The impact of health policies and health sector reform on the readiness of health systems to respond to women’s health needs, with special focus on reproductive health, reproductive rights and HIV/AIDS

Abstract

This paper examines how health policies and health reforms that have been implemented have impacted on the health and well-being of women, with emphasis on reproductive health, rights and HIV/AIDS. It tries to consider how health policies and reforms have tried to improve health systems to respond to health needs of women. Women’s health has been the focus of both international and national state policies. However, many current health policies have tended to regard sexual and reproductive health and rights of women as insignificant. Further health sector reforms that have been implemented by many countries have tended to focus on their implications for the poor, with a few policy makers explicitly taking gender issues into consideration. What needs to be understood is whether the health sector reforms are reducing gender inequality. Some evidence suggests that reforms can produce negative impacts on maternal health service provision and use as changes can strain working relationships or overload health workers (MacIntyre and Klugman, 2003). Yet in other settings, indicators such as maternal mortality rates, decreased as a result of the reforms (Parkhurst et al, 2004). It has been observed that Health sector reforms are complex processes affecting the local systems in which individuals work – shifting incentive structures, regulatory mechanisms, and paths of accountability. They can also change the macro environment of health systems, reorganizing staff numbers and placements, and creating new structures and hierarchies within the health sector (Parkhurst et al 2004).