Celebrate Solutions: Expanding Universal Health Coverage to Save Lives
(Crossposted from Women Deliver)
By: Dr. Jeanette Vega, Managing Director for Health, Rockefeller Foundation
In just over a year since the UN General Assembly passed a historic resolution on Universal Health Coverage (UHC), we have seen incredible momentum around the topic. UHC is fast becoming one of the most important and relevant issues in the global health sector, setting the stage for UHC’s prioritization in the post-2015 development agenda.
Now, global health leaders Jonathan Quick, Jonathan Jay, and Ana Langer have authored a new essay in PLoS Medicine that highlights the importance of Improving Women’s Health through Universal Health Coverage.
What can vouchers do for universal health coverage?
A surprising amount, actually. A voucher gives its recipient the right to access a specific health service (or health service package) at quality-assured health facilities for free. That same voucher enables the health provider to claim payment for the services they provided to the voucher-holding client. That’s why voucher programmes are often described as a demand-side subsidy with a supply-side effect.
This nifty ‘2-for-1’ characteristic means that vouchers can do a lot of good for all three key principles of universal health coverage: equity, financial protection, and quality of care. On the equity front, targeted enforcement of entitlements to free care ensure that even the most vulnerable can benefit from effective coverage. By largely eliminating out of pocket payments, vouchers also contribute to financial protection, while building the systems needed for social health insurance (SHI).
Promoting universal financial protection in Nigeria
Chima Onoka is one of the authors of Promoting universal financial protection: constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria
Nigeria is on the brink of achieving Universal Health Coverage (UHC)... That is probably everyone’s wish. The reality though is that many hurdles separate Nigeria from that dream. Achieving UHC in Nigeria implies having financial risk protection for 150 million people, a step that for certain, will change African and global indices. Eight years after setting up a National Health Insurance Scheme (NHIS), 4% of Nigerians are covered by the scheme, largely through the Formal Sector Social Health Insurance Programme (FSSHIP) that currently, covers employees of the federal government and their families. The NHIS, an agency of the federal government, has established a plethora of social health insurance schemes (SHIPs) to ferry various population groups to the dreamland: Formal Sector SHIP (FSSHIP), Voluntary contributors SHIP (VCSHIP), Tertiary Institutions SHIP (TSSHIP), Community Based SHIP (CBSHIP), Rural Dwellers SHIP (RDSHIP), among others.
Who’s on your guest list? A reason to make sure policymakers are at the table
As co-sponsor and host of the workshop, “Equity in Universal Coverage: How to Reach the Poorest”, in Marrakech, Morocco from September 24-27, 2012, the Moroccan Ministry of Health was clear about the importance of organizing a workshop that acknowledged and linked the political dimension of achieving universal health coverage (UHC), to the discussion and debate on technical achievements and challenges. As RAMED, Morocco’s medical assistance scheme for the poor, moves to rapidly scale-up, ensuring continued government commitment is as critical to the success of the program as getting technical nuts and bolts issues resolved. RAMED needs the support of the Moroccan government to address its challenge of long-term financial sustainability and to continue to elevate affordability and quality in health service delivery as key priorities.
Parliamentarians as key allies in the movement towards universal health coverage
My experience at the equity in universal healthcare coverage workshop in Marrakech, Morocco
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.
Not just your average workshop
The September 24-27, 2012 workshop on “Equity in Universal Health Coverage: How to Reach the Poorest”
As these events go, the workshop on “Equity in Universal Health Coverage: How to Reach the Poorest” hosted last month by the Moroccan Government, the Financial Access to Health Services Community of Practice (FAHS CoP), and the Expanding Coverage Track of the Joint Learning Network for Universal Health Coverage (JLN), in Marrakech, Morocco was more than just your average seminar, symposium, convention, round table or even workshop.
Over 90 participants – including country delegations and individuals from Benin, Burkina Faso, Cote d’Ivoire, Ethiopia, Ghana, Kenya, Mali, Morocco, Nigeria and Senegal came together over the course of four days to engage in peer-to-peer learning and to share their experiences in designing, implementing, managing and advocating for programs to improve access to health care for the poorest. Participants left the workshop with renewed commitment to tackling the challenges they face in reaching the poorest, fresh ideas, and new partnerships.
JLN member countries convene in Morocco to discuss “Equity in universal health coverage: how to reach the poorest”
In co-operation with the Moroccan Government and the Financial Access to Health Services Community of Practice (FAHS CoP), the Expanding Coverage Track of the Joint Learning Network for Universal Health Coverage (JLN) recently organized a workshop in Marrakech, Morocco on the subject of “Equity in universal health care coverage: how to reach the poorest”. Immediately following the four day workshop which took place from September 24-27, 2012, the JLN hosted a one day session member on September 28, 2012 for JLN member countries from Sub-Saharan Africa to review action plans developed over the course of the workshop and to collectively brainstorm potential areas for peer and JLN support.
This was the first time that a JLN sponsored event supported the participation of parliamentarians focusing on the health sector.
Expanding coverage to the formal and informal sectors in Kenya
An interview with Mr. Richard Kerich, CEO of Kenya's National Health Insurance Fund
News of Kenya’s exciting and aggressive plans to expand universal health coverage (UHC) began making headlines in early 2012. The National Health Insurance Fund (NHIF) announced a new partnership with the Kenya National Union of Teachers – one of the largest unions in Kenya – whereby NHIF will provide an affordable and comprehensive package of in and out-patient benefits to more than 1,300,000 teachers and their family members.
In addition, NHIF is offering unlimited out and in-patient benefits for approximately 1,100,000 civil servants and their family members beginning on January 1, 2012. The NHIF is also seeking to extend the unlimited in and out-patient care benefits to the informal sector in a phased out manner.
South Africa Unveils National Health Insurance Plan
Health Minister Aaron Motsoaledi unveiled South Africa’s national health insurance (NHI) plan last Friday that seeks to extend universal health coverage to all citizens by 2025. The plan will be phased in over the next 14 years, starting with pilot schemes in 10 areas in April 2012. The idea of extending coverage to all was first discussed at the African National Congress’s (ANC) 52nd Annual Conference in December 2007 and reinforces South Africa’s Bill of Rights provision that “everyone has the right to have access to healthcare services, including reproductive healthcare.”
Under South Africa’s current two-tiered approach, health care is heavily skewed towards the private sector. Though only 20% of South Africans seek care in the private sector, the majority of resources are concentrated there and it has effectively distorted pricing across the public sector.
Working with Nigerian Policymakers to Share Lessons on National Health Insurance
Health Systems 20/20 features Health economist Dr. Hong Wang and the Joint Learning Network's workshop "Expanding Coverage to the Informal Sector" held in Mombasa, Kenya in June 2011.
Health economist Dr. Hong Wang did not come to the “Expanding Coverage to the Informal Sector” workshop to share a chapter from his book—he came to empower others. National policymakers from 13 developing countries took center stage at the four-day workshop hosted by the Joint Learning Network for Universal Health Coverage (JLN), sharing accomplishments and challenges to providing health coverage to poor and informal sector populations.
During the event in Mombasa, Kenya this June, Health Systems 20/20’s Dr.