Today, on Universal Health Coverage Day, world leaders are arriving in Tokyo to participate in the 2017 Universal Health Coverage Forum, an important milestone for global efforts to achieve universal health coverage. In 2015, United Nations member states agreed to make UHC by 2030 one of the Sustainable Development Goals. Why? Because without satisfactory health coverage for individuals, the well-being of a nation is put into question. It also makes good economic sense, both for the individual and the country.
U.N. figures show that at least 400 million people globally lack one or more essential health services. Every year around 100 million people are pushed into poverty because of medical expenses. So it is a good thing that governments are recognizing the value of investing in health. In countries around the world, from Nepal to Thailand, China to Egypt, Ghana to Cambodia, efforts to achieve UHC are gaining momentum and citizens are demanding quality, affordable health care.
“Good health does not exist in a vacuum. It is inextricably linked to education, sanitation, nutrition, and all other factors that influence the well-being of children and families.”— Luwei Pearson, deputy director for health, UNICEF
UNICEF and other international organizations are supporting these efforts. We are focusing on programs to strengthen health systems in the poorest, most disadvantaged communities. If we fail to reach the most vulnerable children, the goal of UHC will not be achieved.
It will be challenging. Marginalized communities are often mired in poverty and subject to stigma and discrimination. They have little political or economic power. Faced with limited resources, governments may not prioritize investment in these groups.
UHC as an investment
But the evidence is clear. Investments in UHC yield the highest returns when they target the most deprived families and children. UNICEF’s research shows that investment in high-impact solutions such as breast-feeding and immunization targeted to the poorest can save almost twice as many lives as similar levels of investment in groups that are better off financially.
Global efforts to achieve UHC must therefore begin by identifying the most deprived communities and breaking down the barriers to good health. But how can this be done?
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1. Deploy a multi-pronged effort
Health services must be of sufficient quality to ensure that the public will trust and use them. Frontline health workers must be trained, paid, and at work; health facilities must be functional with essential supplies. None of these factors can be ignored, or we run the risk of undermining already weak health services. For example, a health clinic cannot operate without trained personnel who are incentivized to provide quality services. A skilled birth attendant helping with a late-night delivery must have proper lighting, hot water, soap, and other essential items.
2. Integrate services
Good health does not exist in a vacuum. It is inextricably linked to education, sanitation, nutrition, and all other factors that influence the well-being of children and families. Services must be integrated to best serve the people for whom they are designed. By working with governments, civil society, the private sector, and individuals, UNICEF supports efforts to create joined-up services that meet the needs of service users.
3. Consider accountability
This will be key. When people are empowered to provide feedback and shape the services they receive, then quality, demand, and health outcomes improve. Accountability does not stop at the community level, but extends from the village clinic to the ministry of health. In countries around the world, UNICEF is supporting communities and individuals to demand quality health services by strengthening feedback and accountability mechanisms.
UNICEF believes the global effort to achieve UHC is one of the most ambitious undertakings in human history. The stakes are high: the future health, well-being, and prosperity of our world. We cannot be intimidated by the magnitude of the task. The world has the evidence, the knowledge, and resources to achieve good health for every child and family.
We hope governments, civil society groups, organizations, and individuals will join the growing coalition of activists and advocates who assert that no child should die of preventable causes. We can build a healthier, happier world — for every community, for every child.
How do we ensure that people worldwide get the care they need without the risk of being pushed further into poverty? Devex explores the path to universal health coverage. Join us as we ask what it will take to achieve UHC for all by visiting our Healthy Horizons site and tagging #HealthyHorizons, #Health4All and @Devex.
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