UHC Forward: Towards Universal Health Coverage

Between 24th and 27th September 2012, I participated, as part of Ghana’s team, in a workshop themed “Equity in Universal Healthcare Coverage: How to reach the Poorest” jointly organized in Marrakech, Morocco by the Moroccan Ministry of Health, the Financial Access to Health Services Community of Practice (FAHS CoP) and the Joint Learning Network for Universal Health Coverage (JLN).

The workshop provided an opportunity to review efforts by countries in Africa and Asia in their march towards universal health coverage for their populations. As the theme of the 2011 World Health Report, as well as of a number of international and regional conferences over the past 18 months. Indeed, the topical nature of universal healthcare coverage in these two continents is not surprising considering the endemic inequities that bedevil their healthcare delivery systems.

Topics dealt with at the workshop were well selected and included “Overview of mechanisms implemented in Africa to cover the poorest: summary of experiences from participating countries”, Universal Health Coverage Strategy in Morocco and stakes of scaling up the RAMED and other interventions nationally and “The evidence base on mechanisms to expand health coverage to the poorest in developing countries”

The workshop also featured field trips to selected health facilities and district administrations in Marrakech and its environs. By far a notable key innovation of the workshop was a session dubbed “Parliamentary Round Table: Political View on Equity and Universal Health Coverage”. The session provided an opportunity for five lawmakers from four African countries to share their perspectives about the role of Parliaments in the forward march towards universal healthcare coverage.

One thing that struck me during the parliamentary round table was the commonality of purpose and efforts of the participating parliamentarians to expand access to healthcare notwithstanding the diversity of their democracies. Indeed, it emerged from the discussions that as elected representatives of the people, members of parliament can become key agents for catalyzing the movement towards universal coverage in a number of ways including:

1. Eliciting the healthcare needs of their constituents to enrich the universal coverage debate;
2. Informing their constituents about progress being made in the movement towards universal health coverage;
3. Influencing universal health coverage legislation;
4. Influencing the allocation of budgets to universal health coverage programs; and
5. Strengthening parliamentary oversight on universal health coverage programs.

Subsequent to the round table during a country group discussion by the Ghanaian team, it transpired that assessing equity in Ghana’s National Health Insurance Scheme was a challenge. Accordingly the team’s workshop action plan was to develop tools for assessing equity of access within the scheme.

In view of my experience that many such action plans often do not see any progress of implementation following a return home, I took advantage of the opportunity provided by the ongoing revision of the National Health Insurance Bill then pending before Parliament to introduce an amendment into the bill to mandate the National Health Insurance Authority to annually report on equity of access within the National Health Insurance Scheme. I managed to table this amendment within six hours of my return to Ghana and the Bill was passed into law two days after.

Overall the experience in Marrakech was rewarding and reinforced the fact that Ghana’s move towards universal coverage was a right one. The excellent organization and the hospitality of the Moroccan Government contributed in no small way in making the workshop experience a memorable one.