UHC Forward: Towards Universal Health Coverage

Meet Majid. This 15 year old boy is the primary earner for his family in Pakistan. Majid was hit by a tractor, leaving him out of a job, with no money for an operation, and a starving family. More than 120 million people in Pakistan pay out of pocket for needed health care services. As a result, many are at risk of catastrophic expenditures that lead to a downward spiral of poverty or the possibility of becoming indebted for life.

One organization is trying to change this picture, by actively seeking patients who are at risk. Heartfile Health Financing, profiled on the Center for Health Market Innovations (CHMI), is an example of the type of private sector innovation that can be used to mobilize progress towards universal health coverage (UHC).

The World Health Report: Health systems financing: the path to universal coverage chose three dimensions (population, services, direct costs) to consider when moving towards universal coverage, as demonstrated by a graphic cube (on page 12). A major theme emerging on day one of the conference “Universal Coverage in Developing- Country Health Systems: Ethical Dilemmas" is that the cube does not go quite far enough.

The cube is meant to demonstrate the tradeoffs between covering direct costs, the population, and services. A nation has to decide to what extent and to what degree they will cover each area. In essence, universal health coverage is a balancing act or, rather, a tug of war, between these different priorities.

As a partner on the Abt Associates-led Health Finance and Government Project, leveraging its wide network the Joint Learning Network for Universal Health Coverage helped facilitate study tours to Ghana, the Philippines and Rwanda for health sector agency officials from Ethiopia and Benin. These study tours will allow the opportunity to learn from the practical experiences of other countries implementing health insurance reforms and to understand the challenges countries face in operationalizing health insurance reforms.

On March 22-28, Ghana’s National Health Insurance Authority (NHIA) hosted a delegation of fourteen members from the Ethiopia Health Insurance Agency (EHIA) and partner organizations. The NHIA also hosted a delegation from the Benin Ministry of Health on April 8-12.

Governments around the world are engaging in serious political and technical discussions on how to expand health coverage. Still others are considering such reforms, but are struggling to navigate the legal, financial, and political frameworks of their countries to determine the best path towards universal health coverage (UHC).

Below is a list of UHC-related headlines from around the world for the week of April 1, 2013.