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 {Photo credit: MSH}Colin Gilmartin, Dr. San San Aye, Uzaib Saya, and David Collins present at HSR 2014.Photo credit: MSH

This post originally appeared on the MSH at the Third Global Symposium on Health Systems Research conference blog.

On September 30 – October 3, 2014, nearly 3,000 researchers, program managers, and policy makers convened in Cape Town, South Africa for the Third Health Systems Research Symposium (HSR2014) to review evidence and research focused on improving people-centered health systems and service delivery. A key component to strengthening health systems and improving health outcomes is through health care financing mechanisms.

{Photo credit: Rui Pires - Ghana.}Photo credit: Rui Pires - Ghana.

Sometimes the people who know best are, well, the people, say MSH President & CEO Dr. Jonathan D. Quick and colleagues in the second issue of The Strengthening Health Systems Journal.

Achieving the fundamental objectives of universal health coverage (UHC) and meeting the challenges of governing complex health systems requires people-centered schemes that include formal mechanisms to bring civil society and communities into the design and implementation of UHC programmes.

Dr. Quick, Research & Communications Specialist Chelsey Canavan, and Senior Writer Jonathan Jay highlight three areas where civil society and communities play vital roles in people-centered health systems: 1) ensuring the right services are provided under an essential package of health services; 2) removing barriers to care such as user fees; and 3) ensuring equitable access to health services.

In each of these areas and at every level of the health system, "citizen representation is essential", Quick and colleagues say. Bringing communities into the process at every step in the design and implementation of UHC will help "ensure meaningful increases in equity and improvements in health outcomes for the people the health system is meant to serve".

 {Photo credit: MSH/#ToastUHC photo booth/RH}Yvonne Chaka Chaka (center) with members of the UN Mission from Japan (including Toshihisa Nakamura and Masaki Inasa), and Sumie Ishii of JOICFP.Photo credit: MSH/#ToastUHC photo booth/RH

Experience "A Toast to Universal Health Coverage" () through photos and tweets in this Storify story . (Storify is a social media tool for curating digital content, such as photos, videos, links, and tweets.) You can also view the complete Photo album: " Photo Booth" on Facebook. (Share and tag these photos via Facebook, Twitter, Instagram, or your favorite social media channel, using hashtag .)

{Photo credit: Mark Tuschman.}Photo credit: Mark Tuschman.

Universal health coverage (UHC) and non-communicable diseases (NCDs) are high priorities in global health—just look at the proposed post-2015 development goals. The increasing burden of NCDs is widely recognised, and a growing list of countries have joined the UHC movement. But what’s less widely understood is why a UHC approach is necessary for an effective NCD response.

 {Photo credit: Todd Shapera.}Mother and daughter at Kigali Hospital, Rwanda.Photo credit: Todd Shapera.

What do the next 500 days mean for global health?

The looming deadline of the Millennium Development Goals (MDGs) will prompt a final push to achieve the health targets that have helped guide the global community since 2000: to reduce maternal and child mortality, provide contraception and curb the HIV, TB and malaria epidemics. Undoubtedly, many people will benefit from vital health services in the next 500 days.    

But many others won’t, and they’re likely to be the people who are already most vulnerable and least served. For example, as maternal deaths have dropped in developing countries, deaths are more concentrated in poor regions; the HIV epidemic still rages in marginalized populations like sex workers and people who use drugs. A key lesson of the MDG era is that nothing contributes to illness more than poverty and exclusion.

In the next 500 days, therefore, many voices will be calling for a new approach to global health in the post-2015 development framework. It’s a dramatic reinvention around a simple idea: that everyone, everywhere, should have affordable access to the health services they need.

 {Photo credit: Amarachi Obinna-Nnadi/MSH}Dr. Zipporah Kpamor, MSH’s Nigeria Country Representative, speaking during the African Health Innovation meeting in Abuja, Nigeria.Photo credit: Amarachi Obinna-Nnadi/MSH

"Good leadership skills, flexible policies, and constant advocacy will improve health in Africa," said Dr. Zipporah Kpamor during her talk at the Africa Health Innovation meeting in Abuja, Nigeria, on May 7, 2014. As Management Sciences for Health (MSH’s) Nigeria Country Representative and project director for the US President's Emergency Plan for AIDS Relief (PEPFAR)-funded US Agency for International Development (USAID) project, Community-Based Support for Orphans and Vulnerable Children (CUBS), Zipporah is an expert on the conference’s theme: Leapfrogging development challenges to transform Africa’s health. 

Zipporah offered poignant insight on one of the meeting’s discussion topics: Leadership, policy, and advocacy for health in Africa:

 {Photo credit: Brooke Huskey/MSH.}Mother and baby in the pediatric ward at Shinyanga Regional Hospital, Tanzania.Photo credit: Brooke Huskey/MSH.

The most recent edition of the MSH Global Health Impact Newsletter (May 2014, Issue 5) highlights MSH and global efforts moving toward universal health coverage (UHC) in the post-2015 development framework. This issue includes: MSH President & CEO Dr. Jonathan D.

{Photo credit: Chelsey Canavan/MSH, in Kenya.}Photo credit: Chelsey Canavan/MSH, in Kenya.

“While Kenya has seen improvements in areas like HIV care and treatment and child survival, many Kenyans still struggle to access basic healthcare,” says Dr. Jonathan D. Quick, President and CEO of Management Sciences for Health (MSH), in an op-ed published today in The People, a Kenyan newspaper.

Quick returned to the country to speak at Kenya’s launch of the Health for All: Campaign for Universal Health Coverage in Africa (Health for All) last month.

In the op-ed, Quick highlights the country’s progress toward universal health coverage (UHC) and the role of Health for All:

The campaign’s role is to help build awareness at national and county levels about the importance of expanding access to healthcare, and to ensure that issues like infrastructure, health workers, and financing receive adequate attention in the planning process.

{Photo credit: Todd Shapera.}Photo credit: Todd Shapera.

In a health clinic outside Nairobi, Kenya, Janet* waits to see a doctor. Janet is a 32-year-old widow and mother of four from Kibera, a neighborhood of Nairobi. Her 11-year-old daughter, Jane*, isn’t feeling well. Both mother and daughter are HIV-positive.

Janet and Jane are lucky to live walking distance to the Langata Health Center, where they receive high-quality health care for free. Jane has been on antiretroviral medication for more than two years. Janet hasn’t paid a shilling. Around the world, millions of people living with HIV struggle to pay for care, or receive none at all. But Janet and Jane are among the 600,000 Kenyans whose HIV care is free through programs from the Government of Kenya, US President's Emergency Plan for AIDS Relief (PEPFAR) program, and The Global Fund to Fight AIDS, TB and Malaria.

Janet wishes everyone could receive the same care that she does at Langata. But even for her, the system just barely works. She explains:

The doctor is only one, and we are many.

Patients at Langata face long waits to see a doctor or pick up their medications. Patients like Janet spend hours away from work and may have to arrange for child care.

{Photo credit: Rui Pires.}Photo credit: Rui Pires.

Cross-posted with permission from WBUR's CommonHealth Blog.

A study released last week found that insurance is saving lives in Massachusetts. Expanded coverage will mean 3,000 fewer deaths over the next 10 years. We have state-of-the-art health facilities and are among the healthiest of Americans. Despite the fiasco of our failed enrollment website, the state maintains near-universal health coverage, and inspired the Affordable Care Act.

Our example is heartening not just for America, but for the many low- and middle-income countries around the world working toward universal health coverage. These countries aren’t just taking a page from our book, though — they have valuable lessons for us, too.

Here are four things Massachusetts could learn about health from developing countries:

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