Gender inequities in access to health care are a frequent pattern

Due to gender norms and the role of women in society, as well as political, legislative, and administrative failures, the specific needs of women are often neglected in national legislation and mirrored in low affiliation rates to health protection schemes. Lower formal employment than men, higher health care needs, the limited scope of benefit packages as well as cost-sharing requirements for women-specific health care services result in higher out-of-pocket payments (OOP) for women than for men - with often impoverishing effects. In addition, many women, particularly those living in rural areas, are not able to access health care services due to the unavailability of health care facilities and the unequal distribution of health workers.

As a result, Millennium Development Goal (MDG) Number 5, which focuses on improving maternal health, is the most off-track of all MDGs. This is particularly true for low income countries in Sub-Saharan Africa and South Asia, where the proportion of unattended births is highest and antenatal coverage lowest: 85 per cent of maternal deaths take place in these two regions. In many countries, the private expenditure of a hospital birth can be the equivalent of several months' income. Even enlisting skilled attendants at delivery can be a catastrophic expense. Hence, an important risk associated with childbirth and maternity is the loss of income. Mothers are not able to work for limited periods of time before, during, and after delivery. Thus, health protection policies need to financially protect women against expenditures incurred when accessing health care including transport costs and economic loss experienced due to reductions in earnings, particularly during maternity. The ILO Social Protection Floors Recommendation, 2012 (R202) has specified that maternity coverage and income protection be guaranteed.

Inequities in access to maternal health services by wealth quintile by national income level of countries, latest available year (percentage)

Source: ILO calculations based on WHO Global Health Observatory, various years. Link