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Universal Health Coverage: Important challenges and policy issues that SIDS have to face

Universal Health Coverage: Important challenges and policy issues that SIDS have to face. Outline. Definition Strategies for UHC UHC in the African region Challenges Proposed solutions Conclusion. What does UHC mean for people and governments?.

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Universal Health Coverage: Important challenges and policy issues that SIDS have to face

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  1. Universal Health Coverage: Important challenges and policy issues that SIDS have to face

  2. Outline • Definition • Strategies for UHC • UHC in the African region • Challenges • Proposed solutions • Conclusion

  3. What does UHC mean for people and governments? 1. UHC : every person can get access to essential good quality health services that save life and improve well-being; 2. Services include promotion, prevention, treatment, rehabilitation and palliative care; 3. Nobody should suffer severe financial ruin, nor be pushed into poverty; 4.Towards UHC can start before a country reaches high-income or even upper-middle income level.

  4. UHC dimensions • Who is covered (who are the beneficiaries?), • What services are covered (what services are people entitled to receive?), and • How much of the cost is covered (how much does not need to be paid out-of-pocket by the beneficiaries?) .

  5. UHC approach in the AFR region. • Several countries in the African Region are implementing policies in line with the objective of Universal Health Coverage e.g. Ghana, Rwanda and Botswana. • Other countries in the African Region have declared to implement policies towards UHC, these include: • Benin, Burundi, Cape Verde, Congo, Côte d’Ivoire, Gabon, Kenya, Malawi, Mali, Mauritius, Namibia, Senegal, Seychelles, Sierra Leone, South Africa, Tanzania, Togo and Uganda.

  6. Schematic relationship between HSS and UHC Universal Health Coverage Improved health and equity Health System Strengthening

  7. Overall Goals and Outcomes of HS OVERALL GOALS / OUTCOMES SYSTEM BUILDING BLOCKS SERVICE DELIVERY IMPROVED HEALTH (level and equity) ACCESS COVERAGE QUALITY SAFETY HEALTH WORKFORCE RESPONSIVENESS INFORMATION SOCIAL AND FINANCIAL RISK PROTECTION MEDICAL PRODUCTS, VACCINES & TECHNOLOGIES FINANCING IMPROVED EFFICIENCY LEADERSHIP / GOVERNANCE

  8. Major challenges derive from SIDS • Insufficient population size across which to pool risk, especially for high-cost services • Higher cost structure for the system than larger countries would face (ceteris paribus) • international procurements (e.g. medicines) • structure of service delivery (e.g. affectation of publics resources in the service delivery) • how to deal with referral services: have much more than primary and basic secondary services as well as emergency care

  9. Insufficient financial resources • Only 3 countries have managed to allocate 15% of the national budget to health and also managed to reach the USD44 per capita

  10. Financial risks and barriers to access to health services Where OOP spenging < 20% of the THE, catastrophic expenditure and impoverishment become negligible

  11. Health Systems Strengthening towards UHC - Overall • Building sustainable health systems able to provide continuously accessible optimal preventative, curative and rehabilitative health care • in line with values and principles such as social justice, equity, human rights, solidarity, community participation.. for all the people including the most vulnerable; • Expand health services coverage through combined efforts: • integrated health service delivery models which cover most of priority diseases <NCDs, NTDs, Child and maternal Health, Malaria, TB and HIV/AIDs etc. 11

  12. Adequacy and efficient use of financial resources towards UHC • Strengthen Financing for Health • Raise additional funds and diversify funding sources – fuel levies • Move away from direct payments towards prepayment and pooling • Improve efficiency and equitable use of resources • To develop and implement health financing policies in line with the Tunis Declaration on Value for money, Sustainability and Accountability in the Health sector

  13. What SIDS countries should do focus on towards UHC • Reinforce complementarity health financing mechanisms and HSS • Reduce fragmentation and expand pool size • Having a clear service delivery strategy for what will be delivered on- versus off-island • Move towards strategic purchasing and linking payment to core benefits (exploring international cooperation to help bring down costs of some imported inputs) • Explore a global cooperation/collaboration of SIDS (or SISs) to improve exchange of information on how such countries are managing, their innovations, etc.

  14. Conclusion • UHC is a chance to address the challenges our continent is faced with. • It is not granted and it will need an unprecedented efforts of all stakeholders.

  15. THANK YOU

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