Making steps towards Universal Health Coverage

Almost 100 million people are pushed into extreme poverty each year, due to high health care expenses. Every person—no matter who they are, where they live, or how much money they have—should be able to access quality health services without suffering financial hardship. To achieve this vision of universal health coverage by 2030, we need collective action. On 12th December, stakeholders around the world unite together for Universal Health Coverage (UHC) Day, advocating for stronger health systems to ensure no one is left behind.

Access to affordable and quality health care services is highly beneficial, for both individuals and wider society. Economies thrive with a healthy workforce and children who can access health services are more likely to attend school, expanding their opportunities. Despite the advantages of UHC, there are major discrepancies between accessibility, affordability and quality of healthcare across the globe.

Strengthening health systems offers a solution, enabling governments to provide quality care through efficiently financed, accountable, and equitable services. Strong health systems should support all stages of health care, from preventative action, such as vaccine programmes, to treatment and rehabilitation. With good financing policies and an inclusive structure, these services can be provided to patients without subjecting them to unexpected out-of-pocket expenses.

Options is supporting the movement towards UHC through our programmes which increase access and improve the quality of health services. By working at all levels from civil society to national government, we have strengthened systems, acting to heighten accountability and enable more people to use services.

In Bangladesh, the UKAid-funded Urban Health Systems Strengthening Project created a Common Health Care Entitlement Card (CHEC), enabling those living in extreme poverty to access free or subsidised healthcare. The project brought together NGOs, government facilities and private service providers to collectively affirm the importance of providing healthcare to the extreme poor. They agreed to allow those carrying the card to access care at their centres, regardless of their financial circumstances. Those who had previously been excluded from health services, like ten-year old Romana, were granted access for the first time. Romana had been suffering from an undiagnosed heart condition, but her family had been reluctant to take her to hospital as they could not afford the treatment and consultation fees. With the introduction of the CHEC, she received life-saving medicine free-of-charge.

Resilience is also a key goal in health systems strengthening. We work to ensure that systems, policies and guidelines are in place so that essential health services are continued or restored in the face of an economic or political shock; disease outbreak or natural disaster. Working with the Nepali Ministry of Health and Population, the UKAid-funded Nepal Health Sector Support Programme, is retrofitting hospitals and developing construction plans and standards to ensure infrastructure can withstand future shocks, and services can continue uninterrupted.

In Malawi, accountability has been a priority to improve the availability and quality of services. Many medicines fail to reach health centres and patients.  Theft, mismanagement and poor record keeping meant that many facilities frequently ran out of drugs forcing poor patients to go without or buy drugs, which would have been free at public health centres, from private clinics and pharmacies. The UKAid-funded Malawi Health Sector Programme – Technical Assistance supported Health Centre Advisory Committees (HCACs), giving them training and drug monitoring tools to help them oversee the supply chain at local facilities. The HCACs were able to investigate discrepancies at a local level, discouraging thefts and ensuring more medicines were available for all.

Looking to the future, we will continue to work towards UHC, improving health systems to create equitable provision of affordable and quality care. This month has seen the launch of the Women’s Integrated Sexual Health Programme (WISH). Working across ten countries, budget advocacy will lead to increased domestic financing for family planning, and inclusion in the essential service package.

To ensure projects are directed towards achieving UHC, outcomes from health systems strengthening efforts are checked against the following criteria:

• Financial fairness and efficiency
• Quality
• Equity
• Accountability
• Resilience

These factors are at the heart of Options’ work to strengthen systems. They are characteristic of UHC and ensure that Options contributes to the expansion of UHC, leaving no one behind when it comes to obtaining health care.