Annals of Tropical Medicine and Public Health

LETTER TO THE EDITOR
Year
: 2016  |  Volume : 9  |  Issue : 4  |  Page : 292--293

Emphasizing the need to achieve universal health coverage worldwide


Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India




How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Emphasizing the need to achieve universal health coverage worldwide.Ann Trop Med Public Health 2016;9:292-293


How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Emphasizing the need to achieve universal health coverage worldwide. Ann Trop Med Public Health [serial online] 2016 [cited 2019 Sep 21 ];9:292-293
Available from: http://www.atmph.org/text.asp?2016/9/4/292/184797


Full Text

Dear Sir,

The policymakers and international stakeholders together have aimed to achieve universal health coverage (UHC), which means that all people receive the comprehensive package of essential and quality assured health services, without being getting exposed to the financial hardship while paying for them.[1] In the modern era, where the costs of availing health care are increasing day-by-day, and if people only have to pay for most of the expenses through their own pockets, the poor will never be able to avail the health-care services they need and even the rich have to face financial debt, especially for serious/chronic ailments.[1],[2]

In fact, the recent global estimates suggest that almost 0.4 billion people have no access to one or more essential health services, while more than 0.1 billion people land into poverty, and another 0.15 billion people suffer financial catastrophe, predominantly due to their out-of-pocket (OOP) expenditure on health services every year.[1] These are quite alarming estimates (as more than 30% of total health expenditure globally is derived from OOP expenses) and clearly suggest that national policymakers should prioritize health services depending on the epidemiological attributes, quality of the health-care delivery systems, the status of the socioeconomic development, and needs of the general population.[2],[3]

The primary objective for UHC is to sustain the quality of health services to be good enough to eventually improve the health status of the beneficiary population.[1] However, it is very important to understand that UHC cannot be achieved by mere health financing (as none of the nations in the long run can provide all health services free of cost) but should cover all components of the health system to be successful, and it is not limited to extending a minimum package of health services but to gradually upscale the coverage of health services depending on the availability of resources.[1],[2] Additionally, UHC cannot be achieved worldwide overnight, unless all the nations implement measures to move forward toward it, and at the same time sustain the gains already accomplished.[1],[2],[3]

A wide range of prerequisites have been identified to ensure significant movement toward UHC, namely, sustained political support, strengthening of the existing health systems, adopting innovative measures to raise sufficient funds, reduce OOP expenditure, and rationally use available funds; adequate number of health workers; well-functioning health information systems; and a well-designed standardized mechanism to not only monitor the progress (assess both coverage of population with essential health services and financial protection against catastrophic OOP spending) toward UHC but also enable international comparison.[1],[2],[3],[4],[5],[6] Further, in the process of achieving UHC, members of the community are empowered to take appropriate preventive measures on their own to ensure cost-saving efficiency in future.[1],[4]

In Gabon, considering the ever-growing demand of mobile phones, an innovative approach to raise revenue for the national health system has been adopted since 2008 by imposing a 10% levy on the mobile phone manufacturers and on mobile phone usage.[7] Since then, almost 99% of the poor population have been covered for essential health services under the health insurance program, there have been a significant drop of 14% in OOP expenditure on health, newer hospitals with modern equipment have been developed, and improvement in various mother and child welfare indicators have been achieved.[7] However, even now a lot needs to be done to improve the other determinants of health, expand the benefits to the entire unorganized sector, and to meet the increasing demands on the health system.[7]

Acknowledging the need to achieve UHC across the globe, the World Health Organization has played a crucial role in not only supporting various nations but also sustaining the gains by developing a three point framework (viz., coverage of health services, financial risk protection, and equity for all) to monitor the progress.[1],[2],[3] In addition, strengthening of the primary health care, especially in low resource settings and motivating policymakers to increase the usage of quality assured generic drugs, can play a significant role as well.[1],[3],[5],[7]

To conclude, UHC will be one of the best contributions of public health toward the betterment of the general population. However, the need of the hour is that all the stakeholders should work together and deliver the health services in a comprehensive and integrated manner, to ensure that catastrophic financial expenditure is significantly reduced worldwide.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization. Universal Health Coverage (UHC) — Fact Sheet No. 395. 2015. Available from: . [Last accessed on 2015 Dec 14].
2Wong J. Achieving universal health coverage. Bull World Health Organ 2015;93:663-4.
3Saavedra MA, Greer SL, Méndez CA. Governance, Decision-Making, and Universal Health Coverage: Perceptions from Chilean Health Decision-Makers. Value Health 2015;18:A854.
4WHO, World Bank Group. Monitoring Progress towards Universal Health Coverage at Country and Global Levels: Framework, Measures and Targets — Joint WHO/World Bank Group paper. Geneva: WHO Press; 2014. p. 1-13.
5WHO, World Bank Group. Tracking Universal Health Coverage:First Global Monitoring Report. Geneva: WHO Press; 2015. p. 1-7.
6Akashi H, Osanai Y, Akashi R. Human resources for health development: Toward realizing Universal Health Coverage in Japan. Biosci Trends 2015;9:275-9.
7World Health Organization. The Road to Universal Health Coverage: A Case Study on Gabon; 2015. Available from: . [Last accessed on 2015 Dec 13].