Gender inclusive Financial Protection the Pathway to Universal Health Coverage: Women, Indigent and community safety nets!


By Robinah Kaitiritimba, Uganda National Health Consumers’ Organisation


While at a community dialogue organised by Uganda National Health Consumers’ Organisation, Agnes Mirembe [not real names]a resident of Nagojje Subcounty in Mukono District said;


I waited for my husband to give me money so that I visit the hospital to produce. He came back all drunk and without any money on him. He had taken 10 of my sacks of beans for sale. I was rescued by my neighbors who broke the door and rushed me to the hospital. I lost my baby, she’d have made five months, if I sold my beans I’d have gone to hospital in time


This story is told by stay home mothers but becomes nastier for the young parents, if only they can control their hard earned money. Domestic violence has been evidenced owing to the failure of men to support them financially to access timely health care.


There must be a swift appreciation of women as family heads and empower them to control the finances that family incomes generate. This helps them benefit from Government programs like early cervical cancer screening, immunization and health education as they can afford transport to the gazetted health facilities so as to live healthier lives.


Ugandan communities, save for a few find women, inheritance and land ownership as co-wives. Even with article 33 clause 6 of the constitution saying ‘Laws, cultures, customs or traditions which are against the dignity, welfare or interest of women or which undermine their status, are prohibited…’


These communities have accorded the male gender economic empowerment over that of the female gender contrary to Article 33 clause 4 of the Constitution that states‘Women shall have the right to equal treatment with men and that right shall include equal opportunities in political, economic and social activities.’ Practicing this provision functionalises UHC as it improves household income and empowers them to purchase health products on the market.


With the absence of financial empowerment, women as they carry out their maternal functions, breast feeding and tending to their sick children have found themselves at the mercy of the male dominated community. This moral belief is blamed on the budget allocation to the health sector too an approach that is counterproductive to achieving UHC given that Ugandan women’s health seeking behaviour beats that of their male counterparts. The diminishing health sector budget can also be blamed on less involvement of women in governance issues in health sector planning.


Maternity wards, theatres, blood banks, children wards, all when far or not readily accessible by the female gender contribute to their death toll of the female gender.


The gender distribution in critical leadership positions have favoured the male gender as opposed to the female gender. To that end either the female concerns have not made it to discussion or the men have relegated it to pending, why the upbringing does not appreciate the centrality of female gender in the leadership spaces occupied by women.


CSOs have lambasted MPs for supporting purchasing Ipads rather than the pads that are crucial in menstrual hygiene thus keeping girls in school which the NRM was a campaign pledge by the president for this term. It is believed that more women translates to instant political will.


Fortunate Ainomugisha, aged 32, a mother of 3, reminisces of how her community has robbed her of a social safety net when her husband succumbed to cancer. ‘Gone are the days when we last knew happiness as a family. After the death of my husband, his family refused me to administer his estate. The law rejected me, claiming I was not officially married to him. One of our children is suffering from sickle cell and the others ones must support her all the time. I sell charcoal for a living, I cannot buy milk, meat or fruits that we need as a family, pay school fees, pay rent and keep money on standby for hospital bills. The other day, my friend was arrested by the doctor for failing to pay, I think hospital is a luxury.


Without a safer community for the indigents where government takes the lead in subsidies, tax holidays or legislating on national health insurance, integrating right based approaches to all levels of planning and budgeting realising UHC, indigent women shall be left behind.


Whereas Uganda’s Constitution entails principles of good governance that seem to create safety nets for social cohesion like: affirmative action, accountability, transparency, participation in government activities, equal opportunities, inter alia; what we need to do right to cause financial protection is to streamline gender inclusive to financing where women can own property, obtain loads or save for their health choices.



Uganda National Health Consumers’ Organisation is a partner on the Supporting Policy Engagement for evidence-based Decision (SPEED) initiative