4th Ask for Universal Health Coverage

16 April, 2019

Questions motivated by the 4th Ask for Universal Health Coverage:

The 4th of 6 Asks from a UN meeting promoting universal health coverage sets the challenge to “uphold quality of care”. The “action agenda” for this 4th Ask includes: “Build quality assurance measures to achieve..the..safety of patients, families and providers”. (https://www.uhc2030.org/fileadmin/uploads/uhc2030/Documents/UN_HLM/The_U...)

Thinking about that challenge, I have a couple of questions for HIFA members:

Question 1: What is the patients’ role in patient safety?

Eg: Are patients encouraged to observe providers and to ask about procedures? Are patients expected to influence management decisions to improve/fund safety?

Question 2: What should public health agencies tell people about adverse effects?

Eg: Infections and deaths from unsafe healthcare? This question has a simple answer from the Declaration of Lisbon: tell patients about risks. But we can see health agencies not telling people about risks. 

For example, nosocomial transmission contributes to the ongoing ebola outbreak in western DRC. On 28 January, WHO’s assistant director general told WHO’s executive board that an estimated 80-85% of cases in Beni were acquired in health facilities (hear Dr Ryan Circa 48 minutes into the video of the 2nd session, 28 January 2019, available at: https://www.who.int/news-room/events/executive-board-144th-session). Yet periodic reports to the public by WHO Geneva (https://www.who.int/csr/don/archive/disease/ebola/en/), WHO/Africa (https://www.who.int/ebola/situation-reports/drc-2018/en/), and DRC do not say how many people got ebola from health facilities, in which town, what procedures likely infected them, etc.

Is there a problem with such incomplete reports? What if anything should be changed?



HIFA Profile: David Gisselquist is an independent consultant in the United States and has a professional interest in nosocomial risks and transmission of HIV in Africa, agricultural development and agricultural inputs regulation, environment.

Email address: david_gisselquist AT yahoo.com​​