Advancing universal health coverage - English
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This document discusses advancing universal health coverage (UHC) in the Eastern Mediterranean Region. It provides an overview of the current status of UHC in the region, estimates the region's contribution to reaching the UHC goal of the WHO's 13th General Programme of Work, and outlines recommendations for advancing UHC going forward. Key points include: the UHC coverage index for countries in 2015 and projected index for 2023 if recent trends continue; challenges to achieving UHC like fragile health systems, emergencies, and data limitations; and recommendations such as formulating country-specific UHC strategies and expanding prepayment arrangements to improve financial protection.
Advancing universal health coverage - English
- 1. Advancing universal health coverage in the Eastern Mediterranean Region Agenda item 4(a) 65th Session of the Regional Committee for the Eastern Mediterranean 15‒18 October 2018, Khartoum
- 2. Overview Status of UHC in the Region Estimated regional contribution to UHC goal of GPW13 Way forward for advancing UHC in the Region 2
- 3. 3 Stepping up leadership – diplomacy and advocacy; gender equality, health equity and human rights; multisectoral action; finance Driving public health impact in every country – differentiated approach based on capacity and vulnerability Focusing global public goods on impact – normative guidance and agreements; data, research and innovation • Measure impact to be accountable and manage for results • Reshape operating mode to drive country, regional and global impacts • Transform partnerships, communications and financing to resource the strategic priorities • Foster culture change to ensure a seamless, high-performing WHO Strategic shifts Service delivery – to fill critical gaps in emergencies Technical assistance – to build national institutions Strategic support – to build high performing systems Policy dialogue – to develop systems of the future Fragile health systemMature health system Organizational shifts Ensuring healthy lives and promoting well-being for all at all ages by: Achieving universal health coverage- 1 billion more people benefitting from universal health coverage Addressing health emergencies – 1 billion more people better protected from health emergencies Promoting healthier populations – 1 billion more people enjoying better health and well-being Strategic Priorities (and goals) Mission Promote health – keep the world safe – serve the vulnerableOur case for change: WHO 13th General Programme of Work 2019−2023 SDG indicators 3.8.1 (service coverage) 3.8.2 (financial protection)
- 4. 4 650 million people Diverse socioeconomic and geopolitical environments Emergencies A large proportion of the population live in countries with graded emergencies – huge health care needs 9 countries in a fragile situation 30 million displaced people Disease outbreaks 4
- 5. Population coverage Financialprotection UHC means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. SDG Target 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services, medicines and vaccines for all 5
- 6. 1. Developing a vision and strategy for UHC 2. Improving health financing system performance and enhancing financial risk protection 3. Expanding the coverage of needed health services 4. Ensuring expansion and monitoring of population coverage Four strategic components of the Framework for action on advancing UHC in the Eastern Mediterranean Region The Region’s journey towards UHC Regional Committee 2016 Salalah UHC Declaration 2018 UHC2030 Global Compact 6
- 7. 7 UHC service coverage index SDG 3.8.1 – as in 2017 global monitoring report Reproductive, maternal, newborn and child health family planning pregnancy and delivery immunization child treatment Infectious diseases tuberculosis HIV malaria water and sanitation Noncommunicable diseases cardiovascular disease diabetes cancer tobacco control Service capacity and access hospital access health worker density essential medicines health security Advancing UHC involves adequate functions in all aspects of the health care system 7
- 8. 77 77 72 72 70 68 68 68 65 65 65 63 63 63 60 47 43 40 39 34 22 53 0 10 20 30 40 50 60 70 80 90 Kuwait Qatar Bahrain Oman Jordan Egypt Lebanon Saudi Arabia Iran (Islamic republic of) Morocco Tunisia Iraq Libya United Arab Emirates Syrian Arab Republic Djibouti Sudan Pakistan Yemen Afghanistan Somalia EMRO Region UHC coverage Index, 2015 Source: WHO/WB, 2017 8
- 9. 0 10 20 30 40 50 60 70 80 90 Somalia Syria Djibouti Palestine Libya United Arab Emirates Yemen Lebanon Iraq Bahrain Saudi Arabia Afghanistan Jordan Tunisia Kuwait Oman Morocco Qatar Sudan Pakistan Iran (Islamic republic of) Egypt Reporting on regional core indicators, 2014─2018 percent_2018 percent_2014 Recent country consultation: Health information system was given high- priority (12 countries) or medium- priority (8 countries) Data challenges and health information systems 9
- 10. Using the UHC index to plan for achieving regional strategic priorities Projecting tracer indicators to 2023 and project UHC status at the end of GPW 13 Used data from most recent period, 2010−2015 Calculate annual changes in indicator values over the recent period Assume recent trends will continue to 2023 Project tracer indicator values to 2023 for each country Recalculating UHC index for 2023 Compare changes with UHC index of 2015 10
- 11. 11
- 12. 80 80 80 77 75 72 72 72 70 70 69 68 64 64 61 56 53 50 48 43 41 36 60.2 0 10 20 30 40 50 60 70 80 90 Bahrain Qatar Islamic Repulic of Iran Kuwait Oman Egypt Saudi Arabia United Arab Emirates Jordan Lebanon Tunisia Morocco Iraq Palestine Libya Syrian Arab Republic Afghanistan Sudan Pakistan Yemen Djibouti Somalia EMRO Region UHC index 2023 projections – as estimated in July 2018 12
- 13. Projected progress in UHC coverage 2015─2023 0 10 20 30 40 50 60 70 80 90 Regional population adjusted coverage Regional median value country range 2015 country range 2023 UHC coverage in the Region, 2015─2023 2015 2023 13
- 14. GPW 13 projection for advancing in UHC in the Region • 108 million more people covered by UHC by 2023Achievable • Political, economical and programmatic challenges • Requires improvements to all aspects of health care Challenging • New index may mean new realities • Limitation in data in the Region Measurement caveats • Bringing financing and service delivery together • Marginalized, refugees and migrant populations UHC three dimensions 14
- 15. Recommendations for advancing UHC to realize and go beyond UHC index projections for 2023 • Formulate country-specific UHC vision and roadmaps – UHC can and should be pursued in all countries • All countries need to define a context-specific and cost-effective national essential package of health services • Expand prepayment arrangements to ensure full population coverage in order to reduce out-of-pocket payments and ensure financial protection • Improve health information system to better monitor UHC 15
- 16. Thank you 16
Editor's Notes
- #6: Read the definition of UHC
- #8: Emphasize on 16 selected tracer services
- #9: Mention the regional value of 54 with a global value of 64
- #15: I have simply reddened the last bullet point to emphasize the emergency ref Say, in the region UHC cannot be advanced without providing health care to people affected by emergencies. – more than 70 million are in need of health care
- #16: Bullet 1: Keeping in view the income level of the country and burden of disease and recognizing that all countries at different income levels can advance UHC if appropriate choices are made. Mention different income groups and priorities as in the slide that is deleted now. Bullet 2: Based on globally and regionally identified UHC priority benefit packages, and develop appropriate people-centred, integrated models of care with functioning referral systems.