Paper Short Abstract:

Based on ethnographic research on care trajectories of women with advanced reproductive cancer in Indonesia, this article shows how Universal Health Coverage, a global health initiative to improve access to health care, also creates new forms of social inequality.

Paper Abstract:

The World Health Organization promotes Universal Health Coverage (UHC) as a means to improve access to health care ‘for all’ and reduce health inequalities. For those who previously lacked enrolment in insurance schemes or the resources to afford health care costs, the UHC initiative offers the ability to access health care services, including specialized care. However, as I argue in this paper, the mobility that is often needed to receive more specialized care in a UHC system can also lead to inequalities in and exclusion from accessing care. Drawing on ethnographic fieldwork in Indonesia on care trajectories of women with advanced reproductive cancer, I show how these women and their caregiver(s) have to travel long distances to access UHC-covered care. They moreover experience several obstacles in navigating treatment in the place of referral including economic difficulties, emotional stress, and additional care burdens for families. Building on anthropological insights on mobility and social navigation, I demonstrate how the UHC system - while beneficial to many - can also create new challenges when people need to navigate cancer treatment far away from home.