Universal Health Coverage

Universal Health Coverage (UHC)
A cholera patient recovers at a treatment center in Lilongwe District, Malawi. Photo Credit: Erik Schouten/MSH

This story was originally published by Global Health Now

It was January of 1925, and Nome’s children were dying. Diphtheria had struck the Alaskan town, but the curative serum the local doctor needed was in Nenana, nearly 700 miles away.

Sub-zero temperatures meant that shipping the serum by air was not an option, so the governor turned to sled dog teams, which had delivered mail on that route. Over 5 and 1/2 days, 20 mush teams and their human drivers set up a relay and delivered the lifesaving medicine, a trek known as the “Great Race of Mercy”—now commemorated every year in an event called the Iditarod.

The moral: Get help when you need it, no matter how unorthodox.

We need to employ that strategy in global health development by integrating private sector organizations into our health system solutions more often. They operate where governments cannot and are a rich source of flexibility and innovation. When a country’s government is frozen by conflict, natural disasters, financial crisis, or another crippling event, its health care system is all too likely to follow. Health workers flee or fall victim themselves, and hospitals run out of medicine and go dark. Others must step in to fill the void.

Community health workers in Madagascar review patient data. Photo Credit: Samy Rakotoniaina/MSH

Originally published on LeaderNet

When community health programs are well-designed, managed, and sufficiently funded, they can yield substantial health and economic benefits. In addition to contributing to a healthier, more productive population, they can reduce the risk of costly epidemics while generating substantial cost savings for families and health systems (1). On the other hand, when poorly designed or managed and insufficiently funded, community health programs can fail to improve poor health outcomes and advance national health priorities.

Recognizing their potential in strengthening primary care and advancing Universal Health Coverage, countries are increasingly formalizing the role of the community health worker within their health systems. In fact, many countries have passed national community health policies to ensure that community health workers (CHWs) are well trained, incentivized, and equipped to provide a basic package of life-saving services within their communities.

Prize winner Vishal Phanse shares how his company, Piramal Swasthya, uses telemedicine and community outreach programs to make health care more accessible and available to marginalized populations in India. Photo credit: Sarah McKee/MSH

MSH and USAID Co-Host Celebration of Inclusive Health Access Prize Winners

On September 24, the US Agency for International Development (USAID) and MSH recognized the five winners of USAID’s Inclusive Health Access Prize: GIC Med, Infiuss, JokkoSanté, mDoc, and the Piramal Swasthya Management and Research Institute. These private-sector organizations have developed and proven innovative solutions to expand access to lifesaving basic health care in low- and middle-income countries while demonstrating a vision for expanding their approach.

“Locally Leading the Way to UHC: USAID’s Inclusive Health Access Prize,” attended by nearly 200 people in person and online, was held in conjunction with the United Nations General Assembly’s first-ever High-Level Meeting on Universal Health Coverage (UHC).

{A secretary records the weekly collection amounts for a savings and internal lending group in Madagascar. Photo credit: Samy Rakotoniaina/MSH}A secretary records the weekly collection amounts for a savings and internal lending group in Madagascar. Photo credit: Samy Rakotoniaina/MSH

By Amy LiebermanJenny Lei Ravelo

This story was originally published by Devex

The onus to help everyone — including the most marginalized — secure universal health care coverage will likely depend more on individual government spending than on new foreign assistance, experts say.

Funding will be a critical, but not guaranteed, element in the forthcoming universal health coverage agreement governments will sign in September during the opening of the U.N. General Assembly session.

“Aid is not going to help achieve the global health goals. It has to come from domestic spending. But aid is very important for purposes of equity and that the poor do not get left behind.”— Jacob Hughes, senior director of health systems, Management Sciences for Health

{Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity} Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity

This article was originally published by Global Health Now.

Paid or volunteer?

Community health workers are on the frontlines in many countries—and vital to achieving universal health coverage. Yet the public health community has not reached a consensus on which model is the best.

Consensus is urgently needed, both at the global and country levels, to inform future policies and strategies for strengthening health systems and delivering on UHC.

Based on our experiences in rural Peru and Ethiopia, it’s not either-or. It’s both.

