Universal Health Coverage

Universal Health Coverage (UHC)
{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:

 {Photo credit: Crystal Lander/MSH}Gloria Sangiwa (left), MSH Senior Director of Technical Quality and Innovation and Global Technical Lead on Chronic Diseases, talks with another delegate at the Global Health Council (GHC) welcome reception.Photo credit: Crystal Lander/MSH

This blog post is part of our Global Health Impact series on the 67th World Health Assembly in Geneva, May 18-24, 2014. MSH is co-hosting three side events focusing on the role of universal health coverage (May 20), chronic diseases (May 20), and governance for health (May 21) in the post-2015 framework. This year, six MSH representatives are attending WHA as part of the 60-plus-person Global Health Council (GHC) delegation.

Sunday was my first day in Geneva for the World Health Assembly (WHA). I attended WHA last year for the first time, and I am feeling a bit like a second-year college student.

As I prepared for this year’s meeting, a few colleagues asked me: Why is the WHA so important to global health policy? Who attends these things and why? I instantly responded to the questions somewhat defensively: "It’s the WHA--that’s why!"

Unpublished
{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

Please join Management Sciences for Health (MSH) at the 67th World Health Assembly (WHA), May 18-23, 2014, in Geneva, Switzerland. The WHA is the supreme decision-making body of the World Health Organization (WHO), and is attended by delegations from all WHO Member States.

This year, six MSH representatives will attend as part of the 60-plus-person Global Health Council (GHC) delegation.

MSH will co-host three side events focusing on the role of universal health coverage (May 20), chronic diseases (May 20), and governance for health (May 21) in the post-2015 framework.

UHC and Post-2015 Health Discussion

Tuesday, May 20, 2014
10h00 – 13h00 CET

Centre de Conventions de Varembé
Salle C, 9-11 rue de Varembé, Geneva

 {Photo credit: Sarah Lindsay/MSH.}Youth delegates at the World Conference on Youth in Hambantota, Sri Lanka.Photo credit: Sarah Lindsay/MSH.

Good governance is like a large elephant, Ahmed Adamu, Chairperson of the Commonwealth Youth Council, said. One person can touch the trunk, one the stomach, and one the tail, and they have had very different experiences with the elephant. Around the world, everyone has different experiences and different perceptions of good governance. With this anecdote, Adamu, a speaker at the plenary, “Achieving Good Governance and Accountability” at the 2014 World Conference on Youth, captures the challenges of defining good governance often cited in more academic terms. Though the concept of good governance is up for interpretation, there is consensus across countries, generations, and sectors that it is sorely needed. According to a consultation by Restless Development with young people in 12 countries , overall, governance is their most important issue that should be addressed in the post-2015 dialogue. And while good governance might be their most pressing concern, according to Subinay Nandy, Sri Lanka’s Resident Coordinator to the United Nations, it is young people themselves who are the most important tool international agencies can use to guarantee good governance.

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

For the mother who walks miles for health,

Carrying a near-lifeless child on her back,

We envision a world…

 

For the mother, living with HIV, who mentors others,

Helping to prevent transmission of the disease,

We envision a world…

 

For the mother who must choose

Improving the health of a parent or educating a child,

We envision a world…

 

For the mother who births, the mother who feeds,

And the mother who cares for a child,

We envision a world...

 

Where -- all mothers, all children -- everyone

Has the opportunity for a healthy life.

 

Happy Mother’s Day to you and yours!

 

 {Photo credit: Anteneh Tesfaye/MSH.}MSH staff Grace Gatebi and Patrick Borruet at the MSH Kenya UHC Symposium photo exhibition.Photo credit: Anteneh Tesfaye/MSH.

The goal of universal health coverage (UHC) is to improve equitable access to health services while protecting households from impoverishing out-of-pocket health spending. In principle, UHC means that lifesaving services and medicines will be accessible and affordable for those who need them. To create deeper awareness of UHC in Kenya, Management Sciences for Health Kenya (MSH Kenya) country office organized a symposium on setting the national health agenda post 2015, called, “Achieving Universal Health Coverage through Stronger Health Systems”.

During the symposium, MSH Kenya organized a photography contest. MSH staff submitted photographs on the theme of “Achieving Universal Health Coverage in Kenya – Financing, Quality, Access and Essential Medicines” (with a focus on the most vulnerable populations). An independent jury selected 19 of the photos for an exhibition at the symposium.

 {Photo credit: Anteneh Tesfaye Lemma/MSH.}Kenyan Cabinet Secretary for Health James Macharia (left) and MSH President Jonathan D. Quick (right) sign the canvas pledge.Photo credit: Anteneh Tesfaye Lemma/MSH.

I felt like I had traded my mother’s health for my children’s schooling. It was a tough choice, and I cried every day.

This emotional remark was made by Lucy Njoki, a Kenyan mother and grandmother, at the Health for All Campaign Launch Event on April 28, 2014, in Nairobi. She had been forced to choose between paying for her children’s education or her mother’s urgently needed medical treatment. She could not afford both. Affordable and accessible health care remain an unrealized dream for many Kenyan citizens.  

Unfortunately, Lucy’s story is not uncommon. Lucy represents millions of people who are pushed into poverty due to catastrophic health expenditures in Kenya. The Health for All: Campaign for Universal Health Coverage in Africa is building awareness and advocating for universal health coverage (UHC) in Nigeria, Ethiopia, and Kenya. Implemented effectively, UHC ensures that all people have access to the quality services they need, without suffering financial hardship.

 {Photo credit: <a href="http://www.kwibuka.rw/">Kwibuka 20</a>}The #Kwibuka20 Flame of Remembrance burning bright at the Kigali Genocide Memorial Centre, Rwanda.Photo credit: Kwibuka 20

Twenty years ago, the genocide perpetrated against the Tutsi began in Rwanda. Nearly a million people were slaughtered from April through July, 1994.

In 2003, the UN General Assembly designated April 7 as International Day of Reflection on the 1994 Genocide in Rwanda. This year, to mark the 20th anniversary, the Republic of Rwanda launched Kwibuka20 (“Remember20”), a series of events commemorating the tragedy and honoring the nearly one million Rwandans who lost their lives.

The theme of Kwibuka20, “Remember, Unite, Renew”, also celebrates the remarkable story of resilience and hope of the Rwandan people, who are building a new, prosperous, and cohesive society. Kwibuka20 calls on the global community to stand together against genocide in three key ways:

 {Photo credit: MSH}(From left) Hiwot Emishaw (Health for All Campaign); Dr. Femi Thomas (National Health Insurance Scheme); Prof. Khama Rogo (Health in African Initiative, International Finance Corporation in Nigeria); Hon. Minister of Health, Prof. C.O. Onyebuchi; Amb. Bala Sanni (Federal Ministry of Health); Nuhu M. Zabagyi (NHIS Board Chairman); Marie Francoise Marie Nelly (World Bank Country Representative); Pieter Walhof (PharmAccess Foundation); Abuja, March 9, 2014.Photo credit: MSH

In Nigeria, the Health for All: Campaign for Universal Health Coverage in Africa is effectively collaborating with stakeholders to support the government move toward universal health coverage (UHC).  Led by MSH and funded by The Rockefeller Foundation, the Health for All Campaign co-hosted a National Stakeholders Meeting on UHC in conjunction with the National Health Insurance Scheme (NHIS), International Finance Corporation (IFC) and PharmAccess Foundation on March 9, 2014. The prior day, March 8, the campaign hosted a media forum on “Effective coverage of progress towards universal health coverage in Nigeria.”

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