How to fulfil universal healthcare promise

Friday September 27 2019

As the world meets in Nairobi to mark the 25th anniversary of the International Conference on Population and Development (ICPD), it is important to reflect on the deliberations and the commitments made in 1994 at the inaugural meeting in Cairo.

The conference will bring together governments, civil society, private sector, women and youth to discuss how to accelerate the ICPD programme of action, which is critical to achieving the Sustainable Development Goals by 2030.


Investing in the power and potential of women and their sexual and reproductive health and rights is one way of attaining the SDGs. But most of the people of reproductive age, especially in Africa, have inadequate access to sexual and reproductive health services. To achieve the SDGs, particularly universal health coverage, we must ensure that girls, women and their communities have access to quality health services and rights, and we must hold the social, community, and health systems accountable for meeting their needs.

Kenya has made significant progress on sexual and reproductive health and rights, especially maternal and child health, since the first ICPD 25 years ago. Whereas one in four married women used modern contraception 25 years ago, two in four do today. This has resulted in a reduction in the fertility rate from six children per woman 25 years ago to 4.7 today. Today, many more women are able to make their choices and play a role in planning their families.



But, even with these gains, the country and the continent continue struggling to curb adolescent pregnancies, which affect about 19 per cent of all adolescents, with East Africa leading at 22 per cent. This trend robs many young people of a chance to develop their full potential, as it often results in school dropout, early marriages and sometimes deaths from complications of early pregnancy or unsafe abortions.

Many commitments have been made by governments in international and regional declarations, conventions and agendas. Having healthy and empowered young people hinges on a supportive legal and policy environment that assures everyone of sexual and reproductive health. The youth should be the key to fulfilling the promise.


Violation of the rights of women and girls through female genital mutilation, for instance, must be addressed by all. In most communities where this happens, the women are denied a right to education and a chance to reach their full potential.

We need to invest in generating disaggregated data to tell us where we are lagging behind to ensure that our response is targeted and credible. We will only shorten the road to achieving UHC when every woman is able to access information and services that allow her to determine for herself how to take care of her body. Let’s walk the talk.

Dr Gitahi is the AMREF Health Africa CEO and co-chair of UHC2030