Full-time, paid CHWs form the backbone of family- and community-based services, but there aren’t enough to reach all families. We envision teams of government-paid, full-time CHWs providing comprehensive services to a given population, with a primary health center hub as the base of operations. Each CHW, in turn, would lead a team of part-time community health volunteers providing limited health education and referral services—such as maternal and newborn health, nutrition, hygiene, tuberculosis, malaria, and HIV/AIDS—to a small number of neighboring families.

Dr. Mark Dybul, MSH’s newest board member, has been a leader in global health policy as Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria during the Obama administration and as head of the US President's Emergency Plan for AIDS Relief (PEPFAR) during the Bush administration. Dybul is Professor of Medicine and Faculty Co-Director of the Center for Global Health and Quality at Georgetown University Medical Center. He brings tremendous experience and insight into MSH’s work to strengthen systems that improve the health of the world’s most vulnerable populations, including those living with HIV.

As we prepare for the 22nd International AIDS Conference, we sat down with Dybul to discuss the fight against HIV and AIDS, the need for strong systems to support a more effective and sustainable response, and how we must leverage those systems beyond HIV to improve health more broadly. 

Mark Dybul: Building Systems for Health to End HIV and AIDS

This interview was edited for length and clarity.

 {Photo credit: MSH}Loyce Pace of the Global Health Council moderates an expert panel at the WHA71 side event in Geneva, May 22, 2018. Panelists included Dr. Diane Gashumba, Rwanda’s Minister of Health; Catharina Boehme, CEO of the Foundation for Innovative New Diagnostics; and Rüdiger Krech, Director of Health Systems and Innovation at WHO.Photo credit: MSH

Is the world safer today from the threat of infectious diseases than it was a generation ago?

It is true that we have more tools at our disposal: better surveillance and diagnostic systems, stronger frameworks and regulations, such as the Global Health Security Agenda and Joint External Evaluations (JEE), and a deeper understanding of how diseases spread and what is needed to stop them. It is also true that climate change, deforestation, population growth, and our proximity to farm and wild animals are making the threat of epidemics greater than ever before. Although the challenge is great, we have the knowledge to solve it. So what do we need to do?

{Photo Credit: Warren Zelman}Photo Credit: Warren Zelman

This story was originally published on Devex

The World Health Organization recently issued a statement calling on all countries to make three specific commitments to universal health coverage and be prepared to announce them at the World Health Assembly, which begins May 21.

UHC — the assertion that every person must have access to the health services they need, when and where they need them, without facing financial hardship — improves health. But that’s not all: It reduces poverty, creates jobs, drives economic growth, promotes gender equality, and prevents epidemics. It’s a momentous occasion and a great opportunity to start making real progress toward UHC.

But unless country commitments include efforts to strengthen pharmaceutical systems, communities will continue to struggle with inadequate health services and rising health costs that put their health and economic well-being in peril.

{Photo Credit: Warren Zelman}Photo Credit: Warren Zelman

This story was originally published by Women Deliver.

In recent decades, a great deal of resources have been invested in the delivery of essential health services, especially through support to the six building blocks of strong health systems – health financing, health workforce, health information, health governance, medical products, and service delivery. These investments have been hugely important and effective in forming a foundation, supporting frontline health workers to save lives, and in securing unprecedented commitment to the common goal of achieving universal health coverage (UHC).

But the fact remains that over half the world’s population – women, children, and adolescents in particular - is still unable to access the high quality health services they need.

Women, children and adolescents remain underserved by health systems and suffer a disproportionate burden of morbidity and mortality, which endangers the broader well-being of the whole of society.

 {Photo Credit: Diana Tumuhairwe}Mary Nkiinzi, a TRACK TB Community Linkage Facilitator for the Komamboga Health Centre in Uganda, checks on Nakawesi Harriet and her family during a home visit while Harriet and her mother complete treatment for multi-drug resistant TB (MDR-TB).Photo Credit: Diana Tumuhairwe

Tuberculosis remains the world’s leading infectious disease killer. Ending TB will require a comprehensive approach and targeted action, rapid innovation and proven interventions, bold leadership, and intensive community engagement.  

On this World TB Day, the global health community is calling for “Leaders for a TB-Free World” to work together, make history, and end TB once and for all.

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