and girls is not only the right thing to do from a moral and human rights perspective, but it is also smart, strategic, and cost-effective. Because health is a function not only of the health sector but of government, combined with ones working and living conditions, psychosocial status, and other socioeconomic factors, approaches taken by Latin American governments to address the gender dimensions of health reforms are in some cases overlooked because they lie outside the health sector. Therefore, application of a so-called gender lens, defined as the social and cultural constructs that prescribe mens and womens roles in society, requires looking at the health sector and beyond to examine the range of social reforms that affect health outcomes. From my perspective as the former Chilean Minister of Health and Director of UN Women, and two-time President of Chile, I would like to highlight a few distinct and hidden lessons from Latin America on addressing gender inequalities in health, in the hope that making these lessons explicit might serve to draw attention to opportunities for action both within and outside the region. Across the Latin American region, substantial progress has been made in the struggle for gender equality, unlocking the potential for increased participation by women and empowerment, which has a positive effect on health. For example, 18 countries in Latin America provide at least 12 weeks maternity leave.1 These labour laws typically only apply to workers in the formal sector (ie, those who receive social security), but reforms in Brazil, Chile, Costa Rica, and Uruguay recognise the labour rights of domestic workers and provide them with the legal entitlement to maternity leave. Other forms of protection that affect health and are provided by all Latin American countries include protection from discriminatory dismissal during pregnancy and maternity leave, and the provision of at least 1 hour a day for breastfeeding up until the childs first birthday.1 Another legislative imperative for promoting gender equality in health are laws that entitle pregnant teenagers to continue their education both during and after pregnancy. This point is especially important in Latin America because fertility among adolescents in the region has been on the rise since the 1990s.2 A child born to a mother who can read is 50% more likely to survive past the age of 5 years than is a child born to a mother who cannot read.3 Argentina, Chile, Panama, and Mexico have laws that support expectant teenage mothers to continue their education.4 This type of legislation disproportionately helps the poor—a study done in the region shows that girls in the poorest quintile are four times more likely to become pregnant than those in the richest quintile.5 As Minister of Health in Chile between 2000 and 2002, I developed a commission on gender and health that instituted measures to correct regressive health financing on the basis of the ability to pay rather than risk, which disproportionately assisted women. Subsequently, when I became President of Chile in 2006, my administration tripled the number of free early childcare centres for low-income families to support women to continue in the labour force. I also instituted an annual performance-based salary bonus linked to an institutional commitment to work toward gender equality in all public services. This bonus system was used to incentivise the transformation of intentions for mainstreaming gender into measurable goals that were monitored every year
Posted on: Fri, 17 Oct 2014 09:36:45 +0000
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