Univer­sal health cov­er­age pro­motes in­di­vid­ual’s rights

Business Daily (Kenya) - - IDEAS & DEBATE - GITHINJI GITAHI Th­ese chal­lenges call for re­newed com­mit­ments and ac­cel­er­ated progress to­wards UHC

GCEO, Am­ref Health Africa and co-chair, Steer­ing Com­mit­tee, UHC2030

This year’s In­ter­na­tional Univer­sal Health Cov­er­age Day (UHC Day), which will be cel­e­brated on De­cem­ber 12, aims to mo­bi­lize di­verse stake­hold­ers to call for stronger, more eq­ui­table health sys­tems to achieve univer­sal health cov­er­age, leav­ing no one be­hind.

The grow­ing global move­ment for ‘Health for All’ comes at a time when the African re­gion still faces a myr­iad of chal­lenges re­lated health. Many coun­tries con­tinue to strug­gle with high lev­els of child and ma­ter­nal mor­tal­ity and most health sys­tems are un­able to cope with the grow­ing bur­den of chronic dis­eases, such as cancer and di­a­betes.

Th­ese chal­lenges call for re­newed com­mit­ments and ac­cel­er­ated progress to­ward UHC, whose prin­ci­ple is that ev­ery­one re­ceives needed health ser­vices with­out fi­nan­cial hard­ship.

While most African coun­tries have in­te­grated UHC into their na­tional health strate­gies, progress in trans­lat­ing th­ese com­mit­ments into eq­ui­table and qual­ity health ser­vices, and in­creased fi­nan­cial pro­tec­tion, has been slow.

Fi­nan­cial bar­ri­ers con­tinue to hin­der ac­cess in the re­gion, with many in­di­vid­u­als and house­holds fall­ing into poverty from seek­ing health care.

The first Global Mon­i­tor­ing Re­port “Track­ing Univer­sal Health Cov­er­age”, in­di­cates that in 37 coun­tries glob­ally – eight of which are in Africa – about 15 per­cent of poor house­holds are fur­ther im­pov­er­ished by out-of-pocket pay­ments for health care.

In about half of African coun­tries, 40 per­cent or more of the to­tal health ex­pen­di­ture is con­sti­tuted of house­hold out-of-pocket pay­ments, which is the most re­gres­sive way of fund­ing health care.

The re­liance on this pay­ment mech­a­nism cre­ates fi­nan­cial bar­ri­ers to ac­cess to health ser­vices and puts peo­ple at the risk of im­pov­er­ish­ment.

Ev­i­dence shows that cat­a­strophic health ex­pen­di­ture and im­pov­er­ish­ment re­main low in coun­tries where outof-pocket ex­pen­di­ture is less than 15–20 per­cent of the to­tal health ex­pen­di­ture. In ad­di­tion, few house­holds are shown to be im­pov­er­ished where out-of-pocket cost is less than 20 per cent of their to­tal health ex­pen­di­ture.

In­suf­fi­cient in­vest­ment in the health sec­tor and slow re­sponse to ad­dress­ing the en­vi­ron­men­tal and so­cial el­e­ments im­pact­ing health will af­fect health out­comes in Africa, if dras­tic mea­sures are not taken to im­prove the over­all health of peo­ple.

The first step to­wards ad­dress­ing Africa’s health chal­lenges is for govern­ments to un­der­stand and ap­pre­ci­ate that health is a ba­sic hu­man right.

It is to­tally un­ac­cept­able that mil­lions of peo­ple still face death, dis­abil­ity, ill health or im­pov­er­ish­ment for rea­sons that could be ad­dressed at lim­ited cost.

Global health agen­cies and govern­ments need to pri­ori­tise and to move away from ver­ti­cal in­ter­ven­tions that just tackle in­di­vid­ual dis­eases and fo­cus more on im­prov­ing broader health sys­tems.

UHC ben­e­fits economies through stim­u­lat­ing eco­nomic growth by en­sur­ing a more pro­duc­tive work­force; fa­cil­i­tat­ing ed­u­ca­tional gains by en­sur­ing health­ier chil­dren; and em­pow­er­ing women and re­duc­ing poverty associated with health costs.

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