Sexual and reproductive health services in universal health coverage: a review of recent evidence from low- and middle-income countries

Figures & data

Figure 1. Inclusion of SRH services in EPHS packages of countries (N = 26)

Source: Wright ^{11–12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34}, Sundewall³⁵

CSE - any education related to sexuality and reproduction for adolescents & young people

INF - counselling, testing and management of infertility

SA - safe abortion

REP CANCERS - screening (and treatment) for cervical / breast cancers

GBV - services related to the prevention and management of sexual and gender-based violence

PAC - post-abortion care

ASRH - adolescent sexual and reproductive health services

STIs & HIV/AIDS - prevention and treatment, including PMTCT and ARV

FP - contraceptive services

MH - maternal health including emergency obstetric care

Figure 2. Financing of the ICPD costed package, 2012. Source: Drawn based on data from IPPF.²⁰

Table A1. Research questions and search-terms

Research questions	Search terms related to SRH components	Search terms related to UHC dimensions
1. What are the key themes addressed by the SRH literature on UHC?	Sexual and reproductive health services Sexual and reproductive health Sexual and reproductive health and rights	Universal Health Coverage
2. Which SRH services have been included in EPHS of different LMICs? What were the processes through which they were included?	Maternal health services; emergency obstetric care Safe abortion services; post-abortion care Family planning; contraceptive services Adolescent sexual and reproductive health services; comprehensive sexuality education Gynaecological services; infertility treatment Services for gender-based violence Cervical cancer screening; breast cancer screening; cervical cancer treatment; breast cancer treatment	Essential package of health services; essential services packages; basic services packages; Health benefit packages Priority-setting
3. What are the major sources of financing for SRH services? How does this pattern of financing affect population and service coverage and financial risk protection?	Same as above	Financing mechanisms National Health Accounts; SRH sub-accounts; User fees; Social Health Insurance; national health insurance; community-based health insurance; micro-insurance; Conditional cash transfers; Out of pocket expenditure; Catastrophic health expenditure
Research questions	Search terms related to SRH components	Search terms related to UHC dimensions
5. What has been researched on some service delivery challenges unique to/ predominantly affecting SRH services such as restrictive gender norms and gender inequality? Restrictive legal and policy environment? Private sector as a major service provider?	Gender norms; gender inequality; abortion laws; LGBTQI and legal status / criminalisation; disrespect/abuse and maternity; obstetric violence; coercive/ forced sterilisation; third-party authorisation; adolescents; stigma; discrimination; Contracting with private providers; Social marketing; Social franchising; Voucher schemes (for each of the SRH components presented above)
4. What are the accountability mechanisms that have been used w.r.t. to universal access to SRH services at the international, national, and sub-national levels? What were the issues addressed? Who were the actors involved, and what were the processes? What were the outcomes?	Same as above	Accountability Performance accountabilitySocial accountabilityLegal accountability

Wright J. Essential package of health services country snapshot: Afghanistan. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Bangladesh. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: The democratic republic of the Congo. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Ethiopia. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Ghana. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Haiti. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: India. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Indonesia. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Kenya. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Liberia. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Madagascar. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Malawi. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Mali. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Mozambique. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Nepal. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Nigeria. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Pakistan. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Rwanda. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Senegal. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: The republic of South Sudan. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Tanzania. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Uganda. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Yemen. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Wright J. Essential package of health services country snapshot: Zambia. Bethesda (MD): Health Finance & Governance Project Abt Associates Inc; 2015.

 Google Scholar

Sundewall J. Prioritizing essential packages of health services in six countries in sub-Saharan Africa. Implications and lessons for SRHR. 2019. PMNCH and Swedish International Development Agency. Unpublished report.

 Google Scholar