The International Labour Organization (ILO) brief Social health protection for gender equality advocates for gender-responsive social health protection (SHP) systems to eliminate disparities in healthcare access and income security. Globally, one in five people lack legally recognised health entitlements, with women facing disproportionate barriers due to financial constraints, restrictive social norms, and the prioritisation of household budgets toward others. The report emphasises that gender inequality leads to poor physical and mental health outcomes and unhealthy aging, exacerbated by women's overrepresentation in informal and vulnerable employment.
To bridge these gaps, the ILO recommends integrating gender analysis into SHP design, removing financial barriers for maternity care, and ensuring comprehensive benefit packages that include reproductive, mental, and long-term care services.
Key Pillars of Gender-Responsive Health Protection
Financial Barrier Removal: Eliminating user fees and co-payments, particularly for maternity care, to prevent childbirth from becoming a financial burden.
Integrated Benefit Packages: Ensuring healthcare coverage includes primary care, reproductive health, mental health, and specialized services for the elderly.
Income Security Mechanics: Strengthening sick leave and maternity benefits beyond weak employer-liability models to ensure financial stability during life events.
Service Provision Equity: Investing in primary healthcare and the equitable distribution of skilled health workers, particularly in rural and underserved areas.
Gender-Disaggregated Data: Collecting and analyzing robust data to monitor access disparities and inform evidence-based policy adjustments.
Sustainable Financing: Coordinating social protection with domestic funding and employment formalization policies to expand universal coverage.
What is "Gender-Responsive Social Health Protection"? Gender-responsive social health protection is a mechanical framework that identifies and addresses the specific biological and social barriers women face in accessing care. It provides the "Technical Fidelity" to ensure that "Universal Health Coverage" is not just a legal entitlement but a functional reality for women in informal sectors. By addressing the social determinants of health—such as unequal care burdens—this framework acts as a prerequisite for achieving systemic gender equality and sustainable development.
Policy Relevance: India’s Gender-Sensitive Health Strategy
Internalising Barriers in Rural Contexts: While not explicitly mentioned in the report, the ILO’s focus on social norms provides a primary mechanic for India to refine Ayushman Bharat outreach. Addressing the "household budget prioritization" problem can help increase the utilization of secondary and tertiary care among rural women.
Operationalizing Maternal Health Gains: The emphasis on free maternity care serves as a functional solution for India to enhance the Janani Suraksha Yojana (JSY). Strengthening financial protection during childbirth acts as a mechanical shield against out-of-pocket (OOPS) expenditure, which remains higher for women.
Bypassing Informal Sector Gaps: The report’s call for sustainable financing for women in informal employment is a strategic imperative for India, where a vast majority of women work without formal contracts. This provides the "Technical Fidelity" needed to expand ESIC or similar protection to domestic and agricultural workers.
Strengthening Primary Healthcare Infrastructure: The ILO's recommendation to invest in localized primary care aligns with India’s rollout of Health and Wellness Centres (HWCs). Bringing quality services closer to home serves as a "Strategic Barrier Removal" for women restricted by limited mobility or time-poverty.
Follow the full brief here: ILO: Social health protection for gender equality - 2026
