The past year has underscored just how fragile progress in women’s, children’s, and adolescents’ health (WCAH) truly is. Estimates from the Institute for Health Metrics and Evaluation indicate that development assistance for health declined by approximately 20% between 2024 and 2025, with Africa experiencing the steepest reductions and these disparities projected to widen over the next five years (IHME, 2025). This crisis is further compounded by political pushback on rights—particularly sexual and reproductive health and rights (SRHR)—alongside multiple, intersecting global shocks.
The ongoing financing crisis has disrupted service delivery through health facility closures, losses in the frontline workforce, and breakdowns in essential supply chains, while shifting costs onto households through increased out-of-pocket spending. These shocks are undermining progress toward UHC and widening gaps in access to comprehensive sexual and reproductive health services. This is happening at a time when an estimated 224 million women living in developing countries are not currently having access to safe and effective family planning methods (UNFPA, 2025), despite strong evidence that every US $1 invested in contraceptive services can save up to US $3 in costs related to maternal, newborn, and comprehensive abortion care (Guttmacher, 2019).
These trends stand in stark contrast to longstanding global and regional commitments to protect and advance SRHR. Under the Maputo Protocol of the African Union, African States committed to ensure women’s access to comprehensive SRH including family planning and safe abortion. Yet the current financing and policy environment risks widening the gap between these commitments and the lived realities of women and adolescents, particularly those who are poorest and most marginalized.
This moment, therefore, calls for renewed political leadership and deliberate action to place sexual and reproductive health at the centre of UHC reforms through a primary healthcare approach. As countries pursue different pathways toward UHC based on population needs and available resources, explicit health benefit packages have emerged as a critical tool for translating commitments into access, equity, financial protection, and quality of care. Experience from Bangladesh demonstrates the potential impact of this approach, where the inclusion of comprehensive SRH services within the essential service package was associated with a 31.5% reduction in the maternal mortality rate. While not all SRH services can be fully integrated at once, strategic prioritization and progressive realization are essential to embed high-impact SRH services within PHC-oriented UHC reforms, without leaving anyone behind.
This webinar aims to bring together policymakers, practitioners, civil society, and partners to examine how sexual and reproductive health can be protected, prioritized, and progressively integrated within universal health coverage reforms, particularly in contexts of constrained fiscal space and competing policy priorities.
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