ABSTRACT:
Promoting women’s access to sexual and reproductive health (SRH) services is a global health and human rights priority 1,2. International frameworks, including the Convention on the Elimination of All Forms of Discrimination Against Women, ensure women’s right to access information and services supporting their health and well-being. Universal health coverage (UHC) is promoted to expand access to essential services, including SRH. Evidence from low- and middle-income countries shows SRH integration within UHC remains uneven. In Egypt, ongoing UHC reforms offer a critical opportunity to institutionalize equity, and rights-based approaches in SRH delivery 3. The study has two stages—pre- and post-UHC implementation in Ismailia, Egypt. Stage one used qualitative methods. Semi-structured interviews were conducted with twelve married women and two key informants. Stage two uses a qualitative design to examine SRH services integration into UHC. Participants include women of reproductive age who are beneficiaries, healthcare providers from diverse contexts, and policymakers involved in planning, implementing, or monitoring SRH integration. Data will be analyzed using thematic analysis, including triangulation across groups. Stage two builds on stage one by shifting from women’s pre-UHC experiences to a post-UHC assessment of how SRH services are operationalized. Stage one revealed limited SRH knowledge and access among married women. Experiences were shaped by intersecting micro- and macro-level factors—power dynamics, socioeconomic constraints, cultural norms, and religious misconceptions—creating unequal access. Stage two will identify facilitators and challenges of integrating SRH services into UHC. By triangulating perspectives across beneficiaries, providers, and policymakers, stage two extends the analysis to system- and policy-level factors shaping SRH integration. Findings highlight the need to build supportive relationships for women before and after marriage and empower them with accurate and safe SRH services. Educational programs and media campaigns are needed. Stage two is expected to inform evidence-based policy to strengthen SRH integration within Egypt' UHC.