We have been catching up with the Post UN HLM on Universal Health Coverage of 23 September 2019 in New York, and we are struck by the lofty but imperative 'Asks' and 'Milestones' set by the UN. Particularly we are glad to note the emphasis on quality of care throughout the document, which PACK Nigeria programme showed during its pilot that it can be the tool for Nigeria to meet the Quality Goal of UHC in PHC, going forward.
QUOTE: 'Health is the foundationfor people, communities and economies to reach their full potential. Universal Health Coverage (UHC) is primarily the responsibility of governments, which ensure people’s health as a social contract. Achieving UHC is essential for inclusive development, prosperity and fairness, and requires political decisions that go beyond the health sector.'
'Moving Together to Build a Healthier World'
Key asks from the UHC Movement UN High-Level Meeting on Universal Health Coverage:
Ensure political leadership beyond health– Commit to achieve UHC for healthy lives and wellbeing for all at all stages, as a social contract. Health is the foundation for people, communities and economies to reach their full potential. Universal health coverage (UHC) is primarily the responsibility of governments, which ensure people’s health as a social contract. Achieving UHC is essential for inclusive development, prosperity and fairness, and requires political decisions that go beyond the health sector.
Leave No One Behind– Pursue equity in access to quality health services with financial protection.
Health is enshrined as one of the fundamental rights ofevery human being. UHC is key to reducing poverty and promoting equity and social cohesion. Governments should invest in everyone’s health. Extension of geographical coverage and reaching the most marginalised and hard-to-reach populations are essential to achieving positive health outcomes. A strong system for monitoring and evaluation is needed to ensure accountability and participation.
Regulate and Legislate– Create a strong, enabling regulatory and legal environment responsive to people’s needs.
UHC requires a sound legal and regulatory framework and institutional capacity to ensure the rights of people and meet their needs. Governments are the primary duty bearer under the International Covenant on Economic, Social and Cultural Rights, even in cases when they rely on private providers.
Uphold Quality of Care– Build high-quality health systems that people and communities trust.
Quality primary health care (PHC) is the backbone of UHC and creates trust in public institutions. Expansion of health coverage must be accompanied by investments in the quality of health services. People should be able to access a full spectrum of safe, quality services and products in their community, delivered by well-trained, well-paid, culturally and gender-sensitive healthworkers.
Invest More, Invest Better– Sustain public financing andharmonise health investments.
Current funding levels are insufficient to achieve UHC by 2030. Governments need to increase domestic investment and allocate more public financing for health through equitable and mandatory resources. Governments must improve efficiency and equity in the use of existing resources and reduce reliance on impoverishing out-of-pocket payments. Development assistance to health should reduce fragmentation and strengthen national health financing capacities.
Move Together– Establish multi-stakeholder mechanisms forengaging the whole of society for a healthier world.
All countries must take active steps to meaningfully engagemnon-governmental actors- particularly from unserved, underserved or poorly-served populations- in shaping the UHC agenda. Solutions for each country must be tailored to context and population needs. The international community and global health partners should unite to support countries to build a healthier world.
Milestone by 2023, governments incorporate aspirational health-related SDG targets into national planning processes, policies and strategies to ensure everyone can access quality health services without financialhardship.
Milestone by 2023, governments report disaggregated data to SDG official statistics to capture the full spectrum of the equity dimensions of UHC monitoring progress (SDG 3.8.1 and 3.8.2).
Milestone by 2023, governments introduce legal and regulatory measures that accelerate progress toward UHC.
Milestone by 2023, the coverage of quality essential health services has been delivered to one billion additional people (SDG 3.8.1).
Milestone by 2023, governments adopt ambitious investment goals for UHC, make progress in mobilising domestic pooled funding and reduce catastrophic health expenditure (SDG 3.8.2).
Milestone by 2023, all UN Member States endorse the UHC2030 Global Compact and establish multistakeholder platforms to ensure the involvement of civil society, communities and the private sector, in regular policy dialogue and review of progress with all government actors.
HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007.
Joseph is a member of the HIFA Steering Group: http://www.hifa.org/people/steering-group: http://www.hifa.org/support/members/joseph-0
Email: jneana AT yahoo.co.uk