Despite important setbacks and inconsistent rates of progress across countries, achieving Universal Health Coverage (UHC) by 2030 remains a priority for the global health community. The Center for Global Development and the World Bank Group recently convened a panel of experts on the health financing agenda for #UHC2030 moderated by Amanda Glassman. The panel featured: Dinesh Arora, Sommer Scholar (MPH), Johns Hopkins Bloomberg School of Public Health, and Former Deputy CEO, National Health Authority, India; Henrietta Fore, Executive Director, UNICEF; Mohamed Ahmed Maait, Minister of Finance, Egypt; Muhammad Ali Pate, Global Director of the Health, Nutrition and Population Global Practice and Director of the Global Financing Facility, World Bank. Experts were highly aligned on a number of key recommendations. In particular, when looking towards UHC, the international community should:
– Differentiate between health financing and health provision: Efforts should be focused on positioning the government to be a purchaser rather than a provider of healthcare, for specific instances in which it is unable to provide services effectively or at the required scale to achieve UHC.
– Diversify financing mechanisms: A blend of financing mechanisms will be required to provide UHC in countries with aging populations and evolving health needs. In particular, demand-side financing shows emerging promise in certain contexts.
– Prioritize cost-effectiveness: In light of limited healthcare budgets, focus on efficacious and efficient funding, orienting resources towards vulnerable populations who show the greatest need and potential to benefit.
– Outsource responsibilities to independent, accountable agencies outside government: Rather than coordinating all actions within government, federal agencies should outsource some responsibilities to independent agencies who are able to carry out the mandate in an efficient manner while remaining immune to political pressures. This includes empowering the private sector in service provision.
– Shift the focus to quality: In order to adequately leverage UHC to improve health outcomes, both access and quality of healthcare must be enhanced. Quality assurance efforts for UHC have thus far been limited, and could be strengthened by fostering competition between public and private sector providers and offering adjusted pricing.
– Integrate PHC into UHC, including NCD care: Given the rise of NCDs observed today, primary care service delivery models should target the earliest instances of NCD pathology to drive efficiencies in care as the population undergoes an epidemiological transition.
– Leverage IT systems, digital & precision health: While digital and precision health are expanding, many countries are not equipped with personal health data systems. Fostering the development of these systems through public-private partnerships will be essential to enhancing the productivity and ability of countries to look after the health of their citizens.
– Adapt approaches to context: At both the global and country levels, there is a strong need to translate commitments into action and implementation. In order to do so, on-the-ground realities such as availability of human capital, adoption of technologies, and level of infrastructure must be considered to translate commitment to the local context and maximize the potential for success.
These recommendations largely echo those made by other key thought leaders and actors in the development space, and resonate with much of our work at Impact for Health. Despite widespread consensus, progress against these recommendations is often slower than desired. Exploring the potential opportunities and the nature of the barriers to implementation (political, financial, technical, or otherwise) could yield important insights moving forward.
Kariane St-Denis, Associate
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