Orientation workshop UHC and GER mainstreaming

Objectives Strengthen awareness of RO and CO staff on global commitments to mainstream equity, gender and human rights. Build participants' skills and capacities to implement these commitments in the context of UHC. Ensure familiarity with existing equity, gender and human rights tools and frameworks and their adaptation to WPRO needs. Identify entry points and next steps to mainstream equity, gender and human rights in health.

Group photo

Session 2

Group work

What is UHC? What is GER? Two groups

Clarifying concepts

Better Health: Actions towards UHC Introduction Current situation Progress and reforms with commitments to UHC Challenges: socio-economic, demographic, health system Universal Health Coverage (UHC) Moving forward towards UHC 5 health system attributes Monitoring and evaluation framework for UHC Developing Country specific UHC roadmaps

1. Quality 2. Efficiency 3. Equity 4. Accountability 5. Resilience 5 Health System Attributes

Under-five mortality – rural-urban rates and ratios, selected countries Source: UNESCAP, UNDP and ADB, Achieving the Millennium Development Goals in an Era of Global Uncertainty: Asia-Pacific Regional Report 2009/10. Health inequities are widening

How to reduce health inequities? Put health on the development agenda Put equity on the health agenda

Putting health on development agenda Increase resource flows to health (e.g., GFATM, GAVI, IHP) and improve resource allocation Advocacy: promote understanding of health as central to development (e.g., MDGs/SDGs) Cross-sectoral work: address non-health sector determinants of health inequities (e.g., national socioeconomic development plans)

Understand patient pathway and barriers to access Putting equity on health agenda

Tackle barriers to access faced by underserved groups: Geographical barriers: target/prioritize underserved areas Economic barriers: reduce out-of-pocket expenditure, consider targeted subsidies to underserved groups Low knowledge/awareness: language, gender, ethnicity barriers Stigma, fear of social isolation Lack of health system responsiveness: improve quality, reduce provider bias, contracting service delivery Putting equity on health agenda

Gender and health: the links Men’s and women’s health is determined both by their biological and gender-based characteristics. Due to gender norms, roles and relations, there are differences between different groups of men and women in: –exposure to risk factors or vulnerability –household-level investment in nutrition, care and education –access to and use of health services –their experiences in health care settings –the social impact of ill-health Gender intersects with equity & human rights

Gender analysis can… Identify differentials between different groups of men and women in: –risk factors, exposures and manifestations of ill-health –severity and frequency of diseases –health seeking behaviour –access to care, experiences in health care settings –outcomes and impact of ill-health

Gender analysis can… Distinguish between health determinants that are: –common to different groups of women and men (incl. LGBT) –sex- and gender-related because each may require a different type of intervention Identify appropriate responses and their potential impact on gender power relations

x x x REDUCING VULNERABILITY TO ILL-HEALTH THROUGH HUMAN RIGHTS HUMAN RIGHTS VIOLATIONS RESULTING IN ILL-HEALTH PROMOTION OR VIOLATION OF RIGHTS THROUGH HEALTH DEVELOPMENT RIGHT TO WATER RIGHT TO INFORMATION RIGHT TO EDUCATION RIGHT TO FOOD & NUTRITION FREEDOM OF MOVEMENT RIGHT TO PARTICIPATION HARMFUL TRADITIONAL PRACTICES VIOLENCE AGAINST WOMEN TORTURE SLAVERY FREEDOM FROM DISCRIMINATION RIGHT TO PRIVACY HEALTH AND HUMAN RIGHTS

Human rights & health AvailabilityAccessibility Acceptability Quality Functioning public health and health- care facilities, goods and services Underlying determinants of health (e.g. housing, education, gender…) The right to health Functioning and sufficient quantity Services, staff, medicines… Scientifically and medically appropriate Skilled personnel Scientifically approved and unexpired drugs and equipment Information accessibility Economic accessibility (affordability) Physical access Non-discrimination Medical ethics Culture Life-cycle Gender Confidentiality

Ensure human rights in practice A human rights-based approach to health aims to apply the principles of non-discrimination, participation and accountability to all health policies, interventions and processes towards the progressive realization of the right to the highest attainable standard of health for all.

Human Rights Member WHO States HRBA to programming (CCA/UNDAFs) Monitoring & Accountability mechanism Standard-setting New partners Advocacy Practical implications of integrating human rights in the work of WHO

In monitoring and evaluation: Disaggregate information by income, sex, ethnicity, rural-urban residence, employment status, etc. Conduct operational research to: –Analyze incidence of benefits: do the poor benefit at least proportionately? why or why not? –Identify and evaluate options Improve health system responsiveness

QUIZ

True or false? Health as a human right means the right to be healthy.

True or false? Universal health coverage is not concerned with inter- sectoral approaches.

True or false? Gender is about socially constructed characteristics of women and men, such as norms, roles and relationships.

True or false? Health equity means equality with respect to health determinants.

True or false? Inclusion of women and men's needs in programme design for universal health coverage GER mainstreaming is about integrating GER in programme design for universal health coverage.

Session 3

Instructions 4 tables, 4 questions Table hosts stay at the table; everybody else changes tables every 15 minutes Write, scribble, doodle and draw key ideas on the flipchart After 4 rounds, café hosts report back to plenary

Session 4

Making the case for GER

InstructionsInstructions Write the script of a short YouTube video illustrating the impact you had on the ground in mainstreaming GER in the context of UHC… What will you show/film?

End of day 1